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Verified against CMS.gov · on Oct 1, 2026 Plan ID: H4140-016 Cross-check on Medicare.gov →

DrSelect-CFL (HMO)

Plan Year 2026
$0.00 /month
Monthly Premium
Among the lowest-premium plans in 2026
$0.00 Annual Deductible
1,034 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 NOVOLOG insulin aspart Brand Tier 3 $0.00 Details
2 Fetzima LEVOMILNACIPRAN HYDROCHLORIDE Brand Tier 4 $0.00 Details
3 Venclexta Venetoclax Brand Tier 3 $0.00 Details
4 HERNEXEOS zongertinib Brand Tier 5 $0.00 Details
5 Haloperidol Brand Tier 1 $0.00 Details
6 Levothyroxine Sodium levothyroxine sodium Brand Tier 1 $0.00 Details
7 Ibrance palbociclib Brand Tier 5 $0.00 Details
8 ELIQUIS apixaban Brand Tier 3 $0.00 Details
9 Leucovorin Calcium Brand Tier 2 $0.00 Details
10 RYDAPT Brand Tier 5 $0.00 Details
11 Cobenfy xanomeline and trospium chloride Brand Tier 5 $0.00 Details
12 Verzenio abemaciclib Brand Tier 5 $0.00 Details
13 GARDASIL 9 Human Papillomavirus 9-valent Vaccine, Recombinant Brand Tier 2 $0.00 Details
14 Vigabatrin Brand Tier 5 $0.00 Details
15 Cilostazol Brand Tier 1 $0.00 Details
16 Cobenfy xanomeline and trospium chloride Brand Tier 5 $0.00 Details
17 Verzenio abemaciclib Brand Tier 5 $0.00 Details
18 Abrysvo Respiratory Syncytial Virus Vaccine Brand Tier 2 $0.00 Details
19 PedvaxHIB Haemophilus b Conjugate Vaccine (Meningococcal Protein Conjugate) Brand Tier 3 $0.00 Details
20 Loxapine Brand Tier 2 $0.00 Details

Showing 20 of 1,034 covered drugs.

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States Served (1)

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

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