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Verified against CMS.gov · on Apr 1, 2026 Plan ID: H3952-054 Cross-check on Medicare.gov →

Keystone 65 Focus Rx (HMO-POS)

Plan Year 2026
$0.00 /month
Monthly Premium
Among the lowest-premium plans in 2026
$0.00 Annual Deductible
973 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 Trifluoperazine Hydrochloride trifluoperazine hydrochloride Brand Tier 3 0.3% coinsurance Details
2 Paxlovid nirmatrelvir and ritonavir Brand Tier 5 0.3% coinsurance Details
3 Xtandi enzalutamide Brand Tier 5 0.3% coinsurance Details
4 Midodrine Hydrochloride midodrine hydrochloride Brand Tier 3 0.3% coinsurance Details
5 Ceftriaxone Sodium Brand Tier 2 $0.00 Details
6 Calcipotriene Brand Tier 3 0.3% coinsurance Details
7 RECOMBIVAX HB Hepatitis B Vaccine (Recombinant) Brand Tier 1 $0.00 Details
8 Isosorbide Dinitrate Brand Tier 4 0.4% coinsurance Details
9 MERCAPTOPURINE Brand Tier 5 0.3% coinsurance Details
10 Linzess linaclotide Brand Tier 3 0.3% coinsurance Details
11 Nefazodone Hydrochloride Brand Tier 4 0.4% coinsurance Details
12 Tafinlar dabrafenib Brand Tier 5 0.3% coinsurance Details
13 TRUQAP capivasertib Brand Tier 5 0.3% coinsurance Details
14 Fluphenazine Hydrochloride Brand Tier 4 0.4% coinsurance Details
15 Venclexta Venetoclax Brand Tier 3 0.3% coinsurance Details
16 Prochlorperazine Brand Tier 4 0.4% coinsurance Details
17 Levothyroxine Sodium levothyroxine sodium Brand Tier 2 $0.00 Details
18 TESTOSTERONE ENANTHATE Brand Tier 3 0.3% coinsurance Details
19 Trelegy Ellipta fluticasone furoate, umeclidinium bromide and vilanterol trifenatate Brand Tier 3 0.3% coinsurance Details
20 ZOLINZA vorinostat Brand Tier 5 0.3% coinsurance Details

Showing 20 of 973 covered drugs.

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States Served (1)

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

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