Medicare HMO Blue FlexRx (HMO-POS)
$63.30 /month
Monthly Premium
$260.00
Annual Deductible
967
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 | Daurismo glasdegib | Brand | Tier 5 | 0.3% coinsurance | Details |
| 2 | Fetzima LEVOMILNACIPRAN HYDROCHLORIDE | Brand | Tier 4 | $95.00 | Details |
| 3 | Doxepin Hydrochloride doxepin hydrochloride | Brand | Tier 3 | $42.00 | Details |
| 4 | Dicyclomine Hydrochloride | Brand | Tier 3 | $42.00 | Details |
| 5 | Diltiazem Hydrochloride | Brand | Tier 1 | $0.00 | Details |
| 6 | Aprepitant aprepitant | Brand | Tier 2 | $5.00 | Details |
| 7 | Paxlovid nirmatrelvir and ritonavir | Brand | Tier 2 | $5.00 | Details |
| 8 | Tacrolimus | Brand | Tier 2 | $5.00 | Details |
| 9 | Fluphenazine Hydrochloride | Brand | Tier 2 | $5.00 | Details |
| 10 | Clarithromycin | Brand | Tier 2 | $5.00 | Details |
| 11 | Phenobarbital Oral Solution Phenobarbital Oral | Brand | Tier 4 | $95.00 | Details |
| 12 | CALQUENCE acalabrutinib | Brand | Tier 5 | 0.3% coinsurance | Details |
| 13 | Fluphenazine Hydrochloride | Brand | Tier 2 | $5.00 | Details |
| 14 | Methylphenidate Hydrochloride | Brand | Tier 2 | $5.00 | Details |
| 15 | KISQALI ribociclib | Brand | Tier 5 | 0.3% coinsurance | Details |
| 16 | NITROGLYCERIN nitroglycerin | Brand | Tier 2 | $5.00 | Details |
| 17 | Nitroglycerin nitroglycerin | Brand | Tier 2 | $5.00 | Details |
| 18 | FARXIGA DAPAGLIFLOZIN | Brand | Tier 3 | $42.00 | Details |
| 19 | ISENTRESS RALTEGRAVIR | Brand | Tier 5 | 0.3% coinsurance | Details |
| 20 | Talzenna talazoparib | Brand | Tier 5 | 0.3% coinsurance | Details |
Showing 20 of 967 covered drugs.
States Served (1)
This plan is available to Medicare beneficiaries in the following states.
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