Presbyterian Senior Care Plan 3 with Rx (HMO)
$65.80 /month
Monthly Premium
$0.00
Annual Deductible
938
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 | Ibrance palbociclib | Brand | Tier 5 | $0.00 | Details |
| 2 | bexarotene | Brand | Tier 5 | $0.00 | Details |
| 3 | NOVOLOG insulin aspart | Brand | Tier 3 | $0.00 | Details |
| 4 | Nortriptyline Hydrochloride | Brand | Tier 3 | $0.00 | Details |
| 5 | Fluphenazine Hydrochloride | Brand | Tier 4 | $0.00 | Details |
| 6 | Nitroglycerin nitroglycerin | Brand | Tier 2 | $0.00 | Details |
| 7 | Chlorpromazine Hydrochloride | Brand | Tier 4 | $0.00 | Details |
| 8 | Ciprofloxacin | Brand | Tier 2 | $0.00 | Details |
| 9 | Diltiazem Hydrochloride | Brand | Tier 2 | $0.00 | Details |
| 10 | Isosorbide Dinitrate | Brand | Tier 2 | $0.00 | Details |
| 11 | Amoxapine | Brand | Tier 3 | $0.00 | Details |
| 12 | RECOMBIVAX HB Hepatitis B Vaccine (Recombinant) | Brand | Tier 3 | $0.00 | Details |
| 13 | Linzess linaclotide | Brand | Tier 4 | $0.00 | Details |
| 14 | Phenobarbital Oral Solution Phenobarbital Oral | Brand | Tier 2 | $0.00 | Details |
| 15 | Dexamethasone | Brand | Tier 2 | $0.00 | Details |
| 16 | SCEMBLIX asciminib | Brand | Tier 5 | $0.00 | Details |
| 17 | Mefloquine Hydrochloride | Brand | Tier 2 | $0.00 | Details |
| 18 | Xtandi enzalutamide | Brand | Tier 5 | $0.00 | Details |
| 19 | EVOTAZ atazanavir and cobicistat | Brand | Tier 5 | $0.00 | Details |
| 20 | Mercaptopurine | Brand | Tier 2 | $0.00 | Details |
Showing 20 of 938 covered drugs.
States Served (1)
This plan is available to Medicare beneficiaries in the following states.
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