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Verified against CMS.gov · on July 2026 Plan ID: H5991-013 Cross-check on Medicare.gov →

EmblemHealth VIP Dual Enhanced (HMO D-SNP)

Plan Year 2026
$0.00 /month
Monthly Premium
Among the lowest-premium plans in 2026
$615.00 Annual Deductible
928 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 JAYPIRCA pirtobrutinib Brand Tier 5 $0.00 Details
2 Cefuroxime Brand Tier 4 $0.00 Details
3 Everolimus Brand Tier 5 $0.00 Details
4 RECOMBIVAX HB Hepatitis B Vaccine (Recombinant) Brand Tier 6 $0.00 Details
5 Fluphenazine Hydrochloride Brand Tier 4 $0.00 Details
6 Dupixent Dupilumab Brand Tier 5 $0.00 Details
7 Gilotrif afatinib Brand Tier 5 $0.00 Details
8 JANUVIA sitagliptin Brand Tier 3 $0.00 Details
9 Tacrolimus Brand Tier 4 $0.00 Details
10 RETEVMO selpercatinib Brand Tier 5 $0.00 Details
11 Warfarin Sodium Brand Tier 1 $0.00 Details
12 Mefloquine Hydrochloride Brand Tier 3 $0.00 Details
13 Rufinamide Brand Tier 4 $0.00 Details
14 Atomoxetine Brand Tier 4 $0.00 Details
15 COARTEM artemether and lumefantrine Brand Tier 4 $0.00 Details
16 Fetzima LEVOMILNACIPRAN HYDROCHLORIDE Brand Tier 4 $0.00 Details
17 FARXIGA DAPAGLIFLOZIN Brand Tier 3 $0.00 Details
18 Phenobarbital Brand Tier 3 $0.00 Details
19 Lorbrena lorlatinib Brand Tier 5 $0.00 Details
20 Lenalidomide Brand Tier 5 $0.00 Details

Showing 20 of 928 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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