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Verified against CMS.gov · on April 2026 Plan ID: S5617-353 Cross-check on Medicare.gov →

HealthSpring Extra Rx (PDP)

Plan Year 2026
$91.60 /month
Monthly Premium
$615.00 Annual Deductible
939 Drugs Covered
0 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 PODOFILOX Brand Tier 4 0.3% coinsurance Details
2 Kaletra Lopinavir and Ritonavir Brand Tier 3 0.2% coinsurance Details
3 Augtyro repotrectinib Brand Tier 5 0.3% coinsurance Details
4 Verzenio abemaciclib Brand Tier 5 0.3% coinsurance Details
5 Dicloxacillin Sodium Brand Tier 3 0.2% coinsurance Details
6 Exemestane Brand Tier 4 0.3% coinsurance Details
7 Fetzima LEVOMILNACIPRAN HYDROCHLORIDE Brand Tier 4 0.3% coinsurance Details
8 Emtricitabine and Tenofovir Disoproxil Fumarate Brand Tier 4 0.3% coinsurance Details
9 Baclofen baclofen Brand Tier 2 $5.00 Details
10 Valsartan valsartan Brand Tier 1 $0.00 Details
11 Diazepam Brand Tier 2 $5.00 Details
12 Linzess linaclotide Brand Tier 4 0.3% coinsurance Details
13 SCEMBLIX asciminib Brand Tier 5 0.3% coinsurance Details
14 Loxapine Brand Tier 3 0.2% coinsurance Details
15 Thioridazine Hydrochloride thioridazine hydrochloride Brand Tier 3 0.2% coinsurance Details
16 ISENTRESS RALTEGRAVIR Brand Tier 4 0.3% coinsurance Details
17 Emtricitabine, Rilpivirine, Tenofovir Disoproxil Fumarate Brand Tier 5 0.3% coinsurance Details
18 Nefazodone Hydrochloride Brand Tier 4 0.3% coinsurance Details
19 Doxepin Hydrochloride doxepin hydrochloride Brand Tier 4 0.3% coinsurance Details
20 Venclexta Venetoclax Brand Tier 5 0.3% coinsurance Details

Showing 20 of 939 covered drugs.

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