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Verified against CMS.gov · on Apr 1, 2026 Plan ID: S5715-015 Cross-check on Medicare.gov →

Blue Cross MedicareRx Basic (PDP)

Plan Year 2026
$0.00 /month
Monthly Premium
Among the lowest-premium plans in 2026
$615.00 Annual Deductible
878 Drugs Covered
0 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 TABRECTA capmatinib Brand Tier 5 0.3% coinsurance Details
2 Dupixent Dupilumab Brand Tier 5 0.3% coinsurance Details
3 Risperidone Brand Tier 4 0.4% coinsurance Details
4 Nortriptyline Hydrochloride Brand Tier 3 0.2% coinsurance Details
5 Everolimus Brand Tier 4 0.4% coinsurance Details
6 ZEJULA niraparib Brand Tier 5 0.3% coinsurance Details
7 JANUVIA sitagliptin Brand Tier 3 0.2% coinsurance Details
8 Nitroglycerin nitroglycerin Brand Tier 3 0.2% coinsurance Details
9 PIQRAY alpelisib Brand Tier 5 0.3% coinsurance Details
10 Augtyro repotrectinib Brand Tier 5 0.3% coinsurance Details
11 Levothyroxine Sodium levothyroxine sodium Brand Tier 1 $0.00 Details
12 ISENTRESS RALTEGRAVIR Brand Tier 4 0.4% coinsurance Details
13 Isoniazid Brand Tier 2 $5.00 Details
14 VAQTA hepatitis A vaccine, inactivated Brand Tier 1 $0.00 Details
15 Ciprofloxacin Brand Tier 2 $5.00 Details
16 CRESEMBA isavuconazonium sulfate Brand Tier 5 0.3% coinsurance Details
17 Ciprofloxacin Brand Tier 2 $5.00 Details
18 Loxapine Brand Tier 3 0.2% coinsurance Details
19 WELIREG belzutifan Brand Tier 5 0.3% coinsurance Details
20 Mekinist trametinib Brand Tier 5 0.3% coinsurance Details

Showing 20 of 878 covered drugs.

Compare this plan against others for your medications Enter your drugs and ZIP to see personalized out-of-pocket costs.
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