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Verified against CMS.gov · on Apr 1, 2026 Plan ID: H4704-002 Cross-check on Medicare.gov →

Anthem Dual Advantage 2 (PPO D-SNP)

Plan Year 2026
$0.00 /month
Monthly Premium
Among the lowest-premium plans in 2026
$200.00 Annual Deductible
1,022 Drugs Covered
0 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 PIQRAY alpelisib Brand Tier 5 See Plan Details
2 Xalkori CRIZOTINIB Brand Tier 5 See Plan Details
3 Pyridostigmine Bromide PYRIDOSTIGMINE BROMIDE Brand Tier 3 See Plan Details
4 Lenalidomide Brand Tier 5 See Plan Details
5 Chlorpromazine Hydrochloride Brand Tier 4 See Plan Details
6 Levothyroxine Sodium levothyroxine sodium Brand Tier 6 See Plan Details
7 BOSULIF Bosutinib Brand Tier 5 See Plan Details
8 Dicyclomine Hydrochloride Brand Tier 1 See Plan Details
9 SCEMBLIX asciminib Brand Tier 5 See Plan Details
10 Danazol Brand Tier 4 See Plan Details
11 Carbidopa and levodopa Brand Tier 2 See Plan Details
12 Diazepam Brand Tier 2 See Plan Details
13 MERCAPTOPURINE Brand Tier 5 See Plan Details
14 Sulfasalazine Brand Tier 2 See Plan Details
15 Scopolamine scopolamine Brand Tier 4 See Plan Details
16 RETEVMO selpercatinib Brand Tier 5 See Plan Details
17 Diazepam Intensol Brand Tier 2 See Plan Details
18 Haloperidol Brand Tier 2 See Plan Details
19 Atomoxetine Brand Tier 4 See Plan Details
20 Amoxapine Brand Tier 2 See Plan Details

Showing 20 of 1,022 covered drugs.

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