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Verified against CMS.gov · on April 2026 Plan ID: H4733-001 Cross-check on Medicare.gov →

CommuniCare Advantage (HMO D-SNP)

Plan Year 2026
$0.00 /month
Monthly Premium
Among the lowest-premium plans in 2026
$615.00 Annual Deductible
930 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 Gentamicin Sulfate Brand Tier 2 $0.00 Details
2 Fetzima LEVOMILNACIPRAN HYDROCHLORIDE Brand Tier 4 $0.00 Details
3 Xtandi enzalutamide Brand Tier 5 $0.00 Details
4 Efavirenz, Emtricitabine and Tenofovir Disoproxil Fumarate Brand Tier 2 $0.00 Details
5 KISQALI ribociclib Brand Tier 5 $0.00 Details
6 Verzenio abemaciclib Brand Tier 5 $0.00 Details
7 Atomoxetine Brand Tier 2 $0.00 Details
8 Fetzima LEVOMILNACIPRAN HYDROCHLORIDE Brand Tier 4 $0.00 Details
9 Mifepristone Brand Tier 5 $0.00 Details
10 GARDASIL 9 Human Papillomavirus 9-valent Vaccine, Recombinant Brand Tier 3 $0.00 Details
11 Ibrance palbociclib Brand Tier 5 $0.00 Details
12 Dexamethasone Brand Tier 2 $0.00 Details
13 Pilocarpine Hydrochloride Brand Tier 2 $0.00 Details
14 Warfarin Sodium Brand Tier 1 $0.00 Details
15 Levothyroxine Sodium levothyroxine sodium Brand Tier 1 $0.00 Details
16 Amoxicillin and Clavulanate Potassium Brand Tier 2 $0.00 Details
17 Hydrocortisone Brand Tier 1 $0.00 Details
18 Levothyroxine Sodium levothyroxine sodium Brand Tier 1 $0.00 Details
19 ISENTRESS RALTEGRAVIR Brand Tier 5 $0.00 Details
20 PredniSONE Brand Tier 1 $0.00 Details

Showing 20 of 930 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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