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Verified against CMS.gov · on Apr 1, 2026 Plan ID: H0738-002 Cross-check on Medicare.gov →

AmeriHealth Caritas VIP Care Choice (HMO D-SNP)

Plan Year 2026
$0.00 /month
Monthly Premium
Among the lowest-premium plans in 2026
$615.00 Annual Deductible
1,071 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 Abrysvo Respiratory Syncytial Virus Vaccine Brand Tier 6 $0.00 Details
2 DELSTRIGO doravirine, lamivudine, and tenofovir disoproxil fumarate Brand Tier 5 $0.00 Details
3 Dexamethasone Brand Tier 1 $0.00 Details
4 MERCAPTOPURINE Brand Tier 5 $0.00 Details
5 Heparin Sodium Brand Tier 2 $0.00 Details
6 Diazepam Brand Tier 2 $0.00 Details
7 NOVOLOG insulin aspart Brand Tier 3 $0.00 Details
8 ZYKADIA ceritinib Brand Tier 5 $0.00 Details
9 ZEJULA niraparib Brand Tier 5 $0.00 Details
10 Cilostazol Brand Tier 1 $0.00 Details
11 SCEMBLIX asciminib Brand Tier 5 $0.00 Details
12 REYATAZ ATAZANAVIR Brand Tier 4 $0.00 Details
13 Cabergoline Brand Tier 2 $0.00 Details
14 Levothyroxine Sodium levothyroxine sodium Brand Tier 1 $0.00 Details
15 BOSULIF Bosutinib Brand Tier 5 $0.00 Details
16 ISENTRESS RALTEGRAVIR Brand Tier 4 $0.00 Details
17 Phenobarbital Brand Tier 2 $0.00 Details
18 Verzenio abemaciclib Brand Tier 5 $0.00 Details
19 Chlorpromazine Hydrochloride Brand Tier 2 $0.00 Details
20 Tiagabine Hydrochloride Brand Tier 2 $0.00 Details

Showing 20 of 1,071 covered drugs.

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States Served (1)

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

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