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Verified against CMS.gov · on April 2026 Plan ID: H4161-007 Cross-check on Medicare.gov →

Anthem Prime (HMO-POS)

Plan Year 2026
$0.00 /month
Monthly Premium
Among the lowest-premium plans in 2026
$255.00 Annual Deductible
1,017 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 EVOTAZ atazanavir and cobicistat Brand Tier 5 0.3% coinsurance Details
2 Mercaptopurine Brand Tier 2 $0.00 Details
3 Buspirone Hydrochloride Brand Tier 2 $0.00 Details
4 Metoprolol Tartrate metoprolol tartrate Brand Tier 1 $0.00 Details
5 Daurismo glasdegib Brand Tier 5 0.3% coinsurance Details
6 Ciprofloxacin Brand Tier 1 $0.00 Details
7 CALQUENCE acalabrutinib Brand Tier 5 0.3% coinsurance Details
8 Cyclosporine Modified Modified Cyclosporine Brand Tier 2 $0.00 Details
9 Fludrocortisone Acetate FLUDROCORTISONE ACETATE Brand Tier 2 $0.00 Details
10 Calcipotriene Brand Tier 4 0.3% coinsurance Details
11 COARTEM artemether and lumefantrine Brand Tier 4 0.3% coinsurance Details
12 DELSTRIGO doravirine, lamivudine, and tenofovir disoproxil fumarate Brand Tier 5 0.3% coinsurance Details
13 Heparin Sodium Brand Tier 2 $0.00 Details
14 Pyridostigmine Bromide PYRIDOSTIGMINE BROMIDE Brand Tier 2 $0.00 Details
15 Linzess linaclotide Brand Tier 3 0.3% coinsurance Details
16 Loxapine Brand Tier 2 $0.00 Details
17 PIQRAY alpelisib Brand Tier 5 0.3% coinsurance Details
18 Metoclopramide Brand Tier 2 $0.00 Details
19 Buprenorphine Brand Tier 2 $0.00 Details
20 Talzenna talazoparib Brand Tier 5 0.3% coinsurance Details

Showing 20 of 1,017 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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