BlueMedicare Value (PPO)
$0.00 /month
Monthly Premium
Among the lowest-premium plans in 2026
$615.00
Annual Deductible
878
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 | HYDROCODONE BITARTRATE AND ACETAMINOPHEN | Brand | Tier 4 | $0.00 | Details |
| 2 | Sulfasalazine | Brand | Tier 3 | $0.00 | Details |
| 3 | TRUQAP capivasertib | Brand | Tier 5 | $0.00 | Details |
| 4 | Levothyroxine Sodium levothyroxine sodium | Brand | Tier 1 | $0.00 | Details |
| 5 | Perphenazine perphenazine | Brand | Tier 4 | $0.00 | Details |
| 6 | VAQTA hepatitis A vaccine, inactivated | Brand | Tier 6 | $0.00 | Details |
| 7 | Lenalidomide | Brand | Tier 5 | $0.00 | Details |
| 8 | Warfarin Sodium | Brand | Tier 1 | $0.00 | Details |
| 9 | Trifluoperazine Hydrochloride | Brand | Tier 4 | $0.00 | Details |
| 10 | FENTANYL | Brand | Tier 4 | $0.00 | Details |
| 11 | JAYPIRCA pirtobrutinib | Brand | Tier 5 | $0.00 | Details |
| 12 | Mekinist trametinib | Brand | Tier 5 | $0.00 | Details |
| 13 | Levothyroxine Sodium levothyroxine sodium | Brand | Tier 1 | $0.00 | Details |
| 14 | Ibrance palbociclib | Brand | Tier 5 | $0.00 | Details |
| 15 | Daurismo glasdegib | Brand | Tier 5 | $0.00 | Details |
| 16 | Baclofen | Brand | Tier 3 | $0.00 | Details |
| 17 | Clozapine | Brand | Tier 4 | $0.00 | Details |
| 18 | Depo-SubQ Provera medroxyprogesterone acetate | Brand | Tier 3 | $0.00 | Details |
| 19 | Fludrocortisone Acetate FLUDROCORTISONE ACETATE | Brand | Tier 2 | $0.00 | Details |
| 20 | Fetzima LEVOMILNACIPRAN HYDROCHLORIDE | Brand | Tier 4 | $0.00 | Details |
Showing 20 of 878 covered drugs.
States Served (1)
This plan is available to Medicare beneficiaries in the following states.
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