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Verified against CMS.gov · on Apr 1, 2026 Plan ID: H4875-020 Cross-check on Medicare.gov →

PriorityMedicare Edge (PPO)

Plan Year 2026
$0.00 /month
Monthly Premium
Among the lowest-premium plans in 2026
$200.00 Annual Deductible
978 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 REYATAZ ATAZANAVIR Brand Tier 5 0.3% coinsurance Details
2 Everolimus Brand Tier 5 0.3% coinsurance Details
3 NOVOLOG insulin aspart Brand Tier 3 0.2% coinsurance Details
4 Lenalidomide Brand Tier 5 0.3% coinsurance Details
5 Linzess linaclotide Brand Tier 3 0.2% coinsurance Details
6 Amoxicillin and Clavulanate Potassium Brand Tier 2 $8.00 Details
7 Amoxicillin Brand Tier 2 $8.00 Details
8 Clotrimazole clotrimazole Brand Tier 2 $8.00 Details
9 GARDASIL 9 Human Papillomavirus 9-valent Vaccine, Recombinant Brand Tier 3 0.2% coinsurance Details
10 Dicloxacillin Sodium Brand Tier 2 $8.00 Details
11 Buspirone Hydrochloride Brand Tier 2 $8.00 Details
12 Morphine Sulfate Brand Tier 4 0.3% coinsurance Details
13 COARTEM artemether and lumefantrine Brand Tier 4 0.3% coinsurance Details
14 TAGRISSO osimertinib Brand Tier 5 0.3% coinsurance Details
15 Gilotrif afatinib Brand Tier 5 0.3% coinsurance Details
16 VARIVAX Varicella Virus Vaccine Live Brand Tier 3 0.2% coinsurance Details
17 Trumenba meningococcal group B vaccine Brand Tier 3 0.2% coinsurance Details
18 Dexamethasone Brand Tier 2 $8.00 Details
19 Haloperidol Brand Tier 2 $8.00 Details
20 Amoxicillin Brand Tier 2 $8.00 Details

Showing 20 of 978 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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