KelseyCare Advantage Signature (HMO)
$0.00 /month
Monthly Premium
Among the lowest-premium plans in 2026
$0.00
Annual Deductible
966
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 | REYATAZ ATAZANAVIR | Brand | Tier 5 | 0.3% coinsurance | Details |
| 2 | Fluphenazine Hydrochloride | Brand | Tier 4 | 0.3% coinsurance | Details |
| 3 | Acamprosate Calcium acamprosate calcium enteric-coated | Brand | Tier 4 | 0.3% coinsurance | Details |
| 4 | Erlotinib | Brand | Tier 4 | 0.3% coinsurance | Details |
| 5 | Amoxicillin | Brand | Tier 2 | $4.00 | Details |
| 6 | Acarbose | Brand | Tier 2 | $4.00 | Details |
| 7 | Cyclosporine Modified Modified Cyclosporine | Brand | Tier 4 | 0.3% coinsurance | Details |
| 8 | Trifluoperazine Hydrochloride trifluoperazine hydrochloride | Brand | Tier 3 | 0.2% coinsurance | Details |
| 9 | Amoxicillin | Brand | Tier 2 | $4.00 | Details |
| 10 | Bromocriptine mesylate | Brand | Tier 4 | 0.3% coinsurance | Details |
| 11 | Acarbose | Brand | Tier 2 | $4.00 | Details |
| 12 | Imatinib Mesylate | Brand | Tier 5 | 0.3% coinsurance | Details |
| 13 | RECOMBIVAX HB Hepatitis B Vaccine (Recombinant) | Brand | Tier 1 | $0.00 | Details |
| 14 | Perphenazine perphenazine | Brand | Tier 4 | 0.3% coinsurance | Details |
| 15 | VAQTA hepatitis A vaccine, inactivated | Brand | Tier 1 | $0.00 | Details |
| 16 | Linzess linaclotide | Brand | Tier 3 | 0.2% coinsurance | Details |
| 17 | Thioridazine Hydrochloride thioridazine hydrochloride | Brand | Tier 3 | 0.2% coinsurance | Details |
| 18 | Teflaro ceftaroline fosamil | Brand | Tier 5 | 0.3% coinsurance | Details |
| 19 | KOSELUGO SELUMETINIB | Brand | Tier 5 | 0.3% coinsurance | Details |
| 20 | KISQALI ribociclib | Brand | Tier 5 | 0.3% coinsurance | Details |
Showing 20 of 966 covered drugs.
States Served (1)
This plan is available to Medicare beneficiaries in the following states.
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