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Verified against CMS.gov · on April 2026 Plan ID: H4004-048 Cross-check on Medicare.gov →

PMC Premier Platino (HMO D-SNP)

Plan Year 2026
$0.00 /month
Monthly Premium
Among the lowest-premium plans in 2026
$615.00 Annual Deductible
1,036 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 Nicotrol nicotine Brand Tier 3 $0.00 Details
2 COARTEM artemether and lumefantrine Brand Tier 4 $0.00 Details
3 Gilotrif afatinib Brand Tier 6 $0.00 Details
4 Clozapine Brand Tier 2 $0.00 Details
5 ELIQUIS 30-Day Starter Pack 30-Day Starter Pack apixaban Brand Tier 3 $0.00 Details
6 Verzenio abemaciclib Brand Tier 5 $0.00 Details
7 Atomoxetine Brand Tier 2 $0.00 Details
8 Fetzima LEVOMILNACIPRAN HYDROCHLORIDE Brand Tier 3 $0.00 Details
9 Ofev nintedanib Brand Tier 5 $0.00 Details
10 TRETINOIN tretinoin Brand Tier 2 $0.00 Details
11 KOSELUGO SELUMETINIB Brand Tier 6 $0.00 Details
12 Nefazodone Hydrochloride Brand Tier 2 $0.00 Details
13 TRUQAP capivasertib Brand Tier 6 $0.00 Details
14 Estradiol Brand Tier 2 $0.00 Details
15 Depo-SubQ Provera medroxyprogesterone acetate Brand Tier 3 $0.00 Details
16 Valsartan valsartan Brand Tier 1 $0.00 Details
17 Estradiol Brand Tier 2 $0.00 Details
18 BOSULIF Bosutinib Brand Tier 6 $0.00 Details
19 VERQUVO vericiguat Brand Tier 3 $0.00 Details
20 JANUVIA sitagliptin Brand Tier 3 $0.00 Details

Showing 20 of 1,036 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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