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Verified against CMS.gov · on Apr 1, 2026 Plan ID: H4497-005 Cross-check on Medicare.gov →

MedMutual Advantage Access (PPO)

Plan Year 2026
$0.00 /month
Monthly Premium
Among the lowest-premium plans in 2026
$300.00 Annual Deductible
915 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 Metoprolol Tartrate metoprolol tartrate Brand Tier 1 $0.00 Details
2 Daurismo glasdegib Brand Tier 5 0.3% coinsurance Details
3 Ciprofloxacin Brand Tier 2 $0.00 Details
4 Ampicillin Brand Tier 2 $0.00 Details
5 Prograf Tacrolimus Brand Tier 4 0.4% coinsurance Details
6 Venlafaxine Hydrochloride Brand Tier 2 $0.00 Details
7 Pilocarpine Hydrochloride Brand Tier 4 0.4% coinsurance Details
8 Warfarin Sodium Brand Tier 1 $0.00 Details
9 SCEMBLIX asciminib Brand Tier 5 0.3% coinsurance Details
10 Levothyroxine Sodium levothyroxine sodium Brand Tier 1 $0.00 Details
11 Xtandi enzalutamide Brand Tier 5 0.3% coinsurance Details
12 BOSULIF Bosutinib Brand Tier 5 0.3% coinsurance Details
13 TABRECTA capmatinib Brand Tier 5 0.3% coinsurance Details
14 Trifluoperazine Hydrochloride trifluoperazine hydrochloride Brand Tier 3 0.2% coinsurance Details
15 Aprepitant aprepitant Brand Tier 4 0.4% coinsurance Details
16 VAQTA hepatitis A vaccine, inactivated Brand Tier 6 $0.00 Details
17 PIQRAY alpelisib Brand Tier 5 0.3% coinsurance Details
18 Dextrose and Sodium Chloride Brand Tier 4 0.4% coinsurance Details
19 Xalkori CRIZOTINIB Brand Tier 5 0.3% coinsurance Details
20 Ampicillin and Sulbactam Brand Tier 4 0.4% coinsurance Details

Showing 20 of 915 covered drugs.

Compare this plan against others for your medications Enter your drugs and ZIP to see personalized out-of-pocket costs.
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States Served (1)

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

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