Simply Complete (HMO D-SNP)
$4.80 /month
Monthly Premium
Among the lowest-premium plans in 2026
$615.00
Annual Deductible
1,025
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 | Talzenna talazoparib | Brand | Tier 5 | $0.00 | Details |
| 2 | GARDASIL 9 Human Papillomavirus 9-valent Vaccine, Recombinant | Brand | Tier 1 | $0.00 | Details |
| 3 | Medroxyprogesterone Acetate | Brand | Tier 1 | $0.00 | Details |
| 4 | Aptivus tipranavir | Brand | Tier 5 | $0.00 | Details |
| 5 | Isosorbide Dinitrate | Brand | Tier 1 | $0.00 | Details |
| 6 | Enoxaparin Sodium Enoxaparin sodium | Brand | Tier 2 | $0.00 | Details |
| 7 | Exemestane | Brand | Tier 2 | $0.00 | Details |
| 8 | Nefazodone Hydrochloride | Brand | Tier 2 | $0.00 | Details |
| 9 | Fiasp insulin aspart injection | Brand | Tier 3 | $0.00 | Details |
| 10 | Balsalazide Disodium | Brand | Tier 2 | $0.00 | Details |
| 11 | MERCAPTOPURINE | Brand | Tier 5 | $0.00 | Details |
| 12 | Diltiazem Hydrochloride | Brand | Tier 1 | $0.00 | Details |
| 13 | TAGRISSO osimertinib | Brand | Tier 5 | $0.00 | Details |
| 14 | Fluphenazine Hydrochloride | Brand | Tier 1 | $0.00 | Details |
| 15 | Xalkori CRIZOTINIB | Brand | Tier 5 | $0.00 | Details |
| 16 | ZEJULA niraparib | Brand | Tier 5 | $0.00 | Details |
| 17 | amiloride hydrochloride | Brand | Tier 1 | $0.00 | Details |
| 18 | Warfarin Sodium | Brand | Tier 1 | $0.00 | Details |
| 19 | PIFELTRO doravirine | Brand | Tier 5 | $0.00 | Details |
| 20 | Xtandi enzalutamide | Brand | Tier 5 | $0.00 | Details |
Showing 20 of 1,025 covered drugs.
States Served (1)
This plan is available to Medicare beneficiaries in the following states.
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