Blue Cross and Blue Shield of Nebraska MA Core (HMO)
$0.00 /month
Monthly Premium
Among the lowest-premium plans in 2026
$400.00
Annual Deductible
1,003
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 | Ibrance palbociclib | Brand | Tier 5 | $0.00 | Details |
| 2 | Trelegy Ellipta fluticasone furoate, umeclidinium bromide and vilanterol trifenatate | Brand | Tier 3 | $0.00 | Details |
| 3 | INLYTA axitinib | Brand | Tier 5 | $0.00 | Details |
| 4 | RECOMBIVAX HB Hepatitis B Vaccine (Recombinant) | Brand | Tier 1 | $0.00 | Details |
| 5 | Levothyroxine Sodium levothyroxine sodium | Brand | Tier 1 | $0.00 | Details |
| 6 | Ciprofloxacin | Brand | Tier 1 | $0.00 | Details |
| 7 | Methotrexate | Brand | Tier 2 | $0.00 | Details |
| 8 | Leucovorin Calcium | Brand | Tier 4 | $0.00 | Details |
| 9 | PredniSONE | Brand | Tier 1 | $0.00 | Details |
| 10 | Buspirone Hydrochloride | Brand | Tier 2 | $0.00 | Details |
| 11 | HERNEXEOS zongertinib | Brand | Tier 5 | $0.00 | Details |
| 12 | Dicyclomine Dicyclomine hydrochloride | Brand | Tier 2 | $0.00 | Details |
| 13 | TESTOSTERONE ENANTHATE | Brand | Tier 3 | $0.00 | Details |
| 14 | Nefazodone Hydrochloride | Brand | Tier 4 | $0.00 | Details |
| 15 | Augtyro repotrectinib | Brand | Tier 5 | $0.00 | Details |
| 16 | ISENTRESS RALTEGRAVIR | Brand | Tier 5 | $0.00 | Details |
| 17 | Valsartan valsartan | Brand | Tier 1 | $0.00 | Details |
| 18 | Chlorpromazine Hydrochloride | Brand | Tier 4 | $0.00 | Details |
| 19 | Potassium Chloride | Brand | Tier 2 | $0.00 | Details |
| 20 | Ciprofloxacin | Brand | Tier 1 | $0.00 | Details |
Showing 20 of 1,003 covered drugs.
States Served (1)
This plan is available to Medicare beneficiaries in the following states.
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