Select Health Medicare + Kroger (HMO)
$0.00 /month
Monthly Premium
Among the lowest-premium plans in 2026
$200.00
Annual Deductible
1,077
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 | PedvaxHIB Haemophilus b Conjugate Vaccine (Meningococcal Protein Conjugate) | Brand | Tier 3 | 0.2% coinsurance | Details |
| 2 | Digoxin | Brand | Tier 2 | $5.00 | Details |
| 3 | Rufinamide | Brand | Tier 4 | 0.3% coinsurance | Details |
| 4 | Amoxicillin | Brand | Tier 2 | $5.00 | Details |
| 5 | Amoxicillin | Brand | Tier 2 | $5.00 | Details |
| 6 | PredniSONE | Brand | Tier 1 | $0.00 | Details |
| 7 | Dexamethasone | Brand | Tier 2 | $5.00 | Details |
| 8 | PredniSONE | Brand | Tier 1 | $0.00 | Details |
| 9 | Ceftriaxone Sodium | Brand | Tier 2 | $5.00 | Details |
| 10 | TicoVac Tick-Borne Encephalitis Vaccine | Brand | Tier 3 | 0.2% coinsurance | Details |
| 11 | Hydrochlorothiazide | Brand | Tier 1 | $0.00 | Details |
| 12 | Nicotrol nicotine | Brand | Tier 5 | 0.3% coinsurance | Details |
| 13 | Emtricitabine and Tenofovir Disoproxil Fumarate | Brand | Tier 4 | 0.3% coinsurance | Details |
| 14 | Cobenfy xanomeline and trospium chloride | Brand | Tier 5 | 0.3% coinsurance | Details |
| 15 | Balsalazide Disodium | Brand | Tier 3 | 0.2% coinsurance | Details |
| 16 | Perphenazine perphenazine | Brand | Tier 2 | $5.00 | Details |
| 17 | PREVYMIS LETERMOVIR | Brand | Tier 5 | 0.3% coinsurance | Details |
| 18 | Tiagabine Hydrochloride | Brand | Tier 4 | 0.3% coinsurance | Details |
| 19 | Phenobarbital | Brand | Tier 2 | $5.00 | Details |
| 20 | Levothyroxine Sodium levothyroxine sodium | Brand | Tier 1 | $0.00 | Details |
Showing 20 of 1,077 covered drugs.
States Served (1)
This plan is available to Medicare beneficiaries in the following states.
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