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Verified against CMS.gov · on April 2026 Plan ID: H5433-001 Cross-check on Medicare.gov →

CalOptima Health OneCare Complete (HMO D-SNP)

Plan Year 2026
$0.00 /month
Monthly Premium
Among the lowest-premium plans in 2026
$615.00 Annual Deductible
1,182 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 NOVOLOG insulin aspart Brand Tier 2 $0.00 Details
2 Ofev nintedanib Brand Tier 2 $0.00 Details
3 Mercaptopurine Brand Tier 1 $0.00 Details
4 Erlotinib Brand Tier 1 $0.00 Details
5 Teflaro ceftaroline fosamil Brand Tier 2 $0.00 Details
6 BOSULIF Bosutinib Brand Tier 2 $0.00 Details
7 Warfarin Sodium Brand Tier 1 $0.00 Details
8 Prochlorperazine Brand Tier 1 $0.00 Details
9 Dexamethasone Brand Tier 1 $0.00 Details
10 Tiagabine Hydrochloride Brand Tier 1 $0.00 Details
11 Levothyroxine Sodium levothyroxine sodium Brand Tier 1 $0.00 Details
12 Loxapine Brand Tier 1 $0.00 Details
13 Buspirone Hydrochloride Brand Tier 1 $0.00 Details
14 Trifluoperazine Hydrochloride trifluoperazine hydrochloride Brand Tier 1 $0.00 Details
15 Exemestane Brand Tier 1 $0.00 Details
16 Diltiazem Hydrochloride Brand Tier 1 $0.00 Details
17 Pilocarpine Hydrochloride Brand Tier 1 $0.00 Details
18 Emtricitabine, Rilpivirine, Tenofovir Disoproxil Fumarate Brand Tier 1 $0.00 Details
19 Phenobarbital Brand Tier 1 $0.00 Details
20 Levothyroxine Sodium levothyroxine sodium Brand Tier 1 $0.00 Details

Showing 20 of 1,182 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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