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Verified against CMS.gov · on April 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 PENBRAYA meningococcal groups a, b, c, w, and y vaccine Brand Tier 6 See Plan Details
2 EVOTAZ atazanavir and cobicistat Brand Tier 5 See Plan Details
3 Ibrance palbociclib Brand Tier 5 See Plan Details
4 Cobenfy xanomeline and trospium chloride Brand Tier 5 See Plan Details
5 SOMAVERT pegvisomant Brand Tier 5 See Plan Details
6 Primaquine Phosphate Brand Tier 4 See Plan Details
7 Clarithromycin Brand Tier 3 See Plan Details
8 Diltiazem Hydrochloride Brand Tier 1 See Plan Details
9 Phenobarbital Brand Tier 2 See Plan Details
10 Dexamethasone Brand Tier 2 See Plan Details
11 Fludrocortisone Acetate FLUDROCORTISONE ACETATE Brand Tier 2 See Plan Details
12 Cobenfy xanomeline and trospium chloride Brand Tier 5 See Plan Details
13 Lorbrena lorlatinib Brand Tier 5 See Plan Details
14 PedvaxHIB Haemophilus b Conjugate Vaccine (Meningococcal Protein Conjugate) Brand Tier 6 See Plan Details
15 Baclofen baclofen Brand Tier 2 See Plan Details
16 Omeprazole Brand Tier 6 See Plan Details
17 Diazepam Brand Tier 2 See Plan Details
18 Loxapine Brand Tier 4 See Plan Details
19 Metoclopramide Brand Tier 1 See Plan Details
20 Depo-SubQ Provera medroxyprogesterone acetate Brand Tier 3 See Plan Details

Showing 20 of 1,022 covered drugs.

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