Provider Partners Missouri Community Plan (HMO I-SNP)
$0.00 /month
Monthly Premium
Among the lowest-premium plans in 2026
$615.00
Annual Deductible
962
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 1 | $0.00 | Details |
| 2 | Mifepristone | Brand | Tier 1 | $0.00 | Details |
| 3 | Acamprosate Calcium acamprosate calcium enteric-coated | Brand | Tier 1 | $0.00 | Details |
| 4 | Pyridostigmine Bromide PYRIDOSTIGMINE BROMIDE | Brand | Tier 1 | $0.00 | Details |
| 5 | Amoxicillin | Brand | Tier 1 | $0.00 | Details |
| 6 | Cyclosporine Modified Modified Cyclosporine | Brand | Tier 1 | $0.00 | Details |
| 7 | Potassium Chloride | Brand | Tier 1 | $0.00 | Details |
| 8 | Fosamprenavir Calcium fosamprenavir calcium | Brand | Tier 1 | $0.00 | Details |
| 9 | Clotrimazole clotrimazole | Brand | Tier 1 | $0.00 | Details |
| 10 | Tiagabine Hydrochloride | Brand | Tier 1 | $0.00 | Details |
| 11 | Amoxicillin and Clavulanate Potassium | Brand | Tier 1 | $0.00 | Details |
| 12 | Propranolol Hydrochloride propranolol hydrochloride | Brand | Tier 1 | $0.00 | Details |
| 13 | HYDROCODONE BITARTRATE AND ACETAMINOPHEN | Brand | Tier 1 | $0.00 | Details |
| 14 | Perphenazine perphenazine | Brand | Tier 1 | $0.00 | Details |
| 15 | VAQTA hepatitis A vaccine, inactivated | Brand | Tier 1 | $0.00 | Details |
| 16 | Linzess linaclotide | Brand | Tier 1 | $0.00 | Details |
| 17 | JAYPIRCA pirtobrutinib | Brand | Tier 1 | $0.00 | Details |
| 18 | Ciprofloxacin in Dextrose ciprofloxacin | Brand | Tier 1 | $0.00 | Details |
| 19 | TRETINOIN tretinoin | Brand | Tier 1 | $0.00 | Details |
| 20 | Thioridazine Hydrochloride thioridazine hydrochloride | Brand | Tier 1 | $0.00 | Details |
Showing 20 of 962 covered drugs.
States Served (1)
This plan is available to Medicare beneficiaries in the following states.
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