CDPHP Clear Rx (HMO)
$100.00 /month
Monthly Premium
$250.00
Annual Deductible
1,122
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 | Balsalazide Disodium | Brand | Tier 4 | 0.4% coinsurance | Details |
| 2 | Carbidopa and levodopa | Brand | Tier 2 | $2.00 | Details |
| 3 | Levothyroxine Sodium levothyroxine sodium | Brand | Tier 1 | $0.00 | Details |
| 4 | ISENTRESS RALTEGRAVIR | Brand | Tier 5 | 0.3% coinsurance | Details |
| 5 | RotaTeq Rotavirus Vaccine, Live, Oral, Pentavalent | Brand | Tier 4 | 0.4% coinsurance | Details |
| 6 | Gilotrif afatinib | Brand | Tier 5 | 0.3% coinsurance | Details |
| 7 | Haloperidol | Brand | Tier 2 | $2.00 | Details |
| 8 | Verzenio abemaciclib | Brand | Tier 5 | 0.3% coinsurance | Details |
| 9 | JAYPIRCA pirtobrutinib | Brand | Tier 5 | 0.3% coinsurance | Details |
| 10 | Aptivus tipranavir | Brand | Tier 5 | 0.3% coinsurance | Details |
| 11 | RYDAPT | Brand | Tier 5 | 0.3% coinsurance | Details |
| 12 | KISQALI ribociclib | Brand | Tier 5 | 0.3% coinsurance | Details |
| 13 | Medroxyprogesterone Acetate | Brand | Tier 1 | $0.00 | Details |
| 14 | Lynparza olaparib | Brand | Tier 5 | 0.3% coinsurance | Details |
| 15 | Tafinlar dabrafenib | Brand | Tier 5 | 0.3% coinsurance | Details |
| 16 | Pioglitazone | Brand | Tier 1 | $0.00 | Details |
| 17 | POSACONAZOLE Posaconazole | Brand | Tier 5 | 0.3% coinsurance | Details |
| 18 | PIQRAY alpelisib | Brand | Tier 5 | 0.3% coinsurance | Details |
| 19 | Rufinamide | Brand | Tier 5 | 0.3% coinsurance | Details |
| 20 | Talzenna talazoparib | Brand | Tier 5 | 0.3% coinsurance | Details |
Showing 20 of 1,122 covered drugs.
States Served (1)
This plan is available to Medicare beneficiaries in the following states.
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