Blue Cross Medicare Advantage Choice Plus (PPO)
$61.60 /month
Monthly Premium
$450.00
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 | ISENTRESS RALTEGRAVIR | Brand | Tier 5 | 0.3% coinsurance | Details |
| 2 | Valsartan valsartan | Brand | Tier 1 | $0.00 | Details |
| 3 | Chlorpromazine Hydrochloride | Brand | Tier 4 | 0.4% coinsurance | Details |
| 4 | Potassium Chloride | Brand | Tier 2 | $1.00 | Details |
| 5 | Ciprofloxacin | Brand | Tier 1 | $0.00 | Details |
| 6 | Amoxicillin | Brand | Tier 1 | $0.00 | Details |
| 7 | Warfarin Sodium | Brand | Tier 1 | $0.00 | Details |
| 8 | Efavirenz, Emtricitabine and Tenofovir Disoproxil Fumarate | Brand | Tier 4 | 0.4% coinsurance | Details |
| 9 | Nystatin | Brand | Tier 2 | $1.00 | Details |
| 10 | Methylphenidate Hydrochloride | Brand | Tier 3 | 0.2% coinsurance | Details |
| 11 | Mekinist trametinib | Brand | Tier 5 | 0.3% coinsurance | Details |
| 12 | ZEJULA niraparib | Brand | Tier 5 | 0.3% coinsurance | Details |
| 13 | Primaquine Phosphate | Brand | Tier 4 | 0.4% coinsurance | Details |
| 14 | Dexamethasone | Brand | Tier 2 | $1.00 | Details |
| 15 | Medroxyprogesterone Acetate | Brand | Tier 1 | $0.00 | Details |
| 16 | Warfarin Sodium | Brand | Tier 1 | $0.00 | Details |
| 17 | Enoxaparin Sodium Enoxaparin sodium | Brand | Tier 4 | 0.4% coinsurance | Details |
| 18 | Gilotrif afatinib | Brand | Tier 5 | 0.3% coinsurance | Details |
| 19 | Chlorpromazine Hydrochloride | Brand | Tier 4 | 0.4% coinsurance | Details |
| 20 | Aprepitant aprepitant | Brand | Tier 4 | 0.4% coinsurance | 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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