True Blue Rx 37 (HMO)
$111.90 /month
Monthly Premium
$150.00
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 | Fluphenazine Hydrochloride | Brand | Tier 4 | 0.3% coinsurance | Details |
| 2 | REYATAZ ATAZANAVIR | Brand | Tier 5 | 0.3% coinsurance | Details |
| 3 | VARIVAX Varicella Virus Vaccine Live | Brand | Tier 3 | $40.00 | Details |
| 4 | Amoxicillin | Brand | Tier 1 | $0.00 | Details |
| 5 | PREVYMIS LETERMOVIR | Brand | Tier 5 | 0.3% coinsurance | Details |
| 6 | Risperidone | Brand | Tier 4 | 0.3% coinsurance | Details |
| 7 | RECOMBIVAX HB Hepatitis B Vaccine (Recombinant) | Brand | Tier 3 | $40.00 | Details |
| 8 | ProQuad Measles, Mumps, Rubella and Varicella Virus Vaccine Live | Brand | Tier 3 | $40.00 | Details |
| 9 | Verzenio abemaciclib | Brand | Tier 5 | 0.3% coinsurance | Details |
| 10 | Budesonide | Brand | Tier 4 | 0.3% coinsurance | Details |
| 11 | TRUQAP capivasertib | Brand | Tier 5 | 0.3% coinsurance | Details |
| 12 | Perphenazine perphenazine | Brand | Tier 4 | 0.3% coinsurance | Details |
| 13 | Methotrexate | Brand | Tier 3 | $40.00 | Details |
| 14 | Risperidone | Brand | Tier 5 | 0.3% coinsurance | Details |
| 15 | Atomoxetine | Brand | Tier 4 | 0.3% coinsurance | Details |
| 16 | KISQALI ribociclib | Brand | Tier 5 | 0.3% coinsurance | Details |
| 17 | Haloperidol | Brand | Tier 4 | 0.3% coinsurance | Details |
| 18 | Diltiazem Hydrochloride | Brand | Tier 2 | $7.00 | Details |
| 19 | TESTOSTERONE ENANTHATE | Brand | Tier 4 | 0.3% coinsurance | Details |
| 20 | ENTRESTO Sacubitril and Valsartan | Brand | Tier 3 | $40.00 | 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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