Elderplan Extra Help (HMO-POS)
$58.80 /month
Monthly Premium
$375.00
Annual Deductible
979
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 | ZYKADIA ceritinib | Brand | Tier 5 | $0.00 | Details |
| 2 | Spiriva Respimat tiotropium bromide inhalation spray | Brand | Tier 4 | $0.00 | Details |
| 3 | Xospata gilteritinib | Brand | Tier 5 | $0.00 | Details |
| 4 | Nitroglycerin nitroglycerin | Brand | Tier 3 | $0.00 | Details |
| 5 | Dicloxacillin Sodium | Brand | Tier 3 | $0.00 | Details |
| 6 | Fluphenazine Hydrochloride | Brand | Tier 4 | $0.00 | Details |
| 7 | Amoxapine | Brand | Tier 3 | $0.00 | Details |
| 8 | Phenobarbital Oral Solution Phenobarbital Oral | Brand | Tier 4 | $0.00 | Details |
| 9 | JANUVIA sitagliptin | Brand | Tier 3 | $0.00 | Details |
| 10 | Haloperidol | Brand | Tier 3 | $0.00 | Details |
| 11 | Amoxicillin | Brand | Tier 1 | $0.00 | Details |
| 12 | Lenalidomide | Brand | Tier 5 | $0.00 | Details |
| 13 | Cyclosporine Modified Modified Cyclosporine | Brand | Tier 4 | $0.00 | Details |
| 14 | Xtandi enzalutamide | Brand | Tier 5 | $0.00 | Details |
| 15 | Gentamicin Sulfate | Brand | Tier 3 | $0.00 | Details |
| 16 | Hydrochlorothiazide | Brand | Tier 1 | $0.00 | Details |
| 17 | Tacrolimus | Brand | Tier 4 | $0.00 | Details |
| 18 | Calcipotriene | Brand | Tier 3 | $0.00 | Details |
| 19 | PODOFILOX | Brand | Tier 3 | $0.00 | Details |
| 20 | NITROGLYCERIN nitroglycerin | Brand | Tier 4 | $0.00 | Details |
Showing 20 of 979 covered drugs.
States Served (1)
This plan is available to Medicare beneficiaries in the following states.
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