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Verified against CMS.gov · on Apr 1, 2026 Plan ID: H3344-013 Cross-check on Medicare.gov →

Independent Health's Medicare Passport Connect (PPO)

Plan Year 2026
$58.80 /month
Monthly Premium
$615.00 Annual Deductible
996 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 Lynparza olaparib Brand Tier 5 $0.00 Details
2 Acamprosate Calcium acamprosate calcium enteric-coated Brand Tier 4 $0.00 Details
3 Mifepristone Brand Tier 5 $0.00 Details
4 Xalkori CRIZOTINIB Brand Tier 5 $0.00 Details
5 LACTULOSE Lactulose Brand Tier 2 $0.00 Details
6 Methotrexate Brand Tier 2 $0.00 Details
7 PredniSONE Brand Tier 2 $0.00 Details
8 Trifluoperazine Hydrochloride Brand Tier 2 $0.00 Details
9 Combivent Respimat ipratropium bromide and albuterol Brand Tier 4 $0.00 Details
10 GARDASIL 9 Human Papillomavirus 9-valent Vaccine, Recombinant Brand Tier 2 $0.00 Details
11 Tiagabine Hydrochloride Brand Tier 4 $0.00 Details
12 Medroxyprogesterone Acetate Brand Tier 2 $0.00 Details
13 Verzenio abemaciclib Brand Tier 5 $0.00 Details
14 SCEMBLIX asciminib Brand Tier 5 $0.00 Details
15 ELIQUIS apixaban Brand Tier 3 $0.00 Details
16 Levothyroxine Sodium levothyroxine sodium Brand Tier 1 $0.00 Details
17 Diltiazem Hydrochloride Brand Tier 2 $0.00 Details
18 SOMAVERT pegvisomant Brand Tier 5 $0.00 Details
19 ISENTRESS RALTEGRAVIR Brand Tier 5 $0.00 Details
20 Chlorpromazine Hydrochloride Brand Tier 4 $0.00 Details

Showing 20 of 996 covered drugs.

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States Served (1)

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

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