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Verified against CMS.gov · on Oct 1, 2026 Plan ID: H5945-017 Cross-check on Medicare.gov →

Prominence Dual (HMO D-SNP)

Plan Year 2026
$0.00 /month
Monthly Premium
Among the lowest-premium plans in 2026
$615.00 Annual Deductible
988 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 Sodium Chloride Brand Tier 2 $0.00 Details
2 NITROGLYCERIN nitroglycerin Brand Tier 4 $0.00 Details
3 Dupixent Dupilumab Brand Tier 5 $0.00 Details
4 Ibrance palbociclib Brand Tier 5 $0.00 Details
5 Nicotrol nicotine Brand Tier 3 $0.00 Details
6 JANUVIA sitagliptin Brand Tier 3 $0.00 Details
7 Levothyroxine Sodium levothyroxine sodium Brand Tier 1 $0.00 Details
8 Dexamethasone Brand Tier 2 $0.00 Details
9 Ibrance palbociclib Brand Tier 5 $0.00 Details
10 Ibrance palbociclib Brand Tier 5 $0.00 Details
11 Dupixent Dupilumab Brand Tier 5 $0.00 Details
12 CRESEMBA isavuconazonium sulfate Brand Tier 5 $0.00 Details
13 Depo-SubQ Provera medroxyprogesterone acetate Brand Tier 3 $0.00 Details
14 Bromocriptine mesylate Brand Tier 2 $0.00 Details
15 Dicloxacillin Sodium Brand Tier 2 $0.00 Details
16 Morphine Sulfate Brand Tier 4 $0.00 Details
17 Fetzima LEVOMILNACIPRAN HYDROCHLORIDE Brand Tier 4 $0.00 Details
18 Clozapine Brand Tier 4 $0.00 Details
19 Balsalazide Disodium Brand Tier 2 $0.00 Details
20 Phenobarbital Oral Solution Phenobarbital Oral Brand Tier 4 $0.00 Details

Showing 20 of 988 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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