FillMapFreedom Blue PPO Classic (PPO)

Does Freedom Blue PPO Classic (PPO) cover doxycycline?

Freedom Blue PPO Classic (PPO)
H3916-001-0 · MA_LOCAL · Medicare Part D
doxycycline
Do you get help with your Medicare drug costs?None of these

Optional. Some plans charge less at a preferred pharmacy. Enter your ZIP to see which pharmacies near you take this plan — pick yours and the price above is re-worked for it. Until you do, we show what a standard pharmacy costs. Nothing here is saved.

doxycyclineunder Freedom Blue PPO Classic (PPO)
Covered — just walk in
Nothing to clear first — take the prescription to an in-network pharmacy.
What you'd pay
$0per 30-day fill

Part D caps what you pay out of pocket at $2,100 for 2026. From the first fill — no deductible on this drug.

This plan charges the same at every pharmacy in its network — where you fill it will not change this figure.

Tier
Tier 1
Approval first
Not needed
Try another first
No
Amount limit
None
Talk to your pharmacist or doctor before acting on anything here. They can see your full history and this page cannot. Never start, stop, or switch a medication based on it. Coverage rules change and plans make exceptions — your pharmacy can check your exact benefit in seconds.As of Sep 16, 2026 · CMS Part D monthly PUF. Reference information, not medical advice and not a price.

Covered forms and strengths (18)

  • doxycycline hyclate 100 MG Delayed Release Oral TabletTier 2
  • doxycycline hyclate 100 MG InjectionTier 2
  • doxycycline hyclate 100 MG Injection [Doxy]Tier 3
  • doxycycline hyclate 100 MG Oral CapsuleTier 2
  • doxycycline hyclate 100 MG Oral TabletTier 2
  • doxycycline hyclate 150 MG Delayed Release Oral TabletTier 3
  • doxycycline hyclate 20 MG Oral TabletTier 1
  • doxycycline hyclate 200 MG Delayed Release Oral TabletTier 3
  • doxycycline hyclate 50 MG Delayed Release Oral TabletTier 3
  • doxycycline hyclate 50 MG Oral CapsuleTier 2
  • doxycycline hyclate 50 MG Oral TabletTier 4
  • doxycycline hyclate 75 MG Delayed Release Oral TabletTier 1
  • doxycycline monohydrate 100 MG Oral CapsuleTier 2
  • doxycycline monohydrate 100 MG Oral TabletTier 2
  • doxycycline monohydrate 5 MG/ML Oral SuspensionTier 4
  • doxycycline monohydrate 50 MG Oral CapsuleTier 2
  • doxycycline monohydrate 50 MG Oral TabletTier 2
  • doxycycline monohydrate 75 MG Oral TabletTier 2

← All coverage for doxycycline