True Blue Rx 33 (HMO)
$15.70 /month
Monthly Premium
Among the lowest-premium plans in 2026
$175.00
Annual Deductible
862
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 | Levothyroxine Sodium levothyroxine sodium | Brand | Tier 1 | $0.00 | Details |
| 2 | Haloperidol | Brand | Tier 2 | $6.00 | Details |
| 3 | Levothyroxine Sodium levothyroxine sodium | Brand | Tier 1 | $0.00 | Details |
| 4 | Paxlovid nirmatrelvir and ritonavir | Brand | Tier 3 | $40.00 | Details |
| 5 | Venlafaxine Hydrochloride | Brand | Tier 2 | $6.00 | Details |
| 6 | FARXIGA DAPAGLIFLOZIN | Brand | Tier 3 | $40.00 | Details |
| 7 | Enoxaparin Sodium Enoxaparin sodium | Brand | Tier 4 | 0.3% coinsurance | Details |
| 8 | Isosorbide Dinitrate | Brand | Tier 3 | $40.00 | Details |
| 9 | Ipratropium Bromide | Brand | Tier 2 | $6.00 | Details |
| 10 | Tafinlar dabrafenib | Brand | Tier 5 | 0.3% coinsurance | Details |
| 11 | Ciprofloxacin | Brand | Tier 2 | $6.00 | Details |
| 12 | Venclexta Venetoclax | Brand | Tier 3 | $40.00 | Details |
| 13 | Thioridazine Hydrochloride thioridazine hydrochloride | Brand | Tier 4 | 0.3% coinsurance | Details |
| 14 | Thioridazine Hydrochloride thioridazine hydrochloride | Brand | Tier 4 | 0.3% coinsurance | Details |
| 15 | Propranolol Hydrochloride propranolol hydrochloride | Brand | Tier 2 | $6.00 | Details |
| 16 | Tafinlar dabrafenib | Brand | Tier 5 | 0.3% coinsurance | Details |
| 17 | Cyclosporine | Brand | Tier 4 | 0.3% coinsurance | Details |
| 18 | Nefazodone Hydrochloride | Brand | Tier 4 | 0.3% coinsurance | Details |
| 19 | LACTULOSE Lactulose | Brand | Tier 2 | $6.00 | Details |
| 20 | Dexamethasone | Brand | Tier 2 | $6.00 | Details |
Showing 20 of 862 covered drugs.
States Served (1)
This plan is available to Medicare beneficiaries in the following states.
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