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Verified against CMS.gov · on Apr 1, 2026 Plan ID: H5883-002 Cross-check on Medicare.gov →

BCN Advantage Classic (HMO-POS)

Plan Year 2026
$42.20 /month
Monthly Premium
$0.00 Annual Deductible
899 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 Depo-SubQ Provera medroxyprogesterone acetate Brand Tier 3 0.2% coinsurance Details
2 Spiriva Respimat tiotropium bromide inhalation spray Brand Tier 3 0.2% coinsurance Details
3 Amoxapine Brand Tier 3 0.2% coinsurance Details
4 amiloride hydrochloride Brand Tier 3 0.2% coinsurance Details
5 Ibrance palbociclib Brand Tier 5 0.3% coinsurance Details
6 PIFELTRO doravirine Brand Tier 5 0.3% coinsurance Details
7 Propranolol Hydrochloride propranolol hydrochloride Brand Tier 3 0.2% coinsurance Details
8 ISENTRESS RALTEGRAVIR Brand Tier 5 0.3% coinsurance Details
9 Isoniazid Brand Tier 2 $7.00 Details
10 Risperidone Brand Tier 4 0.3% coinsurance Details
11 REYATAZ ATAZANAVIR Brand Tier 5 0.3% coinsurance Details
12 Venlafaxine Hydrochloride Brand Tier 2 $7.00 Details
13 PredniSONE Brand Tier 2 $7.00 Details
14 Tafinlar dabrafenib Brand Tier 5 0.3% coinsurance Details
15 CALQUENCE acalabrutinib Brand Tier 5 0.3% coinsurance Details
16 Haloperidol Brand Tier 3 0.2% coinsurance Details
17 Phenobarbital Brand Tier 3 0.2% coinsurance Details
18 Loxapine Brand Tier 4 0.3% coinsurance Details
19 Chlorpromazine Hydrochloride Brand Tier 4 0.3% coinsurance Details
20 Tiagabine Hydrochloride Brand Tier 4 0.3% coinsurance Details

Showing 20 of 899 covered drugs.

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States Served (1)

This plan is available to Medicare beneficiaries in the following states.

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