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Verified against CMS.gov · on Jul 1, 2026 Plan ID: H3655-045 Cross-check on Medicare.gov →

Anthem Medicare Advantage (HMO-POS)

Plan Year 2026
$0.00 /month
Monthly Premium
Among the lowest-premium plans in 2026
$275.00 Annual Deductible
1,022 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 Potassium Chloride potassium chloride Brand Tier 2 $0.00 Details
2 Xospata gilteritinib Brand Tier 5 0.3% coinsurance Details
3 Clozapine Brand Tier 4 0.3% coinsurance Details
4 Teflaro ceftaroline fosamil Brand Tier 5 0.3% coinsurance Details
5 ENTRESTO Sacubitril and Valsartan Brand Tier 3 0.3% coinsurance Details
6 FARXIGA DAPAGLIFLOZIN Brand Tier 3 0.3% coinsurance Details
7 RotaTeq Rotavirus Vaccine, Live, Oral, Pentavalent Brand Tier 6 $0.00 Details
8 Diazepam Brand Tier 2 $0.00 Details
9 Estradiol Brand Tier 1 $0.00 Details
10 Neomycin Sulfate Brand Tier 2 $0.00 Details
11 Tiagabine Hydrochloride Brand Tier 4 0.3% coinsurance Details
12 Talzenna talazoparib Brand Tier 5 0.3% coinsurance Details
13 Medroxyprogesterone Acetate Brand Tier 1 $0.00 Details
14 Aprepitant aprepitant Brand Tier 5 0.3% coinsurance Details
15 Nefazodone Hydrochloride Brand Tier 4 0.3% coinsurance Details
16 Levothyroxine Sodium levothyroxine sodium Brand Tier 6 $0.00 Details
17 Talzenna talazoparib Brand Tier 5 0.3% coinsurance Details
18 RECOMBIVAX HB Hepatitis B Vaccine (Recombinant) Brand Tier 6 $0.00 Details
19 Acamprosate Calcium acamprosate calcium enteric-coated Brand Tier 4 0.3% coinsurance Details
20 Dexamethasone Brand Tier 2 $0.00 Details

Showing 20 of 1,022 covered drugs.

Compare this plan against others for your medications Enter your drugs and ZIP to see personalized out-of-pocket costs.
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States Served (1)

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

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