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Verified against CMS.gov · on Oct 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 Omeprazole Brand Tier 1 0.2% coinsurance Details
2 Lenalidomide Brand Tier 4 0.3% coinsurance Details
3 SCEMBLIX asciminib Brand Tier 4 0.3% coinsurance Details
4 Xalkori CRIZOTINIB Brand Tier 4 0.3% coinsurance Details
5 BOSULIF Bosutinib Brand Tier 4 0.3% coinsurance Details
6 Nicotrol nicotine Brand Tier 3 0.3% coinsurance Details
7 ISENTRESS RALTEGRAVIR Brand Tier 4 0.3% coinsurance Details
8 Mekinist trametinib Brand Tier 4 0.3% coinsurance Details
9 FARXIGA DAPAGLIFLOZIN Brand Tier 2 0.2% coinsurance Details
10 Balsalazide Disodium Brand Tier 1 0.2% coinsurance Details
11 BOSULIF Bosutinib Brand Tier 4 0.3% coinsurance Details
12 VAQTA hepatitis A vaccine, inactivated Brand Tier 2 0.2% coinsurance Details
13 Dexamethasone Brand Tier 1 0.2% coinsurance Details
14 Nitroglycerin nitroglycerin Brand Tier 1 0.2% coinsurance Details
15 Fluphenazine Hydrochloride Brand Tier 3 0.3% coinsurance Details
16 Estradiol Brand Tier 1 0.2% coinsurance Details
17 Clozapine Brand Tier 1 0.2% coinsurance Details
18 Dicloxacillin Sodium Brand Tier 1 0.2% coinsurance Details
19 Buspirone Hydrochloride Brand Tier 1 0.2% coinsurance Details
20 SOMAVERT pegvisomant Brand Tier 4 0.3% coinsurance Details

Showing 20 of 984 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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