Medication Search for Plans in Ohio

Drug List

Use the medication search tool below, but also review our $0 Drug List, which features $0 options for the following types of medications:

  • High blood pressure
  • Antibiotics, antifungals and antivirals
  • Diabetes
  • Heart health
  • Cholesterol management

$0 High Blood Pressure Medications:

  • AMLODIPINE
  • ATENOLOL
  • ATENOLOL/CHLORTHALIDONE
  • BENAZEPRIL
  • BICALUTAMIDE
  • BISOPROLOL
  • BUMETANIDE
  • CARVEDILOL
  • CHLORTHALIDONE
  • CLONIDINE
  • DILTIAZEM ER CAP
  • DILTIAZEM
  • DOXAZOSIN
  • ENALAPRIL
  • ENALAPRIL/HYDROCHLOROTHIAZIDE
  • FELODIPINE ER
  • FOSINOPRIL
  • FUROSEMIDE
  • HYDROCHLOROTHIAZIDE CAP
  • HYDROCHLOROTHIAZIDE
  • INDAPAMIDE
  • IRBESARTAN
  • IRBESARTAN/HYDROCHLOROTHIAZIDE
  • LABETALOL
  • LISINOPRIL
  • LISINOPRIL/HYDROCHLOROTHIAZIDE
  • LOSARTAN
  • LOSARTAN/HYDROCHLOROTHIAZIDE
  • METOPROLOL ER
  • METOPROLOL
  • NEBIVOLOL HCL
  • NIFEDIPINE ER
  • OLMESARTAN
  • OLMESARTAN/HYDROCHLOROTHIAZIDE
  • PRAZOSIN CAP
  • PROPRANOLOL ER CAP
  • PROPRANOLOL
  • QUINAPRIL
  • RAMIPRIL CAP
  • SPIRONOLACTONE
  • SPIRONOLACTONE/HYDROCHLOROTHIAZIDE
  • TELMISARTAN
  • TERAZOSIN CAP
  • TORSEMIDE
  • TRIAMTERENE/HYDROCHLOROTHIAZIDE CAP
  • TRIAMTERENE/HYDROCHLOROTHIAZIDE
  • VALSARTAN

$0 Diabetes Medications:

  • ACARBOSE
  • B-D INSULIN SYRINGE
  • GLIMEPIRIDE
  • GLIPIZIDE ER
  • GLIPIZIDE
  • GLIPIZIDE/METFORMIN
  • GLYBURIDE
  • GLYBURIDE/METFORMIN
  • GLYBURIDE MCR
  • GLYNASE
  • HUMALOG JR KWIKPEN INJ
  • HUMALOG MIX INJ
  • HUMALOG PEN INJ
  • HUMULIN MIX INJ
  • HUMULIN MIX PEN INJ
  • HUMULIN N INJ
  • HUMULIN N PEN INJ
  • HUMULIN R INJ
  • INSULIN LISPRO INJ
  • INSULIN LISPRO JR
  • KWIKPEN INJ
  • INSULIN LISPRO KWIKPEN INJ
  • METFORMIN ER
  • METFORMIN
  • PIOGLITAZONE
  • SEMGLEE INJ, INSULIN GLARGINE-YFGN INJ
  • SEMGLEE PEN, INSULIN GLARGINE-YFGN PEN

$0 Heart and Cholesterol Medications:

  • AMIODARONE
  • ATORVASTATIN
  • DIGOXIN
  • FENOFIBRATE CAP 67MG, 134MG, 200MG
  • FENOFIBRATE 48MG, 54MG, 145MG, 160MG
  • GEMFIBROZIL
  • ISOSORBIDE DINITRATE
  • ISOSORBIDE MONONITRATE ER
  • LETROZOLE
  • LOVASTATIN
  • NIACIN ER
  • NITROGLYCERIN PATCH
  • NITROGLYCERIN SL
  • PRAVASTATIN
  • RANOLAZINE
  • ROSUVASTATIN
  • SIMVASTATIN
  • SOTALOL AF
  • SOTALOL
  • VERAPAMIL SR CAP
  • VERAPAMIL SR
  • VERAPAMIL
  • WARFARIN

$0 Antidepressant Medications:

  • BUPROPION ER
  • BUPROPION XL
  • BUSPIRONE
  • CITALOPRAM
  • DULOXETINE EC CAP
  • ESCITALOPRAM
  • FLUOXETINE CAP
  • FLUVOXAMINE
  • MIRTAZAPINE
  • PAROXETINE
  • SERTRALINE
  • VENLAFAXINE ER CAP

Other $0 Copay Medications:

  • AEROCHAMBER
  • ALENDRONATE
  • ANASTROZOLE
  • DIALYVITE
  • FLORIVA PLUS DROPS
  • FOLIC ACID 1MG
  • HYDROXYZINE
  • IBANDRONATE 150MG
  • LANCET KIT
  • LANCETS
  • MEGESTROL
  • MULTIVITAMIN/FLOURIDE CHEW 0.25MG
  • MULTIVITAMIN/FLOURIDE CHEW 1MG
  • MULTIVITAMIN/FLUORIDE CHEW
  • PEDIATRIC MULTIPLE
  • VITAMINS/FLUORIDE SOLN
  • PEDIATRIC MULTIPLE VITAMINS/FLUORIDE/IRON SOLN
  • RALOXIFENE
  • RISEDRONATE
  • TAMOXIFEN

‍

The $0 Advanced Rx List includes the $0 Core Rx List and applies to all Elite, Elite+Dental plans Enhanced and Enhanced+Dental plans. Medications listed below and on the $0 Core Rx List are $0 copay regardless of prescribing provider.

‍$0 High Blood Pressure Medications:

  • BETAXOLOL TAB

$0 Diabetes Medications:

  • HUMALOG KWIKPEN INJ
  • HUMALOG MIX KWIKPEN
  • HUMALOG TEMPO PEN
  • HUMULIN R INJ U-500
  • HUMULIN R U-500 KWIKPEN INJ
  • INSULIN LISPRO MIX KWIKPEN
  • INSULIN GLARGINE INJ

Other $0 Copay Medications:

  • CALCITONIN NASAL SPRAY

How to search medications:

If you see “Not Covered,” explore other strengths before deciding. The initial option might not be covered by your plan. Check the Strength and Package dropdown for alternatives and generic versions.
  1. Choose your plan. Select both dropdowns, then select Search.
  2. Search for your medication. Type the name in the search box.
  3. Check the strength and package. Coverage can be different for each strength, form, and brand or generic version. The first one listed may not be covered.
  4. Open the dropdown. Select Strength and Package Selection to see every option. Generic versions are marked Generic.

Review each option. Check the coverage status and tier for each one you try.

At this time, when you click the orange "GET PRICES & PHARMACIES" button, it may not function as expected. Please call Navitus Customer Care at 844-268-9789. We are aware and are working to fix the issue.

Two side-by-side screenshots of a medication selection interface showing a dropdown for strength and package selection; the left screen shows a collapsed dropdown with Alogliptin/Metformin Hcl Tablet selected, marked Not Covered, and the right screen shows an expanded dropdown with options for Metformin Hcl Tablet at 500 MG, 850 MG, and 1000 MG, labeled Generic.

Search our Medication List

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If you see “Not Covered,” explore other strengths before deciding. The initial option might not be covered by your plan. Check the Strength and Package dropdown for alternatives and generic versions.
Standard Bronze On Exchange Plan
Bronze Enhanced Diabetes
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC28901*XNVAHOO
1
Standard Bronze Off Exchange Plan
Bronze Enhanced Diabetes
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC28801*NVAHOX
2
Zero Cost Sharing Plan Variation
Bronze Enhanced Diabetes
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC25301*XNVAHOO
3
Limited Cost Sharing Plan Variation
Bronze Enhanced Diabetes
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC28901*XNVAHOO
4
Standard Bronze On Exchange Plan
Bronze Enhanced Diabetes+Dental
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC28901*XNVAHOO
5
Standard Bronze Off Exchange Plan
Bronze Enhanced Diabetes+Dental
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC28801*NVAHOX
6
Zero Cost Sharing Plan Variation
Bronze Enhanced Diabetes+Dental
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC25301*XNVAHOO
7
Limited Cost Sharing Plan Variation
Bronze Enhanced Diabetes+Dental
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC28901*XNVAHOO
8
Standard Bronze On Exchange Plan
Bronze Enhanced Blood Pressure Management
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC28901*XNVAHOO
9
Standard Bronze Off Exchange Plan
Bronze Enhanced Blood Pressure Management
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC28801*NVAHOX
10
Zero Cost Sharing Plan Variation
Bronze Enhanced Blood Pressure Management
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC25301*XNVAHOO
11
Limited Cost Sharing Plan Variation
Bronze Enhanced Blood Pressure Management
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC28901*XNVAHOO
12
Standard Bronze On Exchange Plan
Bronze Enhanced Blood Pressure Management+Dental
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC28901*XNVAHOO
13
Standard Bronze Off Exchange Plan
Bronze Enhanced Blood Pressure Management+Dental
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC28801*NVAHOX
14
Zero Cost Sharing Plan Variation
Bronze Enhanced Blood Pressure Management+Dental
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC25301*XNVAHOO
15
Limited Cost Sharing Plan Variation
Bronze Enhanced Blood Pressure Management+Dental
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC28901*XNVAHOO
16
Standard Bronze On Exchange Plan
Bronze Complete
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC20901*XNVAHOO
17
Standard Bronze Off Exchange Plan
Bronze Complete
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC27001*NVAHOX
18
Zero Cost Sharing Plan Variation
Bronze Complete
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC21601*XNVAHOO
19
Limited Cost Sharing Plan Variation
Bronze Complete
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC20901*XNVAHOO
20
Standard Bronze On Exchange Plan
Bronze Complete+Dental
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC20901*XNVAHOO
21
Standard Bronze Off Exchange Plan
Bronze Complete+Dental
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC27001*NVAHOX
22
Zero Cost Sharing Plan Variation
Bronze Complete+Dental
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC21601*XNVAHOO
23
Limited Cost Sharing Plan Variation
Bronze Complete+Dental
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC20901*XNVAHOO
24
Standard Bronze On Exchange Plan
Bronze Elite
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC24901*XNVAHOO
25
Standard Bronze Off Exchange Plan
Bronze Elite
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC28001*NVAHOX
26
Zero Cost Sharing Plan Variation
Bronze Elite
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC25301*XNVAHOO
27
Limited Cost Sharing Plan Variation
Bronze Elite
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC24901*XNVAHOO
28
Standard Bronze On Exchange Plan
Bronze Elite+Dental
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC24901*XNVAHOO
29
Standard Bronze Off Exchange Plan
Bronze Elite+Dental
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC28001*NVAHOX
30
Zero Cost Sharing Plan Variation
Bronze Elite+Dental
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC25301*XNVAHOO
31
Limited Cost Sharing Plan Variation
Bronze Elite+Dental
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC24901*XNVAHOO
32
Standard Bronze On Exchange Plan
Bronze Standard
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC23401*XNVAHOO
33
Standard Bronze Off Exchange Plan
Bronze Standard
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC27701*NVAHOX
34
Zero Cost Sharing Plan Variation
Bronze Standard
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC23801*XNVAHOO
35
Limited Cost Sharing Plan Variation
Bronze Standard
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC23401*XNVAHOO
36
Standard Silver On Exchange Plan
Silver Enhanced Diabetes
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC29101*XNVAHOO
37
Standard Silver Off Exchange Plan
Silver Enhanced Diabetes
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC29001*NVAHOX
38
Zero Cost Sharing Plan Variation
Silver Enhanced Diabetes
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC25301*XNVAHOO
39
Limited Cost Sharing Plan Variation
Silver Enhanced Diabetes
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC29101*XNVAHOO
40
73% AV Level Silver Plan
Silver Enhanced Diabetes
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC29201*XNVAHOO
41
87% AV Level Silver Plan
Silver Enhanced Diabetes
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC29301*XNVAHOO
42
94% AV Level Silver Plan
Silver Enhanced Diabetes
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC29401*XNVAHOO
43
Standard Silver On Exchange Plan
Silver Enhanced Diabetes+Dental
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC29101*XNVAHOO
44
Standard Silver Off Exchange Plan
Silver Enhanced Diabetes+Dental
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC29001*NVAHOX
45
Zero Cost Sharing Plan Variation
Silver Enhanced Diabetes+Dental
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC25301*XNVAHOO
46
Limited Cost Sharing Plan Variation
Silver Enhanced Diabetes+Dental
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC29101*XNVAHOO
47
73% AV Level Silver Plan
Silver Enhanced Diabetes+Dental
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC29201*XNVAHOO
48
87% AV Level Silver Plan
Silver Enhanced Diabetes+Dental
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC29301*XNVAHOO
49
94% AV Level Silver Plan
Silver Enhanced Diabetes+Dental
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC29401*XNVAHOO
50
Standard Silver On Exchange Plan
Silver Enhanced Blood Pressure Management
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC29101*XNVAHOO
51
Standard Silver Off Exchange Plan
Silver Enhanced Blood Pressure Management
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC29001*NVAHOX
52
Zero Cost Sharing Plan Variation
Silver Enhanced Blood Pressure Management
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC25301*XNVAHOO
53
Limited Cost Sharing Plan Variation
Silver Enhanced Blood Pressure Management
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC29101*XNVAHOO
54
73% AV Level Silver Plan
Silver Enhanced Blood Pressure Management
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC29201*XNVAHOO
55
87% AV Level Silver Plan
Silver Enhanced Blood Pressure Management
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC29301*XNVAHOO
56
94% AV Level Silver Plan
Silver Enhanced Blood Pressure Management
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC29401*XNVAHOO
57
Standard Silver On Exchange Plan
Silver Enhanced Blood Pressure Management+Dental
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC29101*XNVAHOO
58
Standard Silver Off Exchange Plan
Silver Enhanced Blood Pressure Management+Dental
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC29001*NVAHOX
59
Zero Cost Sharing Plan Variation
Silver Enhanced Blood Pressure Management+Dental
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC25301*XNVAHOO
60
Limited Cost Sharing Plan Variation
Silver Enhanced Blood Pressure Management+Dental
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC29101*XNVAHOO
61
73% AV Level Silver Plan
Silver Enhanced Blood Pressure Management+Dental
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC29201*XNVAHOO
62
87% AV Level Silver Plan
Silver Enhanced Blood Pressure Management+Dental
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC29301*XNVAHOO
63
94% AV Level Silver Plan
Silver Enhanced Blood Pressure Management+Dental
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC29401*XNVAHOO
64
Standard Silver On Exchange Plan
Silver Complete
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC21701*XNVAHOO
65
Standard Silver Off Exchange Plan
Silver Complete
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC27201*NVAHOX
66
Zero Cost Sharing Plan Variation
Silver Complete
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC21601*XNVAHOO
67
Limited Cost Sharing Plan Variation
Silver Complete
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC21701*XNVAHOO
68
73% AV Level Silver Plan
Silver Complete
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC21801*XNVAHOO
69
87% AV Level Silver Plan
Silver Complete
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC21901*XNVAHOO
70
94% AV Level Silver Plan
Silver Complete
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC22001*XNVAHOO
71
Standard Silver On Exchange Plan
Silver Complete+Dental
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC21701*XNVAHOO
72
Standard Silver Off Exchange Plan
Silver Complete+Dental
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC27201*NVAHOX
73
Zero Cost Sharing Plan Variation
Silver Complete+Dental
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC21601*XNVAHOO
74
Limited Cost Sharing Plan Variation
Silver Complete+Dental
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC21701*XNVAHOO
75
73% AV Level Silver Plan
Silver Complete+Dental
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC21801*XNVAHOO
76
87% AV Level Silver Plan
Silver Complete+Dental
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC21901*XNVAHOO
77
94% AV Level Silver Plan
Silver Complete+Dental
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC22001*XNVAHOO
78
Standard Silver On Exchange Plan
Silver Elite
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC25801*XNVAHOO
79
Standard Silver Off Exchange Plan
Silver Elite
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC28201*NVAHOX
80
Zero Cost Sharing Plan Variation
Silver Elite
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC25301*XNVAHOO
81
Limited Cost Sharing Plan Variation
Silver Elite
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC25801*XNVAHOO
82
73% AV Level Silver Plan
Silver Elite
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC25501*XNVAHOO
83
87% AV Level Silver Plan
Silver Elite
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC25601*XNVAHOO
84
94% AV Level Silver Plan
Silver Elite
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC25701*XNVAHOO
85
Standard Silver On Exchange Plan
Silver Elite+Dental
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC25801*XNVAHOO
86
Standard Silver Off Exchange Plan
Silver Elite+Dental
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC28201*NVAHOX
87
Zero Cost Sharing Plan Variation
Silver Elite+Dental
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC25301*XNVAHOO
88
Limited Cost Sharing Plan Variation
Silver Elite+Dental
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC25801*XNVAHOO
89
73% AV Level Silver Plan
Silver Elite+Dental
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC25501*XNVAHOO
90
87% AV Level Silver Plan
Silver Elite+Dental
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC25601*XNVAHOO
91
94% AV Level Silver Plan
Silver Elite+Dental
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC25701*XNVAHOO
92
Standard Silver On Exchange Plan
Silver Standard
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC23701*XNVAHOO
93
Standard Silver Off Exchange Plan
Silver Standard
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC27801*NVAHOX
94
Zero Cost Sharing Plan Variation
Silver Standard
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC23801*XNVAHOO
95
Limited Cost Sharing Plan Variation
Silver Standard
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC23701*XNVAHOO
96
73% AV Level Silver Plan
Silver Standard
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC24001*XNVAHOO
97
87% AV Level Silver Plan
Silver Standard
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC24101*XNVAHOO
98
94% AV Level Silver Plan
Silver Standard
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC24201*XNVAHOO
99
Standard Gold On Exchange Plan
Gold Enhanced Diabetes
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC29601*XNVAHOO
100
Standard Gold Off Exchange Plan
Gold Enhanced Diabetes
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC29501*NVAHOX
101
Zero Cost Sharing Plan Variation
Gold Enhanced Diabetes
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC25301*XNVAHOO
102
Limited Cost Sharing Plan Variation
Gold Enhanced Diabetes
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC29601*XNVAHOO
103
Standard Gold On Exchange Plan
Gold Enhanced Diabetes+Dental
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC29601*XNVAHOO
104
Standard Gold Off Exchange Plan
Gold Enhanced Diabetes+Dental
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC29501*NVAHOX
105
Zero Cost Sharing Plan Variation
Gold Enhanced Diabetes+Dental
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC25301*XNVAHOO
106
Limited Cost Sharing Plan Variation
Gold Enhanced Diabetes+Dental
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC29601*XNVAHOO
107
Standard Gold On Exchange Plan
Gold Enhanced Blood Pressure Management
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC29601*XNVAHOO
108
Standard Gold Off Exchange Plan
Gold Enhanced Blood Pressure Management
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC29501*NVAHOX
109
Zero Cost Sharing Plan Variation
Gold Enhanced Blood Pressure Management
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC25301*XNVAHOO
110
Limited Cost Sharing Plan Variation
Gold Enhanced Blood Pressure Management
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC29601*XNVAHOO
111
Standard Gold On Exchange Plan
Gold Enhanced Blood Pressure Management+Dental
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC29601*XNVAHOO
112
Standard Gold Off Exchange Plan
Gold Enhanced Blood Pressure Management+Dental
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC29501*NVAHOX
113
Zero Cost Sharing Plan Variation
Gold Enhanced Blood Pressure Management+Dental
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC25301*XNVAHOO
114
Limited Cost Sharing Plan Variation
Gold Enhanced Blood Pressure Management+Dental
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC29601*XNVAHOO
115
Standard Gold On Exchange Plan
Gold Complete
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC23201*XNVAHOO
116
Standard Gold Off Exchange Plan
Gold Complete
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC27401*NVAHOX
117
Zero Cost Sharing Plan Variation
Gold Complete
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC21601*XNVAHOO
118
Limited Cost Sharing Plan Variation
Gold Complete
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC23201*XNVAHOO
119
Standard Gold On Exchange Plan
Gold Complete+Dental
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC23201*XNVAHOO
120
Standard Gold Off Exchange Plan
Gold Complete+Dental
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC27401*NVAHOX
121
Zero Cost Sharing Plan Variation
Gold Complete+Dental
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC21601*XNVAHOO
122
Limited Cost Sharing Plan Variation
Gold Complete+Dental
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC23201*XNVAHOO
123
Standard Gold On Exchange Plan
Gold Elite
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC26701*XNVAHOO
124
Standard Gold Off Exchange Plan
Gold Elite
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC28401*NVAHOX
125
Zero Cost Sharing Plan Variation
Gold Elite
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC25301*XNVAHOO
126
Limited Cost Sharing Plan Variation
Gold Elite
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC26701*XNVAHOO
127
Standard Gold On Exchange Plan
Gold Elite+Dental
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC26701*XNVAHOO
128
Standard Gold Off Exchange Plan
Gold Elite+Dental
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC28401*NVAHOX
129
Zero Cost Sharing Plan Variation
Gold Elite+Dental
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC25301*XNVAHOO
130
Limited Cost Sharing Plan Variation
Gold Elite+Dental
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC26701*XNVAHOO
131
Standard Gold On Exchange Plan
Gold Standard
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC24301*XNVAHOO
132
Standard Gold Off Exchange Plan
Gold Standard
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC27901*NVAHOX
133
Zero Cost Sharing Plan Variation
Gold Standard
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC23801*XNVAHOO
134
Limited Cost Sharing Plan Variation
Gold Standard
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC24301*XNVAHOO
135
Standard Catastrophic On Exchange Plan
Catastrophic Standard
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC23301*XNVAHOO
136
Standard Catastrophic Off Exchange Plan
Catastrophic Standard
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC27601*NVAHOX
137
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HMO health plans are offered and insured by Antidote Health Plan of Arizona, Inc., Antidote Health Plan of Georgia, Inc., and Antidote Health Plan of Ohio, Inc. EPO health plans are offered and insured by Antidote Health Insurance Company of Texas. Please note: Antidote’s one-time and monthly telehealth subscription products are not a substitute for comprehensive health insurance. If you are seeking health insurance coverage, it must be purchased separately—either through Antidote in eligible states or from another licensed insurance provider. © 2026 Antidote Health Group, Inc. All rights reserved.