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Verified against CMS.gov · on Apr 1, 2026 Plan ID: H5945-001 Cross-check on Medicare.gov →

Prominence Plus (HMO)

Plan Year 2026
$0.00 /month
Monthly Premium
Among the lowest-premium plans in 2026
$275.00 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 Acamprosate Calcium acamprosate calcium enteric-coated Brand Tier 3 $0.00 Details
2 Amoxicillin Brand Tier 1 $0.00 Details
3 Ciprofloxacin Brand Tier 1 $0.00 Details
4 Risperidone Brand Tier 4 $0.00 Details
5 PIQRAY alpelisib Brand Tier 5 $0.00 Details
6 Trifluoperazine Hydrochloride Brand Tier 2 $0.00 Details
7 Mefloquine Hydrochloride Brand Tier 2 $0.00 Details
8 Imatinib Mesylate Brand Tier 3 $0.00 Details
9 Medroxyprogesterone Acetate Brand Tier 1 $0.00 Details
10 Mercaptopurine Brand Tier 2 $0.00 Details
11 Nefazodone Hydrochloride Brand Tier 4 $0.00 Details
12 Dicloxacillin Sodium Brand Tier 2 $0.00 Details
13 Rufinamide Brand Tier 5 $0.00 Details
14 Paxlovid nirmatrelvir and ritonavir Brand Tier 3 $0.00 Details
15 Warfarin Sodium Brand Tier 1 $0.00 Details
16 ISENTRESS RALTEGRAVIR Brand Tier 4 $0.00 Details
17 Nitroglycerin nitroglycerin Brand Tier 2 $0.00 Details
18 Tiagabine Hydrochloride Brand Tier 4 $0.00 Details
19 RETEVMO selpercatinib Brand Tier 5 $0.00 Details
20 Paxlovid nirmatrelvir and ritonavir Brand Tier 3 $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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