Esteem Rx (HMO-POS)
$0.00 /month
Monthly Premium
Among the lowest-premium plans in 2026
$250.00
Annual Deductible
1,003
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 | SCEMBLIX asciminib | Brand | Tier 5 | $0.00 | Details |
| 2 | TESTOSTERONE ENANTHATE | Brand | Tier 3 | $0.00 | Details |
| 3 | TRETINOIN tretinoin | Brand | Tier 4 | $0.00 | Details |
| 4 | Dicloxacillin Sodium | Brand | Tier 2 | $0.00 | Details |
| 5 | Fetzima LEVOMILNACIPRAN HYDROCHLORIDE | Brand | Tier 4 | $0.00 | Details |
| 6 | TAGRISSO osimertinib | Brand | Tier 5 | $0.00 | Details |
| 7 | BOSULIF Bosutinib | Brand | Tier 5 | $0.00 | Details |
| 8 | Pyridostigmine Bromide PYRIDOSTIGMINE BROMIDE | Brand | Tier 2 | $0.00 | Details |
| 9 | Nortriptyline Hydrochloride | Brand | Tier 4 | $0.00 | Details |
| 10 | Valsartan valsartan | Brand | Tier 6 | $0.00 | Details |
| 11 | Nitroglycerin nitroglycerin | Brand | Tier 2 | $0.00 | Details |
| 12 | Estradiol | Brand | Tier 2 | $0.00 | Details |
| 13 | Efavirenz, Emtricitabine and Tenofovir Disoproxil Fumarate | Brand | Tier 3 | $0.00 | Details |
| 14 | Nystatin | Brand | Tier 2 | $0.00 | Details |
| 15 | Methylphenidate Hydrochloride | Brand | Tier 2 | $0.00 | Details |
| 16 | Tafinlar dabrafenib | Brand | Tier 5 | $0.00 | Details |
| 17 | Talzenna talazoparib | Brand | Tier 5 | $0.00 | Details |
| 18 | Abrysvo Respiratory Syncytial Virus Vaccine | Brand | Tier 1 | $0.00 | Details |
| 19 | Cromolyn Sodium | Brand | Tier 3 | $0.00 | Details |
| 20 | Paxlovid nirmatrelvir and ritonavir | Brand | Tier 3 | $0.00 | Details |
Showing 20 of 1,003 covered drugs.
States Served (1)
This plan is available to Medicare beneficiaries in the following states.
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