2026 Humana Premier Rx Plan (PDP) formulary (drug list)
Contract S5884, plan 152 · Pennsylvania · 3,076 drugs on file · formulary ID 00026402. Each drug links to its cost in every CMS PDP Region 06 plan.
171 drugs starting with M.
| Drug name | Tier | 30-day preferred pharmacy | 90-day mail order | Usage management |
|---|---|---|---|---|
| M-M-R II 1000/12500/1000 [TCID_50]/.5mL Injection, Powder, Lyophilized, For SuspensionMeasles, Mumps, And Rubella Virus Vaccine Live | 1Preferred Generic | $0.00 | $0.00 | None |
| MALATHION .0005 g/mL Lotion | 4Non-Preferred Drug | 50% | 50% | None |
| MARAVIROC 150 mg Tablet, Film Coated | 5Specialty Tier | 33% | N/A |
|
| MARAVIROC 300 mg Tablet, Film Coated | 5Specialty Tier | 33% | N/A |
|
| MARLISSA KitLevonorgestrel And Ethinyl Estradiol | 2Generic | $4.00 | $0.00 | None |
| MATULANE 50 mg CapsuleProcarbazine Hydrochloride | 5Specialty Tier | 33% | N/A | None |
| MECLIZINE HYDROCHLORIDE 12.5 mg TabletMeclizine | 3Preferred Brand | $45.00 | $125.00 | None |
| MECLIZINE HYDROCHLORIDE 25 mg Tablet | 3Preferred Brand | $45.00 | $125.00 | None |
| MEDROXYPROGESTERONE ACETATE 10 mg Tablet | 2Generic | $4.00 | $0.00 | None |
| MEDROXYPROGESTERONE ACETATE 150 mg/mL Injection, Suspension | 2Generic | $4.00 | $0.00 |
|
| MEDROXYPROGESTERONE ACETATE 150 mg/mL Injection, Suspension | 2Generic | $4.00 | $0.00 |
|
| MEDROXYPROGESTERONE ACETATE 2.5 mg Tablet | 2Generic | $4.00 | $0.00 | None |
| MEDROXYPROGESTERONE ACETATE 5 mg Tablet | 2Generic | $4.00 | $0.00 | None |
| MEFLOQUINE HYDROCHLORIDE 250 mg Tablet | 2Generic | $4.00 | $0.00 | None |
| MEGESTROL ACETATE 20 mg Tablet | 2Generic | $4.00 | $0.00 | None |
| MEGESTROL ACETATE 40 mg Tablet | 2Generic | $4.00 | $0.00 | None |
| MEGESTROL ACETATE 40 mg/mL Suspension | 4Non-Preferred Drug | 50% | 50% | None |
| MEKINIST .05 mg/mL Powder, For SolutionTrametinib | 5Specialty Tier | 33% | N/A |
|
| MEKINIST .5 mg Tablet, Film CoatedTrametinib | 5Specialty Tier | 33% | N/A |
|
| MEKINIST 2 mg Tablet, Film CoatedTrametinib | 5Specialty Tier | 33% | N/A |
|
| MEKTOVI 15 mg Tablet, Film CoatedBinimetinib | 5Specialty Tier | 33% | N/A |
|
| MELOXICAM 15 mg Tablet | 1Preferred Generic | $0.00 | $0.00 |
|
| MELOXICAM 7.5 mg Tablet | 1Preferred Generic | $0.00 | $0.00 |
|
| MEMANTINE 2 mg/mL SolutionMemantine Hydrochloride | 4Non-Preferred Drug | 50% | 50% |
|
| MEMANTINE HYDROCHLORIDE 10 mg Tablet | 2Generic | $4.00 | $0.00 |
|
| MEMANTINE HYDROCHLORIDE 14 mg Capsule, Extended Release | 4Non-Preferred Drug | 50% | 50% |
|
| MEMANTINE HYDROCHLORIDE 21 mg Capsule, Extended Release | 4Non-Preferred Drug | 50% | 50% |
|
| MEMANTINE HYDROCHLORIDE 28 mg Capsule, Extended Release | 4Non-Preferred Drug | 50% | 50% |
|
| MEMANTINE HYDROCHLORIDE 5 mg Tablet, Film Coated | 2Generic | $4.00 | $0.00 |
|
| MEMANTINE HYDROCHLORIDE 7 mg Capsule, Extended Release | 4Non-Preferred Drug | 50% | 50% |
|
| MEMANTINE HYDROCHLORIDE Kit | 2Generic | $4.00 | $0.00 |
|
| MENQUADFI 10/10/10/10 ug/.5mL Injection, SolutionNeisseria Meningitidis Group A Capsular Polysaccharide Tetanus Toxoid Conjugate Antigen, Neisseria Meningitidis Group C Capsular Polysaccharide Tetanus Toxoid Conjugate Antigen, Neisseria Meningitidis Group Y Capsular Polysaccharide Tetanus Toxoid Conjugate Antigen, And Neisseria Meningitidis Group W-135 Capsular Polysaccharide Tetanus Toxoid Conjugate Antigen | 1Preferred Generic | $0.00 | $0.00 | None |
| MENVEO KitMeningococcal (Groups A, C, Y And W-135) Oligosaccharide Diphtheria Crm197 Conjugate Vaccine | 1Preferred Generic | $0.00 | $0.00 | None |
| MERCAPTOPURINE 20 mg/mL Suspension | 5Specialty Tier | 33% | N/A | None |
| MERCAPTOPURINE 50 mg Tablet | 3Preferred Brand | $45.00 | $125.00 | None |
| MEROPENEM 1 g Injection, Powder, For Solution | 3Preferred Brand | $45.00 | $125.00 | None |
| MEROPENEM 500 mg Injection, Powder, For Solution | 3Preferred Brand | $45.00 | $125.00 | None |
| MESALAMINE .375 g Capsule, Extended Release | 4Non-Preferred Drug | 50% | 50% |
|
| MESALAMINE 4 g/60mL Enema | 4Non-Preferred Drug | 50% | 50% |
|
| MESNA 400 mg Tablet, Film Coated | 5Specialty Tier | 33% | N/A | None |
| METFORMIN 500 mg Tablet, Extended ReleaseMetformin Er 500 Mg | 1Preferred Generic | $0.00 | $0.00 |
|
| METFORMIN HYDROCHLORIDE 500 mg Tablet | 1Preferred Generic | $0.00 | $0.00 | None |
| METFORMIN HYDROCHLORIDE 750 mg Tablet, Extended Release | 1Preferred Generic | $0.00 | $0.00 |
|
| METFORMIN HYDROCHLORIDE 850 mg Tablet, Film Coated | 1Preferred Generic | $0.00 | $0.00 | None |
| METHADONE HYDROCHLORIDE 10 mg Tablet | 4Non-Preferred Drug | 50% | 50% |
|
| METHADONE HYDROCHLORIDE 10 mg/5mL Solution | 3Preferred Brand | $45.00 | $125.00 |
|
| METHADONE HYDROCHLORIDE 5 mg Tablet | 4Non-Preferred Drug | 50% | 50% |
|
| METHADONE HYDROCHLORIDE 5 mg/5mL Solution | 3Preferred Brand | $45.00 | $125.00 |
|
| METHENAMINE HIPPURATE 1 g Tablet | 3Preferred Brand | $45.00 | $125.00 | None |
| METHIMAZOLE 10 mg Tablet | 2Generic | $4.00 | $0.00 | None |
| METHIMAZOLE 5 mg Tablet | 2Generic | $4.00 | $0.00 | None |
| METHOCARBAMOL 500 mg Tablet, CoatedMethocarbamol Tablets | 2Generic | $4.00 | $0.00 | None |
| METHOCARBAMOL 750 mg Tablet, CoatedMethocarbamol Tablets | 2Generic | $4.00 | $0.00 | None |
| METHOTREXATE 2.5 mg Tablet | 3Preferred Brand | $45.00 | $125.00 |
|
| METHOTREXATE 25 mg/mL Injection, Solution | 2Generic | $4.00 | $0.00 | None |
| METHOTREXATE 25 mg/mL Solution | 2Generic | $4.00 | $0.00 | None |
| METHSUXIMIDE 300 mg Capsule | 4Non-Preferred Drug | 50% | 50% | None |
| METHYLDOPA 250 mg Tablet | 2Generic | $4.00 | $0.00 | None |
| METHYLDOPA 500 mg Tablet | 2Generic | $4.00 | $0.00 | None |
| METHYLPHENIDATE HYDROCHLORIDE 10 mg Tablet | 3Preferred Brand | $45.00 | $125.00 |
|
| METHYLPHENIDATE HYDROCHLORIDE 10 mg Tablet, Extended Release | 3Preferred Brand | $45.00 | $125.00 |
|
| METHYLPHENIDATE HYDROCHLORIDE 20 mg Tablet | 3Preferred Brand | $45.00 | $125.00 |
|
| METHYLPHENIDATE HYDROCHLORIDE 20 mg Tablet, Extended Release | 3Preferred Brand | $45.00 | $125.00 |
|
| METHYLPHENIDATE HYDROCHLORIDE 5 mg Tablet | 3Preferred Brand | $45.00 | $125.00 |
|
| METHYLPREDNISOLONE 16 mg Tablet | 2Generic | $4.00 | $0.00 |
|
| METHYLPREDNISOLONE 32 mg Tablet | 2Generic | $4.00 | $0.00 |
|
| METHYLPREDNISOLONE 4 mg Tablet | 2Generic | $4.00 | $0.00 | None |
| METHYLPREDNISOLONE 4 mg Tablet | 2Generic | $4.00 | $0.00 |
|
| METHYLPREDNISOLONE 8 mg Tablet | 2Generic | $4.00 | $0.00 |
|
| METOCLOPRAMIDE 10 mg Tablet | 1Preferred Generic | $0.00 | $0.00 | None |
| METOCLOPRAMIDE 5 mg Tablet | 1Preferred Generic | $0.00 | $0.00 | None |
| METOLAZONE 10 mg Tablet | 3Preferred Brand | $45.00 | $125.00 | None |
| METOLAZONE 2.5 mg Tablet | 3Preferred Brand | $45.00 | $125.00 | None |
| METOLAZONE 5 mg Tablet | 3Preferred Brand | $45.00 | $125.00 | None |
| METOPROLOL SUCCINATE 100 mg Tablet, Film Coated, Extended Release | 1Preferred Generic | $0.00 | $0.00 | None |
| METOPROLOL SUCCINATE 200 mg Tablet, Film Coated, Extended Release | 1Preferred Generic | $0.00 | $0.00 | None |
| METOPROLOL SUCCINATE 25 mg Tablet, Extended Release | 1Preferred Generic | $0.00 | $0.00 | None |
| METOPROLOL SUCCINATE 50 mg Tablet, Extended Release | 1Preferred Generic | $0.00 | $0.00 | None |
| METOPROLOL TARTRATE 100 mg Tablet, Film Coated | 1Preferred Generic | $0.00 | $0.00 | None |
| METOPROLOL TARTRATE 25 mg Tablet, Film Coated | 1Preferred Generic | $0.00 | $0.00 | None |
| METOPROLOL TARTRATE 37.5 mg Tablet, Film Coated | 1Preferred Generic | $0.00 | $0.00 | None |
| METOPROLOL TARTRATE 50 mg Tablet, Film Coated | 1Preferred Generic | $0.00 | $0.00 | None |
| METOPROLOL TARTRATE 75 mg Tablet, Film Coated | 1Preferred Generic | $0.00 | $0.00 | None |
| METOPROLOL TARTRATE AND HYDROCHLOROTHIAZIDE 100/25 mg Tablet | 3Preferred Brand | $45.00 | $125.00 | None |
| METOPROLOL TARTRATE AND HYDROCHLOROTHIAZIDE 100/50 mg Tablet | 3Preferred Brand | $45.00 | $125.00 | None |
| METOPROLOL TARTRATE AND HYDROCHLOROTHIAZIDE 50/25 mg Tablet | 3Preferred Brand | $45.00 | $125.00 | None |
| METRONIDAZOLE 10 mg/g Gel | 4Non-Preferred Drug | 50% | 50% | None |
| METRONIDAZOLE 250 mg Tablet | 2Generic | $4.00 | $0.00 | None |
| METRONIDAZOLE 500 mg Tablet | 2Generic | $4.00 | $0.00 | None |
| METRONIDAZOLE 500 mg/100mL Injection, Solution | 4Non-Preferred Drug | 50% | 50% | None |
| METRONIDAZOLE 7.5 mg/g Cream | 4Non-Preferred Drug | 50% | 50% | None |
| METRONIDAZOLE 7.5 mg/g Gel | 4Non-Preferred Drug | 50% | 50% | None |
| METRONIDAZOLE 7.5 mg/mL Lotion | 4Non-Preferred Drug | 50% | 50% | None |
| METRONIDAZOLE VAGINAL 7.5 mg/g GelMetronidazole | 4Non-Preferred Drug | 50% | 50% | None |
| METYROSINE 250 mg Capsule | 5Specialty Tier | 33% | N/A | None |
| MICAFUNGIN 100 mg Injection, Powder, Lyophilized, For SolutionMicafungin Sodium | 4Non-Preferred Drug | 50% | 50% | None |
| MICAFUNGIN 50 mg Injection, Powder, Lyophilized, For SolutionMicafungin Sodium | 4Non-Preferred Drug | 50% | 50% | None |
| MICONAZOLE NITRATE 200 mg Suppository | 3Preferred Brand | $45.00 | $125.00 | None |
| MICROGESTIN 1.5/30 KitNorethindrone Acetate/Ethinyl Estradiol | 2Generic | $4.00 | $0.00 | None |
| MICROGESTIN 1/20 KitNorethindrone Acetate/Ethinyl Estradiol | 3Preferred Brand | $45.00 | $125.00 | None |
| MICROGESTIN FE 1.5/30 KitNorethindrone Acetate/Ethinyl Estradiol And Ferrous Fumarate | 2Generic | $4.00 | $0.00 | None |
| MICROGESTIN FE 1/20 KitNorethindrone Acetate/Ethinyl Estradiol And Ferrous Fumarate | 2Generic | $4.00 | $0.00 | None |
| MIDODRINE HYDROCHLORIDE 10 mg Tablet | 3Preferred Brand | $45.00 | $125.00 | None |
| MIDODRINE HYDROCHLORIDE 2.5 mg Tablet | 3Preferred Brand | $45.00 | $125.00 | None |
| MIDODRINE HYDROCHLORIDE 5 mg Tablet | 3Preferred Brand | $45.00 | $125.00 | None |
| MIFEPRISTONE 300 mg Tablet, Film Coated | 5Specialty Tier | 33% | N/A |
|
| MILI KitNorgestimate And Ethinyl Estradiol | 2Generic | $4.00 | $0.00 | None |
| MIMVEY 1/.5 mg Tablet, Film CoatedEstradiol And Norethindrone Acetate | 2Generic | $4.00 | $0.00 | None |
| MINOCYCLINE HYDROCHLORIDE 100 mg Capsule | 2Generic | $4.00 | $0.00 | None |
| MINOCYCLINE HYDROCHLORIDE 50 mg Capsule | 2Generic | $4.00 | $0.00 | None |
| MINOCYCLINE HYDROCHLORIDE 75 mg Capsule | 2Generic | $4.00 | $0.00 | None |
| MINOXIDIL 10 mg Tablet | 2Generic | $4.00 | $0.00 | None |
| MINOXIDIL 2.5 mg Tablet | 2Generic | $4.00 | $0.00 | None |
| MIRENA 52 mg Intrauterine DeviceLevonorgestrel | 3Preferred Brand | $45.00 | $125.00 | None |
| MIRTAZAPINE 15 mg Tablet, Film Coated | 2Generic | $4.00 | $0.00 | None |
| MIRTAZAPINE 15 mg Tablet, Orally Disintegrating | 4Non-Preferred Drug | 50% | 50% |
|
| MIRTAZAPINE 30 mg Tablet, Film Coated | 2Generic | $4.00 | $0.00 | None |
| MIRTAZAPINE 30 mg Tablet, Orally Disintegrating | 4Non-Preferred Drug | 50% | 50% |
|
| MIRTAZAPINE 45 mg Tablet, Film Coated | 2Generic | $4.00 | $0.00 | None |
| MIRTAZAPINE 45 mg Tablet, Orally Disintegrating | 4Non-Preferred Drug | 50% | 50% |
|
| MIRTAZAPINE 7.5 mg Tablet, Film Coated | 2Generic | $4.00 | $0.00 | None |
| MISOPROSTOL 100 ug Tablet | 3Preferred Brand | $45.00 | $125.00 | None |
| MISOPROSTOL 200 ug Tablet | 3Preferred Brand | $45.00 | $125.00 | None |
| MIXED SALTS OF A SINGLE ENTITY AMPHETAMINE PRODUCT XR 2.5/2.5/2.5/2.5 mg Capsule, Extended ReleaseDextroamphetamine Saccharate, Amphetamine Aspartate Monohydrate, Dextroamphetamine Sulfate, Amphetamine Sulfate | 3Preferred Brand | $45.00 | $125.00 |
|
| MIXED SALTS OF A SINGLE ENTITY AMPHETAMINE PRODUCT XR 5/5/5/5 mg Capsule, Extended ReleaseDextroamphetamine Saccharate, Amphetamine Aspartate Monohydrate, Dextroamphetamine Sulfate, Amphetamine Sulfate | 3Preferred Brand | $45.00 | $125.00 |
|
| MODAFINIL 100 mg Tablet | 3Preferred Brand | $45.00 | $125.00 |
|
| MODAFINIL 200 mg Tablet | 3Preferred Brand | $45.00 | $125.00 |
|
| MODEYSO 125 mg CapsuleDordaviprone | 5Specialty Tier | 33% | N/A |
|
| MOEXIPRIL HYDROCHLORIDE 15 mg Tablet, Film Coated | 2Generic | $4.00 | $0.00 | None |
| MOEXIPRIL HYDROCHLORIDE 7.5 mg Tablet, Film Coated | 2Generic | $4.00 | $0.00 | None |
| MOLINDONE HYDROCHLORIDE 10 mg Tablet | 4Non-Preferred Drug | 50% | 50% |
|
| MOLINDONE HYDROCHLORIDE 25 mg Tablet | 4Non-Preferred Drug | 50% | 50% |
|
| MOLINDONE HYDROCHLORIDE 5 mg Tablet | 4Non-Preferred Drug | 50% | 50% |
|
| MOMETASONE FUROATE 1 mg/g Cream | 2Generic | $4.00 | $0.00 |
|
| MOMETASONE FUROATE 1 mg/g Ointment | 2Generic | $4.00 | $0.00 |
|
| MOMETASONE FUROATE 1 mg/mL Solution | 2Generic | $4.00 | $0.00 |
|
| MOMETASONE FUROATE 50 ug Spray, Metered | 4Non-Preferred Drug | 50% | 50% |
|
| MONTELUKAST SODIUM 10 mg Tablet, Film Coated | 1Preferred Generic | $0.00 | $0.00 |
|
| MONTELUKAST SODIUM 4 mg Granule | 4Non-Preferred Drug | 50% | 50% |
|
| MONTELUKAST SODIUM 4 mg Tablet, Chewable | 1Preferred Generic | $0.00 | $0.00 |
|
| MONTELUKAST SODIUM 5 mg Tablet, Chewable | 1Preferred Generic | $0.00 | $0.00 |
|
| MORPHINE SULFATE 15 mg Tablet | 3Preferred Brand | $45.00 | $125.00 |
|
| MORPHINE SULFATE 20 mg/5mL Solution | 3Preferred Brand | $45.00 | $125.00 |
|
| MORPHINE SULFATE 20 mg/mL Solution | 3Preferred Brand | $45.00 | $125.00 |
|
| MORPHINE SULFATE 30 mg Tablet | 3Preferred Brand | $45.00 | $125.00 |
|
| MORPHINE SULFATE EXTENDED RELEASE 100 mg Tablet, Film Coated, Extended ReleaseMorphine Sulfate | 3Preferred Brand | $45.00 | $125.00 |
|
| MORPHINE SULFATE EXTENDED RELEASE 15 mg Tablet, Film Coated, Extended ReleaseMorphine Sulfate | 3Preferred Brand | $45.00 | $125.00 |
|
| MORPHINE SULFATE EXTENDED RELEASE 200 mg Tablet, Film Coated, Extended ReleaseMorphine Sulfate | 3Preferred Brand | $45.00 | $125.00 |
|
| MORPHINE SULFATE EXTENDED RELEASE 30 mg Tablet, Film Coated, Extended ReleaseMorphine Sulfate | 3Preferred Brand | $45.00 | $125.00 |
|
| MORPHINE SULFATE EXTENDED RELEASE 60 mg Tablet, Film Coated, Extended ReleaseMorphine Sulfate | 3Preferred Brand | $45.00 | $125.00 |
|
| MOUNJARO 10 mg/.5mL Injection, SolutionTirzepatide | 3Preferred Brand | $45.00 | $125.00 |
|
| MOUNJARO 12.5 mg/.5mL Injection, SolutionTirzepatide | 3Preferred Brand | $45.00 | $125.00 |
|
| MOUNJARO 15 mg/.5mL Injection, SolutionTirzepatide | 3Preferred Brand | $45.00 | $125.00 |
|
| MOUNJARO 2.5 mg/.5mL Injection, SolutionTirzepatide | 3Preferred Brand | $45.00 | $125.00 |
|
| MOUNJARO 5 mg/.5mL Injection, SolutionTirzepatide | 3Preferred Brand | $45.00 | $125.00 |
|
| MOUNJARO 7.5 mg/.5mL Injection, SolutionTirzepatide | 3Preferred Brand | $45.00 | $125.00 |
|
| MOVANTIK 12.5 mg Tablet, Film CoatedNaloxegol Oxalate | 3Preferred Brand | $45.00 | $125.00 |
|
| MOVANTIK 25 mg Tablet, Film CoatedNaloxegol Oxalate | 3Preferred Brand | $45.00 | $125.00 |
|
| MOXIFLOXACIN 400 mg Tablet, Film Coated | 3Preferred Brand | $45.00 | $125.00 | None |
| MOXIFLOXACIN 5 mg/mL Solution/ Drops | 3Preferred Brand | $45.00 | $125.00 | None |
| MOXIFLOXACIN HYDROCHLORIDE 400 mg/250mL Injection, Solution | 4Non-Preferred Drug | 50% | 50% | None |
| MRESVIA 50 ug/.5mL SuspensionRespiratory Syncytial Virus Vaccine | 1Preferred Generic | $0.00 | $0.00 | None |
| MUPIROCIN 20 mg/g Ointment | 2Generic | $4.00 | $0.00 | None |
| MYCOPHENOLATE MOFETIL 200 mg/mL Powder, For Suspension | 4Non-Preferred Drug | 50% | 50% |
|
| MYCOPHENOLATE MOFETIL 250 mg Capsule | 3Preferred Brand | $45.00 | $125.00 |
|
| MYCOPHENOLATE MOFETIL 500 mg Tablet, Film Coated | 3Preferred Brand | $45.00 | $125.00 |
|
| MYCOPHENOLIC ACID 180 mg Tablet, Delayed Release | 4Non-Preferred Drug | 50% | 50% |
|
| MYCOPHENOLIC ACID 360 mg Tablet, Delayed Release | 4Non-Preferred Drug | 50% | 50% |
|
| MYRBETRIQ 25 mg Tablet, Film Coated, Extended ReleaseMirabegron | 3Preferred Brand | $45.00 | $125.00 |
|
| MYRBETRIQ 50 mg Tablet, Film Coated, Extended ReleaseMirabegron | 3Preferred Brand | $45.00 | $125.00 |
|
| MYRBETRIQ 8 mg/mL Granule, For Suspension, Extended ReleaseMirabegron | 3Preferred Brand | $45.00 | $125.00 |
|
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.