Medication Search for Plans in Arizona

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 Enhanced, Elite, Enhanced+Dental and Elite+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

Before searching, please read the instructions above.

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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=PUBLIC162201*XNVAHZO
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=PUBLIC162101*NVAHZX
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=PUBLIC162301*XNVAHZO
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=PUBLIC162201*XNVAHZO
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=PUBLIC162201*XNVAHZO
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=PUBLIC162101*NVAHZX
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=PUBLIC162301*XNVAHZO
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=PUBLIC162201*XNVAHZO
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=PUBLIC162201*XNVAHZO
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=PUBLIC162101*NVAHZX
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=PUBLIC162301*XNVAHZO
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=PUBLIC162201*XNVAHZO
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=PUBLIC162201*XNVAHZO
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=PUBLIC162101*NVAHZX
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=PUBLIC162301*XNVAHZO
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=PUBLIC162201*XNVAHZO
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=PUBLIC11101*XNVAHZO
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=PUBLIC17201*NVAHZX
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=PUBLIC11201*XNVAHZO
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=PUBLIC11101*XNVAHZO
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=PUBLIC11101*XNVAHZO
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=PUBLIC17201*NVAHZX
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=PUBLIC11201*XNVAHZO
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=PUBLIC11101*XNVAHZO
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=PUBLIC15101*XNVAHZO
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=PUBLIC18201*NVAHZX
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=PUBLIC162301*XNVAHZO
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=PUBLIC15101*XNVAHZO
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=PUBLIC15101*XNVAHZO
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=PUBLIC18201*NVAHZX
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=PUBLIC162301*XNVAHZO
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=PUBLIC15101*XNVAHZO
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=PUBLIC13601*XNVAHZO
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=PUBLIC17901*NVAHZX
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=PUBLIC13701*XNVAHZO
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=PUBLIC13601*XNVAHZO
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=PUBLIC162501*XNVAHZO
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=PUBLIC162401*NVAHZX
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=PUBLIC162301*XNVAHZO
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=PUBLIC162501*XNVAHZO
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=PUBLIC162601*XNVAHZO
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=PUBLIC162701*XNVAHZO
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=PUBLIC162801*XNVAHZO
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=PUBLIC162501*XNVAHZO
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=PUBLIC162401*NVAHZX
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=PUBLIC162301*XNVAHZO
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=PUBLIC162501*XNVAHZO
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=PUBLIC162601*XNVAHZO
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=PUBLIC162701*XNVAHZO
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=PUBLIC162801*XNVAHZO
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=PUBLIC162501*XNVAHZO
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=PUBLIC162401*NVAHZX
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=PUBLIC162301*XNVAHZO
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=PUBLIC162501*XNVAHZO
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=PUBLIC162601*XNVAHZO
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=PUBLIC162701*XNVAHZO
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=PUBLIC162801*XNVAHZO
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=PUBLIC162501*XNVAHZO
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=PUBLIC162401*NVAHZX
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=PUBLIC162301*XNVAHZO
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=PUBLIC162501*XNVAHZO
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=PUBLIC162601*XNVAHZO
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=PUBLIC162701*XNVAHZO
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=PUBLIC162801*XNVAHZO
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=PUBLIC11901*XNVAHZO
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=PUBLIC17401*NVAHZX
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=PUBLIC11201*XNVAHZO
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=PUBLIC11901*XNVAHZO
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=PUBLIC12001*XNVAHZO
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=PUBLIC12101*XNVAHZO
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=PUBLIC12201*XNVAHZO
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=PUBLIC11901*XNVAHZO
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=PUBLIC17401*NVAHZX
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=PUBLIC11201*XNVAHZO
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=PUBLIC11901*XNVAHZO
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=PUBLIC12001*XNVAHZO
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=PUBLIC12101*XNVAHZO
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=PUBLIC12201*XNVAHZO
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=PUBLIC16001*XNVAHZO
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=PUBLIC18401*NVAHZX
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=PUBLIC162301*XNVAHZO
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=PUBLIC16001*XNVAHZO
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=PUBLIC15701*XNVAHZO
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=PUBLIC15801*XNVAHZO
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=PUBLIC15901*XNVAHZO
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=PUBLIC16001*XNVAHZO
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=PUBLIC18401*NVAHZX
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=PUBLIC162301*XNVAHZO
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=PUBLIC16001*XNVAHZO
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=PUBLIC15701*XNVAHZO
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=PUBLIC15801*XNVAHZO
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=PUBLIC15901*XNVAHZO
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=PUBLIC13901*XNVAHZO
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=PUBLIC18001*NVAHZX
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=PUBLIC13701*XNVAHZO
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=PUBLIC13901*XNVAHZO
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=PUBLIC14201*XNVAHZO
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=PUBLIC14201*XNVAHZO
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=PUBLIC14201*XNVAHZO
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=PUBLIC163001*XNVAHZO
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=PUBLIC162901*NVAHZX
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=PUBLIC162301*XNVAHZO
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=PUBLIC163001*XNVAHZO
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=PUBLIC163001*XNVAHZO
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=PUBLIC162901*NVAHZX
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=PUBLIC162301*XNVAHZO
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=PUBLIC163001*XNVAHZO
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=PUBLIC163001*XNVAHZO
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=PUBLIC162901*NVAHZX
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=PUBLIC162301*XNVAHZO
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=PUBLIC163001*XNVAHZO
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=PUBLIC163001*XNVAHZO
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=PUBLIC162901*NVAHZX
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=PUBLIC162301*XNVAHZO
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=PUBLIC163001*XNVAHZO
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=PUBLIC13401*XNVAHZO
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=PUBLIC17701*NVAHZX
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=PUBLIC11201*XNVAHZO
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=PUBLIC13401*XNVAHZO
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=PUBLIC13401*XNVAHZO
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=PUBLIC17701*NVAHZX
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=PUBLIC11201*XNVAHZO
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=PUBLIC13401*XNVAHZO
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=PUBLIC16901*XNVAHZO
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=PUBLIC18601*NVAHZX
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=PUBLIC162301*XNVAHZO
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=PUBLIC16901*XNVAHZO
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=PUBLIC16901*XNVAHZO
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=PUBLIC18601*NVAHZX
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=PUBLIC162301*XNVAHZO
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=PUBLIC16901*XNVAHZO
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=PUBLIC14501*XNVAHZO
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=PUBLIC18101*NVAHZX
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=PUBLIC13701*XNVAHZO
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=PUBLIC14501*XNVAHZO
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=PUBLIC13501*XNVAHZO
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=PUBLIC17801*NVAHZX
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.