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Verified against CMS.gov · on Jul 1, 2026 Plan ID: H4286-005 Cross-check on Medicare.gov →

Leon MediMax (HMO D-SNP)

Plan Year 2026
$0.00 /month
Monthly Premium
Among the lowest-premium plans in 2026
$615.00 Annual Deductible
984 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 PIFELTRO doravirine Brand Tier 4 0.3% coinsurance Details
2 WELIREG belzutifan Brand Tier 4 0.3% coinsurance Details
3 PIQRAY alpelisib Brand Tier 4 0.3% coinsurance Details
4 Diltiazem Hydrochloride Brand Tier 1 0.2% coinsurance Details
5 GARDASIL 9 Human Papillomavirus 9-valent Vaccine, Recombinant Brand Tier 2 0.2% coinsurance Details
6 Diazepam Brand Tier 1 0.2% coinsurance Details
7 Doxepin Hydrochloride doxepin hydrochloride Brand Tier 1 0.2% coinsurance Details
8 Fludrocortisone Acetate FLUDROCORTISONE ACETATE Brand Tier 1 0.2% coinsurance Details
9 PredniSONE Brand Tier 1 0.2% coinsurance Details
10 Cyclosporine Modified Modified Cyclosporine Brand Tier 1 0.2% coinsurance Details
11 Cilostazol Brand Tier 1 0.2% coinsurance Details
12 Loxapine Brand Tier 1 0.2% coinsurance Details
13 Nefazodone Hydrochloride Brand Tier 1 0.2% coinsurance Details
14 TABRECTA capmatinib Brand Tier 4 0.3% coinsurance Details
15 Levothyroxine Sodium levothyroxine sodium Brand Tier 1 0.2% coinsurance Details
16 Talzenna talazoparib Brand Tier 4 0.3% coinsurance Details
17 Cyclosporine Brand Tier 1 0.2% coinsurance Details
18 Cromolyn Sodium Brand Tier 1 0.2% coinsurance Details
19 Clarithromycin Brand Tier 1 0.2% coinsurance Details
20 Pioglitazone Brand Tier 1 0.2% coinsurance Details

Showing 20 of 984 covered drugs.

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States Served (1)

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

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