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Verified against CMS.gov · on Apr 1, 2026 Plan ID: H4232-003 Cross-check on Medicare.gov →

American Health Advantage of Idaho (HMO I-SNP)

Plan Year 2026
$37.60 /month
Monthly Premium
$615.00 Annual Deductible
975 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 Augtyro repotrectinib Brand Tier 1 $0.00 Details
2 Bupropion Hydrochloride SR SR bupropion hydrochloride Brand Tier 1 $0.00 Details
3 ETHOSUXIMIDE Brand Tier 1 $0.00 Details
4 Venlafaxine Hydrochloride Brand Tier 1 $0.00 Details
5 Nefazodone Hydrochloride Brand Tier 1 $0.00 Details
6 Fluvoxamine maleate Brand Tier 1 $0.00 Details
7 Diazepam Brand Tier 1 $0.00 Details
8 Fetzima LEVOMILNACIPRAN HYDROCHLORIDE Brand Tier 1 $0.00 Details
9 Lenalidomide Brand Tier 1 $0.00 Details
10 Haloperidol Brand Tier 1 $0.00 Details
11 Estradiol Brand Tier 1 $0.00 Details
12 Fluphenazine Hydrochloride Brand Tier 1 $0.00 Details
13 Nitroglycerin nitroglycerin Brand Tier 1 $0.00 Details
14 KISQALI ribociclib Brand Tier 1 $0.00 Details
15 Mekinist trametinib Brand Tier 1 $0.00 Details
16 FARXIGA DAPAGLIFLOZIN Brand Tier 1 $0.00 Details
17 Scopolamine scopolamine Brand Tier 1 $0.00 Details
18 Pilocarpine Hydrochloride Brand Tier 1 $0.00 Details
19 Ciprofloxacin Brand Tier 1 $0.00 Details
20 Warfarin Sodium Brand Tier 1 $0.00 Details

Showing 20 of 975 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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