Astiva Health C-SNP Deluxe (HMO C-SNP)
$0.00 /month
Monthly Premium
Among the lowest-premium plans in 2026
$0.00
Annual Deductible
925
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 | FARXIGA DAPAGLIFLOZIN | Brand | Tier 3 | $0.00 | Details |
| 2 | Hydrocortisone | Brand | Tier 1 | $0.00 | Details |
| 3 | Abrysvo Respiratory Syncytial Virus Vaccine | Brand | Tier 3 | $0.00 | Details |
| 4 | Gilotrif afatinib | Brand | Tier 5 | $0.00 | Details |
| 5 | Levothyroxine Sodium levothyroxine sodium | Brand | Tier 1 | $0.00 | Details |
| 6 | Nortriptyline Hydrochloride | Brand | Tier 4 | $0.00 | Details |
| 7 | Estradiol | Brand | Tier 1 | $0.00 | Details |
| 8 | NOVOLOG insulin aspart | Brand | Tier 3 | $0.00 | Details |
| 9 | WELIREG belzutifan | Brand | Tier 5 | $0.00 | Details |
| 10 | Cabergoline | Brand | Tier 2 | $0.00 | Details |
| 11 | Rufinamide | Brand | Tier 2 | $0.00 | Details |
| 12 | RECOMBIVAX HB Hepatitis B Vaccine (Recombinant) | Brand | Tier 3 | $0.00 | Details |
| 13 | Vizimpro dacomitinib | Brand | Tier 5 | $0.00 | Details |
| 14 | Linzess linaclotide | Brand | Tier 3 | $0.00 | Details |
| 15 | Diltiazem Hydrochloride | Brand | Tier 1 | $0.00 | Details |
| 16 | Fluphenazine Hydrochloride | Brand | Tier 4 | $0.00 | Details |
| 17 | Haloperidol | Brand | Tier 2 | $0.00 | Details |
| 18 | JANUVIA sitagliptin | Brand | Tier 3 | $0.00 | Details |
| 19 | Fludrocortisone Acetate FLUDROCORTISONE ACETATE | Brand | Tier 1 | $0.00 | Details |
| 20 | KISQALI ribociclib | Brand | Tier 5 | $0.00 | Details |
Showing 20 of 925 covered drugs.
States Served (1)
This plan is available to Medicare beneficiaries in the following states.
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