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Verified against CMS.gov · on Apr 1, 2026 Plan ID: H2962-025 Cross-check on Medicare.gov →

Advantage Care COPD by Ultimate (HMO C-SNP)

Plan Year 2026
$0.00 /month
Monthly Premium
Among the lowest-premium plans in 2026
$0.00 Annual Deductible
962 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 SCEMBLIX asciminib Brand Tier 5 $0.00 Details
2 Haloperidol Brand Tier 2 $0.00 Details
3 Ofev nintedanib Brand Tier 5 $0.00 Details
4 Fetzima LEVOMILNACIPRAN HYDROCHLORIDE Brand Tier 4 $0.00 Details
5 Ofev nintedanib Brand Tier 5 $0.00 Details
6 Valsartan valsartan Brand Tier 2 $0.00 Details
7 Cabergoline Brand Tier 3 $0.00 Details
8 Everolimus Brand Tier 5 $0.00 Details
9 Vizimpro dacomitinib Brand Tier 5 $0.00 Details
10 Amoxapine Brand Tier 4 $0.00 Details
11 JANUVIA sitagliptin Brand Tier 6 $0.00 Details
12 Doxepin Hydrochloride doxepin hydrochloride Brand Tier 3 $0.00 Details
13 Estradiol Brand Tier 2 $0.00 Details
14 Valsartan valsartan Brand Tier 2 $0.00 Details
15 Dicyclomine Hydrochloride Brand Tier 2 $0.00 Details
16 Warfarin Sodium Brand Tier 1 $0.00 Details
17 FARXIGA DAPAGLIFLOZIN Brand Tier 6 $0.00 Details
18 VAQTA hepatitis A vaccine, inactivated Brand Tier 3 $0.00 Details
19 Dexamethasone Brand Tier 2 $0.00 Details
20 KOSELUGO SELUMETINIB Brand Tier 5 $0.00 Details

Showing 20 of 962 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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