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Verified against CMS.gov · on April 2026 Plan ID: H5594-031 Cross-check on Medicare.gov →

Optimum Diamond Savings COPD (HMO C-SNP)

Plan Year 2026
$0.00 /month
Monthly Premium
Among the lowest-premium plans in 2026
$0.00 Annual Deductible
964 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 Dexamethasone Brand Tier 1 $0.00 Details
2 Budesonide Brand Tier 3 $85.00 Details
3 CALQUENCE acalabrutinib Brand Tier 4 0.3% coinsurance Details
4 Amoxicillin and Clavulanate Potassium Brand Tier 1 $0.00 Details
5 Haloperidol Brand Tier 1 $0.00 Details
6 Combivent Respimat ipratropium bromide and albuterol Brand Tier 3 $85.00 Details
7 Fiasp insulin aspart injection Brand Tier 2 $35.00 Details
8 Amoxicillin and Clavulanate Potassium Brand Tier 1 $0.00 Details
9 Isosorbide Dinitrate Brand Tier 1 $0.00 Details
10 Enoxaparin Sodium Enoxaparin sodium Brand Tier 3 $85.00 Details
11 Digoxin Brand Tier 1 $0.00 Details
12 Carbidopa and levodopa Brand Tier 1 $0.00 Details
13 Everolimus Brand Tier 4 0.3% coinsurance Details
14 Vizimpro dacomitinib Brand Tier 4 0.3% coinsurance Details
15 Heparin Sodium Brand Tier 2 $35.00 Details
16 Diazepam Brand Tier 1 $0.00 Details
17 Lenalidomide Brand Tier 4 0.3% coinsurance Details
18 Risperidone Brand Tier 4 0.3% coinsurance Details
19 SCEMBLIX asciminib Brand Tier 4 0.3% coinsurance Details
20 Estradiol Brand Tier 1 $0.00 Details

Showing 20 of 964 covered drugs.

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States Served (1)

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

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