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Verified against CMS.gov · on April 2026 Plan ID: H3817-009 Cross-check on Medicare.gov →

Regence MedAdvantage + Rx Enhanced (PPO)

Plan Year 2026
$62.50 /month
Monthly Premium
$200.00 Annual Deductible
1,023 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 Nefazodone Hydrochloride Brand Tier 4 0.4% coinsurance Details
2 RECOMBIVAX HB Hepatitis B Vaccine (Recombinant) Brand Tier 3 0.2% coinsurance Details
3 Loxapine Brand Tier 2 $3.00 Details
4 Ampicillin Brand Tier 2 $3.00 Details
5 Diazepam Brand Tier 2 $3.00 Details
6 BCG VACCINE BACILLUS CALMETTE-GUERIN SUBSTRAIN TICE LIVE ANTIGEN Brand Tier 3 0.2% coinsurance Details
7 Estradiol Brand Tier 1 $0.00 Details
8 Cyclosporine Modified Modified Cyclosporine Brand Tier 4 0.4% coinsurance Details
9 PIFELTRO doravirine Brand Tier 5 0.3% coinsurance Details
10 Clozapine Brand Tier 4 0.4% coinsurance Details
11 Vizimpro dacomitinib Brand Tier 5 0.3% coinsurance Details
12 Prograf Tacrolimus Brand Tier 4 0.4% coinsurance Details
13 Trifluoperazine Hydrochloride Brand Tier 3 0.2% coinsurance Details
14 Phenobarbital Brand Tier 3 0.2% coinsurance Details
15 Amoxicillin Brand Tier 1 $0.00 Details
16 Cilostazol Brand Tier 2 $3.00 Details
17 Valsartan valsartan Brand Tier 1 $0.00 Details
18 Nitroglycerin nitroglycerin Brand Tier 2 $3.00 Details
19 Amoxicillin and Clavulanate Potassium Brand Tier 2 $3.00 Details
20 Nicotrol nicotine Brand Tier 4 0.4% coinsurance Details

Showing 20 of 1,023 covered drugs.

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States Served (1)

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

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