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Verified against CMS.gov · on July 2026 Plan ID: H2256-034 Cross-check on Medicare.gov →

Tufts Medicare Preferred HMO Value Rx (HMO)

Plan Year 2026
$14.60 /month
Monthly Premium
Among the lowest-premium plans in 2026
$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 ELIQUIS apixaban Brand Tier 3 0.2% coinsurance Details
2 Tacrolimus Brand Tier 4 0.4% coinsurance Details
3 ProQuad Measles, Mumps, Rubella and Varicella Virus Vaccine Live Brand Tier 6 $0.00 Details
4 Clonidine Hydrochloride Brand Tier 1 $0.00 Details
5 Gilotrif afatinib Brand Tier 5 0.3% coinsurance Details
6 Trumenba meningococcal group B vaccine Brand Tier 6 $0.00 Details
7 Ipratropium Bromide Brand Tier 2 $4.00 Details
8 Haloperidol Brand Tier 2 $4.00 Details
9 Jardiance Empagliflozin Brand Tier 3 0.2% coinsurance Details
10 ISENTRESS RALTEGRAVIR Brand Tier 5 0.3% coinsurance Details
11 RETEVMO selpercatinib Brand Tier 5 0.3% coinsurance Details
12 Mekinist trametinib Brand Tier 5 0.3% coinsurance Details
13 Nitroglycerin nitroglycerin Brand Tier 3 0.2% coinsurance Details
14 Nortriptyline Hydrochloride Brand Tier 2 $4.00 Details
15 Levothyroxine Sodium levothyroxine sodium Brand Tier 1 $0.00 Details
16 Ciprofloxacin Brand Tier 1 $0.00 Details
17 KOSELUGO SELUMETINIB Brand Tier 5 0.3% coinsurance Details
18 Trifluoperazine Hydrochloride trifluoperazine hydrochloride Brand Tier 4 0.4% coinsurance Details
19 Levothyroxine Sodium levothyroxine sodium Brand Tier 1 $0.00 Details
20 Xalkori CRIZOTINIB Brand Tier 5 0.3% coinsurance Details

Showing 20 of 1,010 covered drugs.

Compare this plan against others for your medications Enter your drugs and ZIP to see personalized out-of-pocket costs.
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States Served (1)

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

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