Blue adVantage Reliance (HMO-POS)
$32.90 /month
Monthly Premium
$300.00
Annual Deductible
960
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 | Trifluoperazine Hydrochloride trifluoperazine hydrochloride | Brand | Tier 3 | $45.00 | Details |
| 2 | Cilostazol | Brand | Tier 2 | $12.00 | Details |
| 3 | Mekinist trametinib | Brand | Tier 5 | 0.3% coinsurance | Details |
| 4 | Prednisone | Brand | Tier 1 | $0.00 | Details |
| 5 | Diltiazem Hydrochloride | Brand | Tier 2 | $12.00 | Details |
| 6 | Levothyroxine Sodium levothyroxine sodium | Brand | Tier 1 | $0.00 | Details |
| 7 | TRUQAP capivasertib | Brand | Tier 5 | 0.3% coinsurance | Details |
| 8 | Ibrance palbociclib | Brand | Tier 5 | 0.3% coinsurance | Details |
| 9 | Perphenazine perphenazine | Brand | Tier 4 | 0.5% coinsurance | Details |
| 10 | NOVOLOG insulin aspart | Brand | Tier 3 | $45.00 | Details |
| 11 | VAQTA hepatitis A vaccine, inactivated | Brand | Tier 1 | $0.00 | Details |
| 12 | CRESEMBA isavuconazonium sulfate | Brand | Tier 5 | 0.3% coinsurance | Details |
| 13 | Nitroglycerin nitroglycerin | Brand | Tier 2 | $12.00 | Details |
| 14 | Trifluoperazine Hydrochloride trifluoperazine hydrochloride | Brand | Tier 3 | $45.00 | Details |
| 15 | Xalkori CRIZOTINIB | Brand | Tier 5 | 0.3% coinsurance | Details |
| 16 | KOSELUGO SELUMETINIB | Brand | Tier 5 | 0.3% coinsurance | Details |
| 17 | COARTEM artemether and lumefantrine | Brand | Tier 4 | 0.5% coinsurance | Details |
| 18 | Tacrolimus | Brand | Tier 3 | $45.00 | Details |
| 19 | RotaTeq Rotavirus Vaccine, Live, Oral, Pentavalent | Brand | Tier 3 | $45.00 | Details |
| 20 | Clozapine | Brand | Tier 4 | 0.5% coinsurance | Details |
Showing 20 of 960 covered drugs.
States Served (1)
This plan is available to Medicare beneficiaries in the following states.
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