Medications and Pricing

Abnormal uterine bleeding
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Medication

Out-of-pocket price

Amethia Lo Generic

pack

Up to $

120

/month

Amethyst

pack

Up to $

70

/month

Balziva

pack

Up to $

45

/month

Blisovi FE 1/20

pack

Up to $

20

/month

Brand Yaz

pack

Up to $

190

/month

Acid reflux
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Medication

Out-of-pocket price

Cimetidine

Tablets

Up to $

100

/month

Dexlansoprazole DR

Tablets

Up to $

420

/month

Esomeprazole DR

Tablets

Up to $

35

/month

Lansoprazole DR

Tablets

Up to $

30

/month

Omeprazole and Sodium Carbonate

Tablets

Up to $

105

/month

Allergies
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Medication

Out-of-pocket price

Alomide

Up to $

235

/month

Alrex

Up to $

29

/month

Azelastine 0.15%

Up to $

72

/month

Azelastine 0.1%

Up to $

29

/month

Azelastine Hydrochloride Ophthalmic Solution

Up to $

25

/month

Anxiety and depression
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Medication

Out-of-pocket price

Bupropion

Up to $

30

/month

Buspirone

Up to $

26

/month

Citalopram

Up to $

35

/month

Duloxetine DR

Up to $

25

/month

Escitalopram

Up to $

19

/month

Asthma
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Medication

Out-of-pocket price

Advair Diskus

Inhaler

Up to $

700

/month

Advair HFA

Inhaler

Up to $

670

/month

Albuterol Sulfate HFA

Inhaler

Up to $

80

/month

Asmanex HFA

Inhaler

Up to $

280

/month

Beclomethasone Dipropionate HFA

Inhaler

Up to $

360

/month

Birth control
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Medication

Out-of-pocket price

Amethia Lo Generic

pack

Up to $

120

/month

Amethyst

pack

Up to $

70

/month

Annovera

ring

Up to $

2030

/month

Balziva

pack

Up to $

45

/month

Blisovi FE 1/20

pack

Up to $

20

/month

Cold sores
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Medication

Out-of-pocket price

Valacyclovir

Tablets

Up to $

45

/month

Diabetes
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Medication

Out-of-pocket price

Basaglar, Lantus

Pen/Syringe

Up to $

4500

/month

Glimepiride

Tablet

Up to $

40

/month

Glipizide

Tablet

Up to $

60

/month

Glyburide

Tablet

Up to $

155

/month

Humalog

Pen/Syringe

Up to $

1300

/month

Eczema
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Medication

Out-of-pocket price

Betamethasone valerate

Cream or ointment

Up to $

72

/month

Betamethasone Diproprionate

Cream

Up to $

75

/month

Cephalexin

Tablet or suspension

Up to $

30

/month

Clobetasol Proprionate

Foam, cream, or ointment

Up to $

240

/month

Desonide

Cream

Up to $

90

/month

Emergency contraception
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Medication

Out-of-pocket price

My Way

pill

Up to $

25

/month

Endometriosis
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Medication

Out-of-pocket price

Sprintec

pack

Up to $

65

/month

Xulane Patch

box (3 patches)

Up to $

175

/month

Nuvaring

ring

Up to $

170

/month

SubQ Depo Provera

syringe

Up to $

330

/month

Norethindrone 5 mg

Tablets

Up to $

315

/month

Hair loss
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Medication

Out-of-pocket price

Spironolactone

Tablets

Up to $

40

/month

Minoxidil

Up to $

50

/month

Herpes
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Medication

Out-of-pocket price

Valacyclovir (acute)

tablets

Up to $

45

/month

Valacyclovir (preventive)

Tablets

Up to $

30

/month

High cholesterol
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Medication

Out-of-pocket price

Atorvastatin

tablets

Up to $

25

/month

Colesevelam

tablets

Up to $

350

/month

Ezetimibe

tablets

Up to $

33

/month

Ezetimibe and Simvastatin

tablets

Up to $

180

/month

Fenofibrate

tablets

Up to $

40

/month

Lashes
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Medication

Out-of-pocket price

Latisse

Bottle

Up to $

215

/month

Bimatoprost ophthalmic solution, 0.03%

Bottle

Up to $

110

/month

Menopause
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Medication

Out-of-pocket price

Activella

Pill

Up to $

400

/month

Alora

Patch

Up to $

205

/month

Angeliq

Pill

Up to $

290

/month

Brisdelle

capsule

Up to $

320

/month

Climara

Patch

Up to $

215

/month

Migraine
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Medication

Out-of-pocket price

Frovatriptan

Tablet

Up to $

600

/month

Propranolol

Tablet

Up to $

70

/month

Sumatriptan

Syringe or tablet

Up to $

380

/month

Timolol

Tablet

Up to $

150

/month

Topiramate

Tablet

Up to $

45

/month

Nail infection
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Medication

Out-of-pocket price

Terbinafine

Tablet

Up to $

28

/month

Ciclopirox Topical Solution

Bottle

Up to $

35

/month

Jublia

Bottle

Up to $

680

/month

Polycystic ovarian syndrome (PCOS)
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Medication

Out-of-pocket price

Amethia Lo Generic

pack

Up to $

120

/month

Amethyst

pack

Up to $

70

/month

Balziva

pack

Up to $

45

/month

Blisovi FE 1/20

pack

Up to $

20

/month

Brand Yaz

pack

Up to $

190

/month

Quit smoking
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Medication

Out-of-pocket price

Nicotine Patch

Patch

Up to $

120

/month

Nicotine Patch Bundle

Patch

Up to $

260

/month

Varenicline

Tablet

Up to $

500

/month

Zyban

Tablet

Up to $

35

/month

Thyroid disease
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Medication

Out-of-pocket price

Levothryoxine

tablets

Up to $

20

/month

Synthroid

tablet

Up to $

20

/month

Weight loss
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Medication

Out-of-pocket price

Bupropion SR

Tablet

Up to $

60

/month

Contrave ER

Pill

Up to $

750

/month

Metformin (for weight-loss)

Tablet

Up to $

57

/month

Mounjaro

Pen/Syringe

Up to $

1500

/month

Ozempic

Pen/Syringe

Up to $

4000

/month