Glaucoma eye drops on every 2026 Pennsylvania Part D plan
Pick a drug class, or type the drugs you want to check, and see which of the 12 stand-alone Part D plans in Pennsylvania cover each one, on what tier, and with what restrictions.
- Covered
- Covered, needs prior authorization (PA) or step therapy (ST)
- Not on the formulary
- QL 60/30d = quantity limit, 60 units per 30 days
12 plans, cheapest premium first. Scroll sideways for all of them →
| Drug | Humana Basic Rx Plan$6.60/moS5884-104 | Wellcare Value Script$8.20/moS4802-141 | Wellcare Classic$14.70/moS4802-080 | Humana Value Rx Plan$19.40/moS5884-185 | SilverScript Choice$22.70/moS5601-012 | AARP Medicare Rx Saver from UHC$43.50/moS5921-351 | HealthSpring Extra Rx$62.60/moS5617-356 | HealthSpring Assurance Rx$74.00/moS5617-215 | AARP Medicare Rx Preferred from UHC$121.90/moS5921-388 | Humana Premier Rx Plan$123.60/moS5884-152 | Blue Rx PDP Complete$164.80/moS5593-003 | Blue Rx PDP Plus$193.20/moS5593-002 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| latanoprostgeneric Xalatan | Tier 2$1.00QL 5/25d | Tier 1$0.00 | Tier 1$0.00 | Tier 1$0.00QL 5/25d | Tier 1$2.00 | Tier 2$7.00 | Tier 1$0.00 | Tier 1$0.00 | Tier 1$5.00 | Tier 1$0.00QL 5/25d | Tier 1$0.00 | Tier 125% |
| timololgeneric Timoptic | Tier 1$0.00 | Tier 1$0.00 | Tier 1$0.00 | Tier 1$0.00 | Tier 1$2.00 | Tier 2$7.00 | Tier 1$0.00 | Tier 1$0.00 | Tier 1$5.00 | Tier 1$0.00 | Tier 1$0.00 | Tier 125% |
| dorzolamide-timololgeneric Cosopt | Tier 2$1.00 | Tier 2$3.00 | Tier 2$10.00 | Tier 2$0.00 | Tier 1$2.00 | Tier 2$7.00 | Tier 317% | Tier 2$2.00 | Tier 2$10.00 | Tier 2$4.00 | Tier 2$5.00 | Tier 225% |
| brimonidinegeneric Alphagan | Tier 1$0.00 | Tier 1$0.00 | Tier 2$10.00 | Tier 1$0.00 | Tier 1$2.00 | Tier 2$7.00 | Tier 2$5.00 | Tier 2$2.00 | Tier 2$10.00 | Tier 1$0.00 | Tier 2$5.00 | Tier 225% |
| Lumiganbimatoprost | Tier 325%QL 2.5/25d | Not covered | Not covered | Tier 320%QL 2.5/25d | Tier 319% | Not covered | Tier 317% | Tier 321% | Tier 316% | Tier 3$45.00QL 2.5/25d | Tier 325%QL 5/31d | Tier 325%QL 5/31d |
| Combiganbrimonidine and timolol | Not covered | Tier 325% | Tier 325% | Not covered | Tier 319% | Not covered | Not covered | Not covered | Tier 316% | Not covered | Tier 325% | Tier 325% |
| Rhopressanetarsudil | Not covered | Not covered | Not covered | Not covered | Tier 435% | Not covered | Tier 317% | Tier 321% | Tier 3ST16% | Not covered | Tier 4ST25% | Tier 4ST25% |
| Vyzultalatanoprostene bunod | Tier 433%QL 2.5/25d | Tier 440% | Tier 428% | Tier 433%QL 2.5/25d | Tier 435% | Tier 441% | Not covered | Not covered | Tier 433% | Tier 450%QL 2.5/25d | Not covered | Not covered |
Where a plan covers several strengths or forms of a drug, the cell shows the least restricted one. Costs are the 30-day preferred-pharmacy cost-sharing in the initial coverage phase, from the CMS 2026 formulary files. Click a plan for its full drug list.