Blue Shield 65 Plus (HMO)
$0.00 /month
Monthly Premium
Among the lowest-premium plans in 2026
$425.00
Annual Deductible
966
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 | Loxapine | Brand | Tier 2 | $5.00 | Details |
| 2 | Dexamethasone | Brand | Tier 2 | $5.00 | Details |
| 3 | Pioglitazone | Brand | Tier 1 | $0.00 | Details |
| 4 | Heparin Sodium | Brand | Tier 2 | $5.00 | Details |
| 5 | Dupixent Dupilumab | Brand | Tier 5 | 0.3% coinsurance | Details |
| 6 | Fosamprenavir Calcium fosamprenavir calcium | Brand | Tier 4 | 0.3% coinsurance | Details |
| 7 | amiloride hydrochloride | Brand | Tier 2 | $5.00 | Details |
| 8 | Acarbose | Brand | Tier 2 | $5.00 | Details |
| 9 | Tiagabine Hydrochloride | Brand | Tier 4 | 0.3% coinsurance | Details |
| 10 | SOMAVERT pegvisomant | Brand | Tier 5 | 0.3% coinsurance | Details |
| 11 | Amoxapine | Brand | Tier 3 | 0.3% coinsurance | Details |
| 12 | Leucovorin Calcium | Brand | Tier 2 | $5.00 | Details |
| 13 | ISENTRESS RALTEGRAVIR | Brand | Tier 3 | 0.3% coinsurance | Details |
| 14 | BOSULIF Bosutinib | Brand | Tier 5 | 0.3% coinsurance | Details |
| 15 | ZYKADIA ceritinib | Brand | Tier 5 | 0.3% coinsurance | Details |
| 16 | Dicyclomine Dicyclomine hydrochloride | Brand | Tier 2 | $5.00 | Details |
| 17 | Dicloxacillin Sodium | Brand | Tier 2 | $5.00 | Details |
| 18 | Xalkori CRIZOTINIB | Brand | Tier 5 | 0.3% coinsurance | Details |
| 19 | Teflaro ceftaroline fosamil | Brand | Tier 5 | 0.3% coinsurance | Details |
| 20 | Verzenio abemaciclib | Brand | Tier 5 | 0.3% coinsurance | Details |
Showing 20 of 966 covered drugs.
States Served (1)
This plan is available to Medicare beneficiaries in the following states.
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