Freedom Platinum Rewards Plan Rx (HMO)
$0.00 /month
Monthly Premium
Among the lowest-premium plans in 2026
$0.00
Annual Deductible
964
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 | Baclofen baclofen | Brand | Tier 1 | $0.00 | Details |
| 2 | PREVYMIS LETERMOVIR | Brand | Tier 4 | 0.3% coinsurance | Details |
| 3 | Potassium Chloride | Brand | Tier 1 | $0.00 | Details |
| 4 | INLYTA axitinib | Brand | Tier 4 | 0.3% coinsurance | Details |
| 5 | Nitroglycerin nitroglycerin | Brand | Tier 1 | $0.00 | Details |
| 6 | Haloperidol | Brand | Tier 1 | $0.00 | Details |
| 7 | Aptivus tipranavir | Brand | Tier 4 | 0.3% coinsurance | Details |
| 8 | Amoxicillin | Brand | Tier 1 | $0.00 | Details |
| 9 | RECOMBIVAX HB Hepatitis B Vaccine (Recombinant) | Brand | Tier 1 | $0.00 | Details |
| 10 | Dexamethasone | Brand | Tier 1 | $0.00 | Details |
| 11 | Priftin rifapentine | Brand | Tier 3 | $50.00 | Details |
| 12 | Fluphenazine Hydrochloride | Brand | Tier 1 | $0.00 | Details |
| 13 | Warfarin Sodium | Brand | Tier 1 | $0.00 | Details |
| 14 | Dextrose and Sodium Chloride | Brand | Tier 2 | $10.00 | Details |
| 15 | Jardiance Empagliflozin | Brand | Tier 2 | $10.00 | Details |
| 16 | Fetzima LEVOMILNACIPRAN HYDROCHLORIDE | Brand | Tier 3 | $50.00 | Details |
| 17 | Imatinib Mesylate | Brand | Tier 4 | 0.3% coinsurance | Details |
| 18 | Mercaptopurine | Brand | Tier 1 | $0.00 | Details |
| 19 | ELIQUIS apixaban | Brand | Tier 2 | $10.00 | Details |
| 20 | Fetzima LEVOMILNACIPRAN HYDROCHLORIDE | Brand | Tier 3 | $50.00 | Details |
Showing 20 of 964 covered drugs.
States Served (1)
This plan is available to Medicare beneficiaries in the following states.
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