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Verified against CMS.gov · on Apr 1, 2026 Plan ID: H5119-001 Cross-check on Medicare.gov →

Contra Costa Health Care Plus (HMO D-SNP)

Plan Year 2026
$0.00 /month
Monthly Premium
Among the lowest-premium plans in 2026
$615.00 Annual Deductible
1,085 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 VAQTA hepatitis A vaccine, inactivated Brand Tier 6 $0.00 Details
2 Cabergoline Brand Tier 2 $0.00 Details
3 Thioridazine Hydrochloride thioridazine hydrochloride Brand Tier 2 $0.00 Details
4 Daurismo glasdegib Brand Tier 5 $0.00 Details
5 Methotrexate Brand Tier 2 $0.00 Details
6 GARDASIL 9 Human Papillomavirus 9-valent Vaccine, Recombinant Brand Tier 6 $0.00 Details
7 Nitroglycerin nitroglycerin Brand Tier 2 $0.00 Details
8 Levothyroxine Sodium levothyroxine sodium Brand Tier 1 $0.00 Details
9 M-M-R II measles, mumps, and rubella virus vaccine live Brand Tier 6 $0.00 Details
10 Phenobarbital Brand Tier 2 $0.00 Details
11 Methylphenidate Hydrochloride Brand Tier 2 $0.00 Details
12 Mekinist trametinib Brand Tier 5 $0.00 Details
13 PENBRAYA meningococcal groups a, b, c, w, and y vaccine Brand Tier 6 $0.00 Details
14 Acarbose Brand Tier 2 $0.00 Details
15 Hydrochlorothiazide Brand Tier 1 $0.00 Details
16 Teflaro ceftaroline fosamil Brand Tier 5 $0.00 Details
17 Erlotinib Brand Tier 5 $0.00 Details
18 Imatinib Mesylate Brand Tier 2 $0.00 Details
19 TAGRISSO osimertinib Brand Tier 5 $0.00 Details
20 Fluphenazine Hydrochloride Brand Tier 2 $0.00 Details

Showing 20 of 1,085 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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