Mass General Brigham Advantage Signature (PPO)
$147.20 /month
Monthly Premium
$350.00
Annual Deductible
1,154
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 | Levothyroxine Sodium levothyroxine sodium | Brand | Tier 1 | $0.00 | Details |
| 2 | Metoclopramide | Brand | Tier 1 | $0.00 | Details |
| 3 | Chlorhexidine Gluconate | Brand | Tier 1 | $0.00 | Details |
| 4 | Trifluoperazine Hydrochloride trifluoperazine hydrochloride | Brand | Tier 3 | $0.00 | Details |
| 5 | Probenecid | Brand | Tier 2 | $0.00 | Details |
| 6 | Everolimus | Brand | Tier 5 | $0.00 | Details |
| 7 | Dupixent Dupilumab | Brand | Tier 5 | $0.00 | Details |
| 8 | Jardiance Empagliflozin | Brand | Tier 3 | $0.00 | Details |
| 9 | Buprenorphine | Brand | Tier 2 | $0.00 | Details |
| 10 | VAQTA hepatitis A vaccine, inactivated | Brand | Tier 3 | $0.00 | Details |
| 11 | Prochlorperazine | Brand | Tier 3 | $0.00 | Details |
| 12 | Methylphenidate Hydrochloride | Brand | Tier 2 | $0.00 | Details |
| 13 | PIFELTRO doravirine | Brand | Tier 5 | $0.00 | Details |
| 14 | Haloperidol | Brand | Tier 2 | $0.00 | Details |
| 15 | SCEMBLIX asciminib | Brand | Tier 5 | $0.00 | Details |
| 16 | Isosorbide Dinitrate | Brand | Tier 3 | $0.00 | Details |
| 17 | Isosorbide Dinitrate | Brand | Tier 3 | $0.00 | Details |
| 18 | Venlafaxine Hydrochloride | Brand | Tier 3 | $0.00 | Details |
| 19 | TicoVac Tick-Borne Encephalitis Vaccine | Brand | Tier 3 | $0.00 | Details |
| 20 | BCG VACCINE BACILLUS CALMETTE-GUERIN SUBSTRAIN TICE LIVE ANTIGEN | Brand | Tier 3 | $0.00 | Details |
Showing 20 of 1,154 covered drugs.
States Served (1)
This plan is available to Medicare beneficiaries in the following states.
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