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Verified against CMS.gov · on April 2026 Plan ID: H1692-005 Cross-check on Medicare.gov →

Aetna Medicare Advantra Dual (HMO D-SNP)

Plan Year 2026
$0.00 /month
Monthly Premium
Among the lowest-premium plans in 2026
$615.00 Annual Deductible
1,055 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 Buspirone Hydrochloride Brand Tier 1 $0.00 Details
2 Trifluoperazine Hydrochloride trifluoperazine hydrochloride Brand Tier 3 $0.00 Details
3 ZEJULA niraparib Brand Tier 5 $0.00 Details
4 Warfarin Sodium Brand Tier 1 $0.00 Details
5 Ipratropium Bromide Brand Tier 2 $0.00 Details
6 Tacrolimus Brand Tier 4 $0.00 Details
7 SCEMBLIX asciminib Brand Tier 5 $0.00 Details
8 Dicyclomine Dicyclomine hydrochloride Brand Tier 2 $0.00 Details
9 RETEVMO selpercatinib Brand Tier 5 $0.00 Details
10 Aprepitant aprepitant Brand Tier 5 $0.00 Details
11 TABRECTA capmatinib Brand Tier 5 $0.00 Details
12 Amoxapine Brand Tier 3 $0.00 Details
13 PedvaxHIB Haemophilus b Conjugate Vaccine (Meningococcal Protein Conjugate) Brand Tier 1 $0.00 Details
14 Levothyroxine Sodium levothyroxine sodium Brand Tier 1 $0.00 Details
15 Ibrance palbociclib Brand Tier 5 $0.00 Details
16 Fluvoxamine maleate Brand Tier 2 $0.00 Details
17 Isosorbide Dinitrate Brand Tier 2 $0.00 Details
18 Nitroglycerin nitroglycerin Brand Tier 2 $0.00 Details
19 Isoniazid Brand Tier 1 $0.00 Details
20 Chlorpromazine Hydrochloride Brand Tier 4 $0.00 Details

Showing 20 of 1,055 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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