Anthem Medicare Advantage (HMO)
$33.70 /month
Monthly Premium
$215.00
Annual Deductible
1,022
Drugs Covered
1
States Served
Top Covered Drugs
Most popular medications covered by this plan, ordered by national search frequency. Click any drug to see exact copay, restrictions, and alternatives.
| # | Drug Name | Type | Tier | 30-Day Copay | |
|---|---|---|---|---|---|
| 1 | Amoxapine | Brand | Tier 2 | $0.00 | Details |
| 2 | Carbidopa and levodopa | Brand | Tier 2 | $0.00 | Details |
| 3 | TAGRISSO osimertinib | Brand | Tier 5 | 0.3% coinsurance | Details |
| 4 | Levothyroxine Sodium levothyroxine sodium | Brand | Tier 6 | $0.00 | Details |
| 5 | Amoxapine | Brand | Tier 2 | $0.00 | Details |
| 6 | Fetzima LEVOMILNACIPRAN HYDROCHLORIDE | Brand | Tier 4 | 0.3% coinsurance | Details |
| 7 | Vizimpro dacomitinib | Brand | Tier 5 | 0.3% coinsurance | Details |
| 8 | JANUVIA sitagliptin | Brand | Tier 3 | 0.3% coinsurance | Details |
| 9 | Potassium Chloride potassium chloride | Brand | Tier 2 | $0.00 | Details |
| 10 | Xospata gilteritinib | Brand | Tier 5 | 0.3% coinsurance | Details |
| 11 | Clozapine | Brand | Tier 4 | 0.3% coinsurance | Details |
| 12 | Teflaro ceftaroline fosamil | Brand | Tier 5 | 0.3% coinsurance | Details |
| 13 | ENTRESTO Sacubitril and Valsartan | Brand | Tier 3 | 0.3% coinsurance | Details |
| 14 | FARXIGA DAPAGLIFLOZIN | Brand | Tier 3 | 0.3% coinsurance | Details |
| 15 | RotaTeq Rotavirus Vaccine, Live, Oral, Pentavalent | Brand | Tier 6 | $0.00 | Details |
| 16 | Diazepam | Brand | Tier 2 | $0.00 | Details |
| 17 | Estradiol | Brand | Tier 1 | $0.00 | Details |
| 18 | Neomycin Sulfate | Brand | Tier 2 | $0.00 | Details |
| 19 | Tiagabine Hydrochloride | Brand | Tier 4 | 0.3% coinsurance | Details |
| 20 | Talzenna talazoparib | Brand | Tier 5 | 0.3% coinsurance | Details |
Showing 20 of 1,022 covered drugs.
States Served (1)
This plan is available to Medicare beneficiaries in the following states.
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