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Verified against CMS.gov · on Jul 1, 2026 Plan ID: H4490-001 Cross-check on Medicare.gov →

American Health Advantage of Missouri (HMO I-SNP)

Plan Year 2026
$43.00 /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 Sulfasalazine Brand Tier 1 $0.00 Details
2 Vizimpro dacomitinib Brand Tier 1 $0.00 Details
3 Trifluoperazine Hydrochloride trifluoperazine hydrochloride Brand Tier 1 $0.00 Details
4 WINREVAIR SOTATERCEPT-CSRK Brand Tier 1 $0.00 Details
5 Ibrance palbociclib Brand Tier 1 $0.00 Details
6 Isosorbide Dinitrate Brand Tier 1 $0.00 Details
7 Enoxaparin Sodium Enoxaparin sodium Brand Tier 1 $0.00 Details
8 Carbidopa and levodopa Brand Tier 1 $0.00 Details
9 REYATAZ ATAZANAVIR Brand Tier 1 $0.00 Details
10 Emtricitabine, Rilpivirine, Tenofovir Disoproxil Fumarate Brand Tier 1 $0.00 Details
11 Everolimus Brand Tier 1 $0.00 Details
12 Daurismo glasdegib Brand Tier 1 $0.00 Details
13 NOVOLOG insulin aspart Brand Tier 1 $0.00 Details
14 Prograf Tacrolimus Brand Tier 1 $0.00 Details
15 SCEMBLIX asciminib Brand Tier 1 $0.00 Details
16 Spiriva Respimat tiotropium bromide inhalation spray Brand Tier 1 $0.00 Details
17 Xospata gilteritinib Brand Tier 1 $0.00 Details
18 Cilostazol Brand Tier 1 $0.00 Details
19 Nefazodone Hydrochloride Brand Tier 1 $0.00 Details
20 Morphine Sulfate Brand Tier 1 $0.00 Details

Showing 20 of 975 covered drugs.

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States Served (1)

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

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