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Verified against CMS.gov · on April 2026 Plan ID: H4471-005 Cross-check on Medicare.gov →

Anthem Dual Advantage (HMO D-SNP)

Plan Year 2026
$0.00 /month
Monthly Premium
Among the lowest-premium plans in 2026
$105.00 Annual Deductible
1,017 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 Nefazodone Hydrochloride Brand Tier 2 See Plan Details
2 Diltiazem Hydrochloride Brand Tier 2 See Plan Details
3 Fluphenazine Hydrochloride Brand Tier 2 See Plan Details
4 Haloperidol Brand Tier 2 See Plan Details
5 Phenobarbital Brand Tier 2 See Plan Details
6 EVOTAZ atazanavir and cobicistat Brand Tier 5 See Plan Details
7 Mercaptopurine Brand Tier 2 See Plan Details
8 Buspirone Hydrochloride Brand Tier 2 See Plan Details
9 Metoprolol Tartrate metoprolol tartrate Brand Tier 1 See Plan Details
10 Daurismo glasdegib Brand Tier 5 See Plan Details
11 Ciprofloxacin Brand Tier 1 See Plan Details
12 CALQUENCE acalabrutinib Brand Tier 5 See Plan Details
13 Cyclosporine Modified Modified Cyclosporine Brand Tier 2 See Plan Details
14 Fludrocortisone Acetate FLUDROCORTISONE ACETATE Brand Tier 2 See Plan Details
15 Calcipotriene Brand Tier 4 See Plan Details
16 COARTEM artemether and lumefantrine Brand Tier 4 See Plan Details
17 DELSTRIGO doravirine, lamivudine, and tenofovir disoproxil fumarate Brand Tier 5 See Plan Details
18 Heparin Sodium Brand Tier 2 See Plan Details
19 Pyridostigmine Bromide PYRIDOSTIGMINE BROMIDE Brand Tier 2 See Plan Details
20 Linzess linaclotide Brand Tier 3 See Plan Details

Showing 20 of 1,017 covered drugs.

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