Anthem Medicare Advantage (PPO)
$15.00 /month
Monthly Premium
Among the lowest-premium plans in 2026
$250.00
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 | PENBRAYA meningococcal groups a, b, c, w, and y vaccine | Brand | Tier 6 | $0.00 | Details |
| 2 | EVOTAZ atazanavir and cobicistat | Brand | Tier 5 | 0.3% coinsurance | Details |
| 3 | Ibrance palbociclib | Brand | Tier 5 | 0.3% coinsurance | Details |
| 4 | Cobenfy xanomeline and trospium chloride | Brand | Tier 5 | 0.3% coinsurance | Details |
| 5 | SOMAVERT pegvisomant | Brand | Tier 5 | 0.3% coinsurance | Details |
| 6 | Primaquine Phosphate | Brand | Tier 4 | 0.3% coinsurance | Details |
| 7 | Clarithromycin | Brand | Tier 3 | 0.3% coinsurance | Details |
| 8 | Diltiazem Hydrochloride | Brand | Tier 1 | $0.00 | Details |
| 9 | Phenobarbital | Brand | Tier 2 | $0.00 | Details |
| 10 | Dexamethasone | Brand | Tier 2 | $0.00 | Details |
| 11 | Fludrocortisone Acetate FLUDROCORTISONE ACETATE | Brand | Tier 2 | $0.00 | Details |
| 12 | Cobenfy xanomeline and trospium chloride | Brand | Tier 5 | 0.3% coinsurance | Details |
| 13 | Lorbrena lorlatinib | Brand | Tier 5 | 0.3% coinsurance | Details |
| 14 | PedvaxHIB Haemophilus b Conjugate Vaccine (Meningococcal Protein Conjugate) | Brand | Tier 6 | $0.00 | Details |
| 15 | Baclofen baclofen | Brand | Tier 2 | $0.00 | Details |
| 16 | Omeprazole | Brand | Tier 6 | $0.00 | Details |
| 17 | Diazepam | Brand | Tier 2 | $0.00 | Details |
| 18 | Loxapine | Brand | Tier 4 | 0.3% coinsurance | Details |
| 19 | Metoclopramide | Brand | Tier 1 | $0.00 | Details |
| 20 | Depo-SubQ Provera medroxyprogesterone acetate | Brand | Tier 3 | 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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