BlueAdvantage Total Heart and Diabetes (PPO C-SNP)
$0.00 /month
Monthly Premium
Among the lowest-premium plans in 2026
$250.00
Annual Deductible
998
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 | Leucovorin Calcium | Brand | Tier 2 | $0.00 | Details |
| 2 | Venclexta Venetoclax | Brand | Tier 5 | 0.3% coinsurance | Details |
| 3 | Lynparza olaparib | Brand | Tier 5 | 0.3% coinsurance | Details |
| 4 | HERNEXEOS zongertinib | Brand | Tier 5 | 0.3% coinsurance | Details |
| 5 | Dicyclomine Dicyclomine hydrochloride | Brand | Tier 2 | $0.00 | Details |
| 6 | Medroxyprogesterone Acetate | Brand | Tier 2 | $0.00 | Details |
| 7 | Diltiazem Hydrochloride | Brand | Tier 1 | $0.00 | Details |
| 8 | ELIQUIS apixaban | Brand | Tier 3 | $42.00 | Details |
| 9 | Trifluoperazine Hydrochloride trifluoperazine hydrochloride | Brand | Tier 2 | $0.00 | Details |
| 10 | Exemestane | Brand | Tier 2 | $0.00 | Details |
| 11 | SOMAVERT pegvisomant | Brand | Tier 5 | 0.3% coinsurance | Details |
| 12 | Baclofen baclofen | Brand | Tier 1 | $0.00 | Details |
| 13 | BOSULIF Bosutinib | Brand | Tier 5 | 0.3% coinsurance | Details |
| 14 | ELIQUIS 30-Day Starter Pack 30-Day Starter Pack apixaban | Brand | Tier 3 | $42.00 | Details |
| 15 | VAQTA hepatitis A vaccine, inactivated | Brand | Tier 3 | $42.00 | Details |
| 16 | Valsartan valsartan | Brand | Tier 1 | $0.00 | Details |
| 17 | Tacrolimus | Brand | Tier 4 | 0.5% coinsurance | Details |
| 18 | RETEVMO selpercatinib | Brand | Tier 5 | 0.3% coinsurance | Details |
| 19 | Warfarin Sodium | Brand | Tier 1 | $0.00 | Details |
| 20 | Efavirenz, Emtricitabine and Tenofovir Disoproxil Fumarate | Brand | Tier 4 | 0.5% coinsurance | Details |
Showing 20 of 998 covered drugs.
States Served (1)
This plan is available to Medicare beneficiaries in the following states.
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