PacificSource Medicare Essentials Choice Rx 14 (HMO-POS)
$29.10 /month
Monthly Premium
Among the lowest-premium plans in 2026
$199.00
Annual Deductible
1,037
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 | Cilostazol | Brand | Tier 2 | $0.00 | Details |
| 2 | WELIREG belzutifan | Brand | Tier 5 | $0.00 | Details |
| 3 | Tacrolimus | Brand | Tier 2 | $0.00 | Details |
| 4 | ENTRESTO Sacubitril and Valsartan | Brand | Tier 3 | $0.00 | Details |
| 5 | Ibrance palbociclib | Brand | Tier 5 | $0.00 | Details |
| 6 | Tafinlar dabrafenib | Brand | Tier 5 | $0.00 | Details |
| 7 | Phenobarbital Oral Solution Phenobarbital Oral | Brand | Tier 2 | $0.00 | Details |
| 8 | POSACONAZOLE Posaconazole | Brand | Tier 5 | $0.00 | Details |
| 9 | Warfarin Sodium | Brand | Tier 1 | $0.00 | Details |
| 10 | Tiagabine Hydrochloride | Brand | Tier 4 | $0.00 | Details |
| 11 | Vigabatrin | Brand | Tier 5 | $0.00 | Details |
| 12 | BOSULIF Bosutinib | Brand | Tier 5 | $0.00 | Details |
| 13 | Nefazodone Hydrochloride | Brand | Tier 4 | $0.00 | Details |
| 14 | Danazol | Brand | Tier 2 | $0.00 | Details |
| 15 | Talzenna talazoparib | Brand | Tier 5 | $0.00 | Details |
| 16 | Venlafaxine Hydrochloride | Brand | Tier 2 | $0.00 | Details |
| 17 | Amoxicillin | Brand | Tier 2 | $0.00 | Details |
| 18 | Budesonide | Brand | Tier 2 | $0.00 | Details |
| 19 | Diazepam | Brand | Tier 2 | $0.00 | Details |
| 20 | TRUQAP capivasertib | Brand | Tier 5 | $0.00 | Details |
Showing 20 of 1,037 covered drugs.
States Served (1)
This plan is available to Medicare beneficiaries in the following states.
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