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Verified against CMS.gov · on Apr 1, 2026 Plan ID: H0628-018 Cross-check on Medicare.gov →

Aetna Medicare Longevity (HMO I-SNP)

Plan Year 2026
$31.40 /month
Monthly Premium
$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 RYDAPT Brand Tier 5 $0.00 Details
2 Talzenna talazoparib Brand Tier 5 $0.00 Details
3 Dexamethasone Brand Tier 4 $0.00 Details
4 Tafinlar dabrafenib Brand Tier 5 $0.00 Details
5 Budesonide Brand Tier 4 $0.00 Details
6 Warfarin Sodium Brand Tier 1 $0.00 Details
7 EVOTAZ atazanavir and cobicistat Brand Tier 5 $0.00 Details
8 Diltiazem Hydrochloride Brand Tier 2 $0.00 Details
9 KOSELUGO SELUMETINIB Brand Tier 5 $0.00 Details
10 Digoxin Brand Tier 2 $0.00 Details
11 Dexamethasone Brand Tier 4 $0.00 Details
12 Everolimus Brand Tier 5 $0.00 Details
13 Amoxicillin Brand Tier 1 $0.00 Details
14 Vizimpro dacomitinib Brand Tier 5 $0.00 Details
15 Xtandi enzalutamide Brand Tier 5 $0.00 Details
16 Fludrocortisone Acetate FLUDROCORTISONE ACETATE Brand Tier 2 $0.00 Details
17 Depo-SubQ Provera medroxyprogesterone acetate Brand Tier 3 $0.00 Details
18 Tafinlar dabrafenib Brand Tier 5 $0.00 Details
19 Venclexta Venetoclax Brand Tier 5 $0.00 Details
20 VERQUVO vericiguat Brand Tier 3 $0.00 Details

Showing 20 of 1,055 covered drugs.

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States Served (1)

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

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