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Verified against CMS.gov · on Oct 1, 2026 Plan ID: H5928-004 Cross-check on Medicare.gov →

Blue Shield AdvantageOptimum Plan (HMO)

Plan Year 2026
$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 Verzenio abemaciclib Brand Tier 5 0.3% coinsurance Details
2 Mekinist trametinib Brand Tier 5 0.3% coinsurance Details
3 Thioridazine Hydrochloride thioridazine hydrochloride Brand Tier 3 0.2% coinsurance Details
4 Daurismo glasdegib Brand Tier 5 0.3% coinsurance Details
5 Clozapine Brand Tier 4 0.3% coinsurance Details
6 Haloperidol Brand Tier 2 $3.00 Details
7 Pilocarpine Hydrochloride Brand Tier 3 0.2% coinsurance Details
8 Amoxicillin Brand Tier 2 $3.00 Details
9 Warfarin Sodium Brand Tier 1 $0.00 Details
10 Levothyroxine Sodium levothyroxine sodium Brand Tier 1 $0.00 Details
11 Nystatin Brand Tier 2 $3.00 Details
12 Levothyroxine Sodium levothyroxine sodium Brand Tier 1 $0.00 Details
13 Cefuroxime Brand Tier 4 0.3% coinsurance Details
14 VAQTA hepatitis A vaccine, inactivated Brand Tier 3 0.2% coinsurance Details
15 Linzess linaclotide Brand Tier 3 0.2% coinsurance Details
16 KOSELUGO SELUMETINIB Brand Tier 5 0.3% coinsurance Details
17 PODOFILOX Brand Tier 2 $3.00 Details
18 Haloperidol Brand Tier 2 $3.00 Details
19 PIFELTRO doravirine Brand Tier 5 0.3% coinsurance Details
20 ELIQUIS apixaban Brand Tier 3 0.2% coinsurance Details

Showing 20 of 966 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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States Served (1)

This plan is available to Medicare beneficiaries in the following states.

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