2026 AARP Medicare Rx Preferred from UHC (PDP) formulary (drug list)
Contract S5921, plan 384 · New Hampshire · 3,518 drugs on file · formulary ID 00026000. Each drug links to its cost in every CMS PDP Region 01 plan.
122 drugs starting with I.
| Drug name | Tier | 30-day preferred pharmacy | 90-day mail order | Usage management |
|---|---|---|---|---|
| IBANDRONATE SODIUM 150 mg Tablet | 3Preferred Brand | 15% | 15% |
|
| IBRANCE 100 mg CapsulePalbociclib | 5Specialty Tier | 31% | N/A |
|
| IBRANCE 100 mg Tablet, Film CoatedPalbociclib | 5Specialty Tier | 31% | N/A |
|
| IBRANCE 125 mg CapsulePalbociclib | 5Specialty Tier | 31% | N/A |
|
| IBRANCE 125 mg Tablet, Film CoatedPalbociclib | 5Specialty Tier | 31% | N/A |
|
| IBRANCE 75 mg CapsulePalbociclib | 5Specialty Tier | 31% | N/A |
|
| IBRANCE 75 mg Tablet, Film CoatedPalbociclib | 5Specialty Tier | 31% | N/A |
|
| IBU 600 mg TabletIbuprofen | 1Preferred Generic | $5.00 | $0.00 | None |
| IBU 800 mg TabletIbuprofen | 1Preferred Generic | $5.00 | $0.00 | None |
| IBUPROFEN 100 mg/5mL Suspension | 1Preferred Generic | $5.00 | $0.00 | None |
| IBUPROFEN 400 mg Tablet, Film Coated | 1Preferred Generic | $5.00 | $0.00 | None |
| IBUPROFEN 600 mg Tablet, Film Coated | 1Preferred Generic | $5.00 | $0.00 | None |
| IBUPROFEN 800 mg Tablet, Film Coated | 1Preferred Generic | $5.00 | $0.00 | None |
| ICATIBANT 10 mg/mL Injection, Solution | 5Specialty Tier | 31% | N/A |
|
| ICLEVIA KitLevonorgestrel And Ethinyl Estradiol | 3Preferred Brand | 15% | 15% | None |
| ICLUSIG 10 mg Tablet, Film CoatedPonatinib Hydrochloride | 5Specialty Tier | 31% | N/A |
|
| ICLUSIG 15 mg Tablet, Film CoatedPonatinib Hydrochloride | 5Specialty Tier | 31% | N/A |
|
| ICLUSIG 30 mg Tablet, Film CoatedPonatinib Hydrochloride | 5Specialty Tier | 31% | N/A |
|
| ICLUSIG 45 mg Tablet, Film CoatedPonatinib Hydrochloride | 5Specialty Tier | 31% | N/A |
|
| IDHIFA 100 mg Tablet, Film CoatedEnasidenib Mesylate | 5Specialty Tier | 31% | N/A |
|
| IDHIFA 50 mg Tablet, Film CoatedEnasidenib Mesylate | 5Specialty Tier | 31% | N/A |
|
| ILEVRO 3 mg/mL Suspension/ DropsNepafenac | 3Preferred Brand | 15% | 15% | None |
| IMATINIB MESYLATE 100 mg Tablet, Film Coated | 3Preferred Brand | 15% | 15% |
|
| IMATINIB MESYLATE 400 mg Tablet, Film Coated | 3Preferred Brand | 15% | 15% |
|
| IMBRUVICA 140 mg CapsuleIbrutinib | 5Specialty Tier | 31% | N/A |
|
| IMBRUVICA 140 mg Tablet, Film CoatedIbrutinib | 5Specialty Tier | 31% | N/A |
|
| IMBRUVICA 280 mg Tablet, Film CoatedIbrutinib | 5Specialty Tier | 31% | N/A |
|
| IMBRUVICA 420 mg Tablet, Film CoatedIbrutinib | 5Specialty Tier | 31% | N/A |
|
| IMBRUVICA 70 mg CapsuleIbrutinib | 5Specialty Tier | 31% | N/A |
|
| IMBRUVICA 70 mg/mL SuspensionIbrutinib | 5Specialty Tier | 31% | N/A |
|
| IMIPENEM AND CILASTATIN 250/250 mg/20mL Injection, Powder, For SolutionImipenem And Cilastatin Sodium | 4Non-Preferred Drug | 30% | N/A | None |
| IMIPENEM AND CILASTATIN 500/500 mg/20mL Injection, Powder, For SolutionImipenem And Cilastatin Sodium | 4Non-Preferred Drug | 30% | N/A | None |
| IMIPRAMINE HYDROCHLORIDE 10 mg Tablet | 4Non-Preferred Drug | 30% | N/A | None |
| IMIQUIMOD 12.5 mg/.25g Cream | 4Non-Preferred Drug | 30% | N/A |
|
| IMKELDI 80 mg/mL SolutionImatinib Oral | 5Specialty Tier | 31% | N/A |
|
| IMOVAX RABIES KitRabies Virus Strain Pm-1503-3M Antigen (Propiolactone Inactivated) And Water | 3Preferred Brand | 15% | 15% |
|
| INBRIJA 42 mg CapsuleLevodopa | 5Specialty Tier | 31% | N/A |
|
| INCASSIA .35 mg TabletNorethindrone | 3Preferred Brand | 15% | 15% | None |
| INCRELEX 40 mg/4mL Injection, SolutionMecasermin | 5Specialty Tier | 31% | N/A |
|
| INCRUSE ELLIPTA 62.5 ug Aerosol, PowderUmeclidinium | 3Preferred Brand | 15% | 15% |
|
| INDAPAMIDE 1.25 mg Tablet, Film Coated | 1Preferred Generic | $5.00 | $0.00 | None |
| INDAPAMIDE 2.5 mg Tablet, Film Coated | 1Preferred Generic | $5.00 | $0.00 | None |
| INDOMETHACIN 25 mg Capsule | 2Generic | $10.00 | $0.00 | None |
| INDOMETHACIN 50 mg Capsule | 2Generic | $10.00 | $0.00 | None |
| INDOMETHACIN 75 mg Capsule, Extended Release | 3Preferred Brand | 15% | 15% | None |
| INFANRIX 10/25/25/25/8 [iU]/.5mL/ug/.5mL SuspensionDiphtheria And Tetanus Toxoids And Acellular Pertussis Vaccine Adsorbed | 3Preferred Brand | 15% | 15% |
|
| INGREZZA 40 mg CapsuleValbenazine | 5Specialty Tier | 31% | N/A |
|
| INGREZZA 60 mg CapsuleValbenazine | 5Specialty Tier | 31% | N/A |
|
| INGREZZA 80 mg CapsuleValbenazine | 5Specialty Tier | 31% | N/A |
|
| INGREZZA KitValbenazine | 5Specialty Tier | 31% | N/A |
|
| INGREZZA SPRINKLE 40 mg CapsuleValbenazine | 5Specialty Tier | 31% | N/A |
|
| INGREZZA SPRINKLE 60 mg CapsuleValbenazine | 5Specialty Tier | 31% | N/A |
|
| INGREZZA SPRINKLE 80 mg CapsuleValbenazine | 5Specialty Tier | 31% | N/A |
|
| INLURIYO 200 mg Tablet, Film CoatedImlunestrant | 5Specialty Tier | 31% | N/A |
|
| INLYTA 1 mg Tablet, Film CoatedAxitinib | 5Specialty Tier | 31% | N/A |
|
| INLYTA 5 mg Tablet, Film CoatedAxitinib | 5Specialty Tier | 31% | N/A |
|
| INQOVI 100/35 mg Tablet, Film CoatedCedazuridine And Decitabine | 5Specialty Tier | 31% | N/A |
|
| INREBIC 100 mg CapsuleFedratinib Hydrochloride | 5Specialty Tier | 31% | N/A |
|
| INSULIN LISPRO 100 [iU]/mL Injection, Solution | 3Preferred Brand | 15% | 15% | None |
| INSULIN LISPRO JUNIOR KWIKPEN 100 [iU]/mL Injection, SolutionInsulin Lispro | 3Preferred Brand | 15% | 15% | None |
| INSULIN LISPRO KWIKPEN 100 [iU]/mL Injection, SolutionInsulin Lispro | 3Preferred Brand | 15% | 15% | None |
| INSULIN LISPRO PROTAMINE AND INSULIN LISPRO INJECTABLE SUSPENSION MIX75/25 KWIKPEN 100 [iU]/mL Injection, SuspensionInsulin Lispro | 3Preferred Brand | 15% | 15% | None |
| INTELENCE 25 mg TabletEtravirine | 4Non-Preferred Drug | 30% | N/A |
|
| INTRALIPID 20 g/100mL EmulsionI.V. Fat Emulsion | 4Non-Preferred Drug | 30% | N/A |
|
| INTRALIPID 30 g/100mL EmulsionI.V. Fat Emulsion | 4Non-Preferred Drug | 30% | N/A |
|
| INTROVALE KitLevonorgestrel And Ethinyl Estradiol | 3Preferred Brand | 15% | 15% | None |
| INVEGA HAFYERA 1092 mg/3.5mL Injection, Suspension, Extended ReleasePaliperidone Palmitate | 5Specialty Tier | 31% | N/A | None |
| INVEGA HAFYERA 1560 mg/5mL Injection, Suspension, Extended ReleasePaliperidone Palmitate | 5Specialty Tier | 31% | N/A | None |
| INVEGA SUSTENNA 117 mg/.75mL InjectionPaliperidone Palmitate | 5Specialty Tier | 31% | N/A | None |
| INVEGA SUSTENNA 156 mg/mL InjectionPaliperidone Palmitate | 5Specialty Tier | 31% | N/A | None |
| INVEGA SUSTENNA 234 mg/1.5mL InjectionPaliperidone Palmitate | 5Specialty Tier | 31% | N/A | None |
| INVEGA SUSTENNA 39 mg/.25mL InjectionPaliperidone Palmitate | 4Non-Preferred Drug | 30% | N/A | None |
| INVEGA SUSTENNA 78 mg/.5mL InjectionPaliperidone Palmitate | 5Specialty Tier | 31% | N/A | None |
| INVEGA TRINZA 273 mg/.88mL Injection, Suspension, Extended ReleasePaliperidone Palmitate | 5Specialty Tier | 31% | N/A | None |
| INVEGA TRINZA 410 mg/1.32mL Injection, Suspension, Extended ReleasePaliperidone Palmitate | 5Specialty Tier | 31% | N/A | None |
| INVEGA TRINZA 546 mg/1.75mL Injection, Suspension, Extended ReleasePaliperidone Palmitate | 5Specialty Tier | 31% | N/A | None |
| INVEGA TRINZA 819 mg/2.63mL Injection, Suspension, Extended ReleasePaliperidone Palmitate | 5Specialty Tier | 31% | N/A | None |
| IPOL 40/8/32 [D'ag'U]/.5mL Injection, SuspensionPoliovirus Type 1 Antigen (Formaldehyde Inactivated), Poliovirus Type 2 Antigen (Formaldehyde Inactivated), And Poliovirus Type 3 Antigen (Formaldehyde Inactivated) | 3Preferred Brand | 15% | 15% |
|
| IPRATROPIUM BROMIDE .5 mg/2.5mL Solution | 2Generic | $10.00 | $0.00 |
|
| IPRATROPIUM BROMIDE 21 ug Spray, Metered | 2Generic | $10.00 | $0.00 | None |
| IPRATROPIUM BROMIDE 42 ug Spray, Metered | 2Generic | $10.00 | $0.00 | None |
| IPRATROPIUM BROMIDE AND ALBUTEROL SULFATE 2.5/.5 mg/3mL Solution | 2Generic | $10.00 | $0.00 |
|
| IRBESARTAN 150 mg Tablet | 1Preferred Generic | $5.00 | $0.00 | None |
| IRBESARTAN 300 mg Tablet | 1Preferred Generic | $5.00 | $0.00 | None |
| IRBESARTAN 75 mg Tablet | 1Preferred Generic | $5.00 | $0.00 | None |
| IRBESARTAN AND HYDROCHLOROTHIAZIDE 150/12.5 mg Tablet | 1Preferred Generic | $5.00 | $0.00 | None |
| IRBESARTAN AND HYDROCHLOROTHIAZIDE 300/12.5 mg Tablet | 1Preferred Generic | $5.00 | $0.00 | None |
| ISENTRESS 100 mg Granule, For SuspensionRaltegravir | 4Non-Preferred Drug | 30% | N/A |
|
| ISENTRESS 100 mg Tablet, ChewableRaltegravir | 4Non-Preferred Drug | 30% | N/A |
|
| ISENTRESS 25 mg Tablet, ChewableRaltegravir | 3Preferred Brand | 15% | 15% |
|
| ISENTRESS 400 mg Tablet, Film CoatedRaltegravir | 5Specialty Tier | 31% | N/A |
|
| ISENTRESS 600 mg Tablet, Film CoatedRaltegravir | 5Specialty Tier | 31% | N/A |
|
| ISIBLOOM KitDesogestrel And Ethinyl Estradiol | 3Preferred Brand | 15% | 15% | None |
| ISOLYTE P IN DEXTROSE 5/.32/.13/.031/.026 g/100mL Injection, SolutionDextrose, Sodium Acetate, Potassium Chloride, Magnesium Chloride, And Potassium Phosphate, Dibasic | 4Non-Preferred Drug | 30% | N/A | None |
| ISOLYTE S PH 7.4 .53/.5/.37/.037/.03/.012/.00082 g/100mL Injection, SolutionSodium Chloride, Sodium Gluconate, Sodium Acetate, Potassium Chloride, Magnesium Chloride, Sodium Phosphate, Dibasic, And Potassium Phosphate | 4Non-Preferred Drug | 30% | N/A | None |
| ISONIAZID 100 mg Tablet | 1Preferred Generic | $5.00 | $0.00 | None |
| ISONIAZID 300 mg Tablet | 1Preferred Generic | $5.00 | $0.00 | None |
| ISONIAZID 50 mg/5mL Solution | 4Non-Preferred Drug | 30% | N/A | None |
| ISOSORBIDE DINITRATE 10 mg Tablet | 2Generic | $10.00 | $0.00 | None |
| ISOSORBIDE DINITRATE 20 mg Tablet | 2Generic | $10.00 | $0.00 | None |
| ISOSORBIDE DINITRATE 30 mg Tablet | 2Generic | $10.00 | $0.00 | None |
| ISOSORBIDE DINITRATE 5 mg Tablet | 2Generic | $10.00 | $0.00 | None |
| ISOSORBIDE DINITRATE AND HYDRALAZINE HYDROCHLORIDE 37.5/20 mg Tablet | 3Preferred Brand | 15% | 15% |
|
| ISOSORBIDE MONONITRATE 10 mg Tablet | 2Generic | $10.00 | $0.00 | None |
| ISOSORBIDE MONONITRATE 120 mg Tablet, Extended Release | 2Generic | $10.00 | $0.00 | None |
| ISOSORBIDE MONONITRATE 20 mg Tablet | 2Generic | $10.00 | $0.00 | None |
| ISOSORBIDE MONONITRATE 30 mg Tablet, Extended Release | 2Generic | $10.00 | $0.00 | None |
| ISOSORBIDE MONONITRATE 60 mg Tablet, Extended Release | 2Generic | $10.00 | $0.00 | None |
| ISOTRETINOIN 10 mg Capsule, Liquid Filled | 4Non-Preferred Drug | 30% | N/A |
|
| ISOTRETINOIN 20 mg Capsule, Liquid Filled | 4Non-Preferred Drug | 30% | N/A |
|
| ISOTRETINOIN 25 mg Capsule | 4Non-Preferred Drug | 30% | N/A |
|
| ISOTRETINOIN 30 mg Capsule, Liquid Filled | 4Non-Preferred Drug | 30% | N/A |
|
| ISOTRETINOIN 35 mg Capsule | 4Non-Preferred Drug | 30% | N/A |
|
| ISOTRETINOIN 40 mg Capsule, Liquid Filled | 4Non-Preferred Drug | 30% | N/A |
|
| ITOVEBI 3 mg Tablet, Film CoatedInavolisib | 5Specialty Tier | 31% | N/A |
|
| ITOVEBI 9 mg Tablet, Film CoatedInavolisib | 5Specialty Tier | 31% | N/A |
|
| ITRACONAZOLE 100 mg Capsule, Coated Pellets | 4Non-Preferred Drug | 30% | N/A |
|
| IVABRADINE 5 mg Tablet, Film Coated | 4Non-Preferred Drug | 30% | N/A |
|
| IVABRADINE 7.5 mg Tablet, Film Coated | 4Non-Preferred Drug | 30% | N/A |
|
| IVERMECTIN 3 mg Tablet | 3Preferred Brand | 15% | 15% |
|
| IWILFIN 250 mg TabletEflornithine Hydrochloride | 5Specialty Tier | 31% | N/A |
|
| IXIARO 6 [arb'U]/.5mL Injection, SuspensionJapanese Encephalitis Vaccine, Inactivated, Adsorbed | 3Preferred Brand | 15% | 15% |
|
PA = prior authorization, ST = step therapy, QL = quantity limit. Costs are the plan’s initial-coverage cost-sharing from the CMS 2026 formulary files; a drug not listed here is not on this plan’s formulary, though a formulary exception may still be possible.