Tufts Medicare Preferred HMO Value Rx (HMO)
$51.90 /month
Monthly Premium
$0.00
Annual Deductible
1,010
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 | Cyclosporine | Brand | Tier 4 | 0.4% coinsurance | Details |
| 2 | Balsalazide Disodium | Brand | Tier 4 | 0.4% coinsurance | Details |
| 3 | BOSULIF Bosutinib | Brand | Tier 5 | 0.3% coinsurance | Details |
| 4 | Budesonide | Brand | Tier 4 | 0.4% coinsurance | Details |
| 5 | ISENTRESS RALTEGRAVIR | Brand | Tier 4 | 0.4% coinsurance | Details |
| 6 | BCG VACCINE BACILLUS CALMETTE-GUERIN SUBSTRAIN TICE LIVE ANTIGEN | Brand | Tier 6 | $0.00 | Details |
| 7 | Bromocriptine mesylate | Brand | Tier 4 | 0.4% coinsurance | Details |
| 8 | Warfarin Sodium | Brand | Tier 1 | $0.00 | Details |
| 9 | Imatinib Mesylate | Brand | Tier 5 | 0.3% coinsurance | Details |
| 10 | HYDROCODONE BITARTRATE AND ACETAMINOPHEN | Brand | Tier 2 | $4.00 | Details |
| 11 | Venclexta Venetoclax | Brand | Tier 5 | 0.3% coinsurance | Details |
| 12 | Norvir Ritonavir | Brand | Tier 4 | 0.4% coinsurance | Details |
| 13 | Clozapine | Brand | Tier 4 | 0.4% coinsurance | Details |
| 14 | Prograf Tacrolimus | Brand | Tier 4 | 0.4% coinsurance | Details |
| 15 | Vizimpro dacomitinib | Brand | Tier 5 | 0.3% coinsurance | Details |
| 16 | JANUVIA sitagliptin | Brand | Tier 3 | 0.2% coinsurance | Details |
| 17 | Methylphenidate Hydrochloride | Brand | Tier 2 | $4.00 | Details |
| 18 | PENBRAYA meningococcal groups a, b, c, w, and y vaccine | Brand | Tier 6 | $0.00 | Details |
| 19 | ETHOSUXIMIDE | Brand | Tier 3 | 0.2% coinsurance | Details |
| 20 | KOSELUGO SELUMETINIB | Brand | Tier 5 | 0.3% coinsurance | Details |
Showing 20 of 1,010 covered drugs.
States Served (1)
This plan is available to Medicare beneficiaries in the following states.
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