Blue Medicare Advantage PPO (PPO)
$0.00 /month
Monthly Premium
Among the lowest-premium plans in 2026
$300.00
Annual Deductible
938
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 | Clarithromycin | Brand | Tier 3 | $0.00 | Details |
| 2 | Clozapine | Brand | Tier 4 | $0.00 | Details |
| 3 | TicoVac Tick-Borne Encephalitis Vaccine | Brand | Tier 1 | $0.00 | Details |
| 4 | Ciprofloxacin | Brand | Tier 1 | $0.00 | Details |
| 5 | Potassium Chloride | Brand | Tier 2 | $0.00 | Details |
| 6 | Dicyclomine Dicyclomine hydrochloride | Brand | Tier 3 | $0.00 | Details |
| 7 | INLYTA axitinib | Brand | Tier 5 | $0.00 | Details |
| 8 | Medroxyprogesterone Acetate | Brand | Tier 1 | $0.00 | Details |
| 9 | Warfarin Sodium | Brand | Tier 1 | $0.00 | Details |
| 10 | Augtyro repotrectinib | Brand | Tier 5 | $0.00 | Details |
| 11 | PIQRAY alpelisib | Brand | Tier 5 | $0.00 | Details |
| 12 | Enoxaparin Sodium Enoxaparin sodium | Brand | Tier 4 | $0.00 | Details |
| 13 | Xalkori CRIZOTINIB | Brand | Tier 5 | $0.00 | Details |
| 14 | POSACONAZOLE Posaconazole | Brand | Tier 5 | $0.00 | Details |
| 15 | SCEMBLIX asciminib | Brand | Tier 5 | $0.00 | Details |
| 16 | Fetzima LEVOMILNACIPRAN HYDROCHLORIDE | Brand | Tier 4 | $0.00 | Details |
| 17 | Imatinib Mesylate | Brand | Tier 5 | $0.00 | Details |
| 18 | Mekinist trametinib | Brand | Tier 5 | $0.00 | Details |
| 19 | Pyridostigmine Bromide PYRIDOSTIGMINE BROMIDE | Brand | Tier 3 | $0.00 | Details |
| 20 | Lorbrena lorlatinib | Brand | Tier 5 | $0.00 | Details |
Showing 20 of 938 covered drugs.
States Served (1)
This plan is available to Medicare beneficiaries in the following states.
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