UPMC for Life PPO Essential Care Rx (PPO)
$0.00 /month
Monthly Premium
Among the lowest-premium plans in 2026
$500.00
Annual Deductible
1,044
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 | Amoxicillin | Brand | Tier 2 | $0.00 | Details |
| 2 | Diazepam | Brand | Tier 4 | 0.3% coinsurance | Details |
| 3 | Vizimpro dacomitinib | Brand | Tier 5 | 0.3% coinsurance | Details |
| 4 | Venclexta Venetoclax | Brand | Tier 4 | 0.3% coinsurance | Details |
| 5 | Amoxicillin | Brand | Tier 2 | $0.00 | Details |
| 6 | RETEVMO selpercatinib | Brand | Tier 5 | 0.3% coinsurance | Details |
| 7 | TESTOSTERONE ENANTHATE | Brand | Tier 3 | 0.2% coinsurance | Details |
| 8 | Acarbose | Brand | Tier 2 | $0.00 | Details |
| 9 | Aptivus tipranavir | Brand | Tier 5 | 0.3% coinsurance | Details |
| 10 | Amoxicillin and Clavulanate Potassium | Brand | Tier 3 | 0.2% coinsurance | Details |
| 11 | Nicotrol nicotine | Brand | Tier 4 | 0.3% coinsurance | Details |
| 12 | Risperidone | Brand | Tier 4 | 0.3% coinsurance | Details |
| 13 | Lynparza olaparib | Brand | Tier 5 | 0.3% coinsurance | Details |
| 14 | bexarotene | Brand | Tier 3 | 0.2% coinsurance | Details |
| 15 | Mifepristone | Brand | Tier 5 | 0.3% coinsurance | Details |
| 16 | Clozapine | Brand | Tier 4 | 0.3% coinsurance | Details |
| 17 | ELIQUIS 30-Day Starter Pack 30-Day Starter Pack apixaban | Brand | Tier 3 | 0.2% coinsurance | Details |
| 18 | Vizimpro dacomitinib | Brand | Tier 5 | 0.3% coinsurance | Details |
| 19 | Tacrolimus | Brand | Tier 4 | 0.3% coinsurance | Details |
| 20 | Cobenfy xanomeline and trospium chloride | Brand | Tier 5 | 0.3% coinsurance | Details |
Showing 20 of 1,044 covered drugs.
States Served (1)
This plan is available to Medicare beneficiaries in the following states.
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