Jefferson Health Plans Choice (PPO)
$0.00 /month
Monthly Premium
Among the lowest-premium plans in 2026
$0.00
Annual Deductible
1,019
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 | PIFELTRO doravirine | Brand | Tier 5 | $0.00 | Details |
| 2 | Haloperidol | Brand | Tier 2 | $0.00 | Details |
| 3 | Mekinist trametinib | Brand | Tier 5 | $0.00 | Details |
| 4 | RYDAPT | Brand | Tier 5 | $0.00 | Details |
| 5 | Clonidine Hydrochloride | Brand | Tier 1 | $0.00 | Details |
| 6 | bexarotene | Brand | Tier 5 | $0.00 | Details |
| 7 | Daurismo glasdegib | Brand | Tier 5 | $0.00 | Details |
| 8 | Clozapine | Brand | Tier 4 | $0.00 | Details |
| 9 | Amoxicillin | Brand | Tier 1 | $0.00 | Details |
| 10 | Fluphenazine Hydrochloride | Brand | Tier 4 | $0.00 | Details |
| 11 | Haloperidol | Brand | Tier 2 | $0.00 | Details |
| 12 | Trifluoperazine Hydrochloride trifluoperazine hydrochloride | Brand | Tier 3 | $0.00 | Details |
| 13 | Ampicillin and Sulbactam | Brand | Tier 4 | $0.00 | Details |
| 14 | Cilostazol | Brand | Tier 2 | $0.00 | Details |
| 15 | ETHOSUXIMIDE | Brand | Tier 4 | $0.00 | Details |
| 16 | FENTANYL | Brand | Tier 4 | $0.00 | Details |
| 17 | Linzess linaclotide | Brand | Tier 3 | $0.00 | Details |
| 18 | Fluphenazine Hydrochloride | Brand | Tier 2 | $0.00 | Details |
| 19 | Pilocarpine Hydrochloride | Brand | Tier 4 | $0.00 | Details |
| 20 | Warfarin Sodium | Brand | Tier 1 | $0.00 | Details |
Showing 20 of 1,019 covered drugs.
States Served (1)
This plan is available to Medicare beneficiaries in the following states.
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