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Verified against CMS.gov · on Jul 1, 2026 Plan ID: H8390-017 Cross-check on Medicare.gov →

CareSource Dual Advantage Plus (HMO D-SNP)

Plan Year 2026
$0.00 /month
Monthly Premium
Among the lowest-premium plans in 2026
$615.00 Annual Deductible
968 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 SCEMBLIX asciminib Brand Tier 5 $0.00 Details
2 Fluphenazine Hydrochloride Brand Tier 4 $0.00 Details
3 Ofev nintedanib Brand Tier 5 $0.00 Details
4 Ciprofloxacin in Dextrose ciprofloxacin Brand Tier 4 $0.00 Details
5 Ofev nintedanib Brand Tier 5 $0.00 Details
6 Nicotrol nicotine Brand Tier 4 $0.00 Details
7 Valsartan valsartan Brand Tier 1 $0.00 Details
8 Clonidine Hydrochloride Brand Tier 1 $0.00 Details
9 Gilotrif afatinib Brand Tier 5 $0.00 Details
10 Phenobarbital Brand Tier 3 $0.00 Details
11 Leucovorin Calcium Brand Tier 3 $0.00 Details
12 ZEJULA niraparib Brand Tier 5 $0.00 Details
13 Estradiol Brand Tier 4 $0.00 Details
14 Levothyroxine Sodium levothyroxine sodium Brand Tier 1 $0.00 Details
15 Medroxyprogesterone Acetate Brand Tier 2 $0.00 Details
16 Warfarin Sodium Brand Tier 1 $0.00 Details
17 Hydrochlorothiazide Brand Tier 1 $0.00 Details
18 Paxlovid nirmatrelvir and ritonavir Brand Tier 2 $0.00 Details
19 INLYTA axitinib Brand Tier 5 $0.00 Details
20 DELSTRIGO doravirine, lamivudine, and tenofovir disoproxil fumarate Brand Tier 5 $0.00 Details

Showing 20 of 968 covered drugs.

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States Served (1)

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

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