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Verified against CMS.gov · on Apr 1, 2026 Plan ID: H5471-141 Cross-check on Medicare.gov →

Simply Integrated Platinum (HMO D-SNP)

Plan Year 2026
$0.00 /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 Verzenio abemaciclib Brand Tier 5 $0.00 Details
2 Venclexta Venetoclax Brand Tier 5 $0.00 Details
3 TABRECTA capmatinib Brand Tier 5 $0.00 Details
4 FARXIGA DAPAGLIFLOZIN Brand Tier 3 $0.00 Details
5 Cabergoline Brand Tier 2 $0.00 Details
6 ZEJULA niraparib Brand Tier 5 $0.00 Details
7 Metoprolol Tartrate metoprolol tartrate Brand Tier 1 $0.00 Details
8 bexarotene Brand Tier 5 $0.00 Details
9 Dexamethasone Brand Tier 1 $0.00 Details
10 Fludrocortisone Acetate FLUDROCORTISONE ACETATE Brand Tier 1 $0.00 Details
11 Thioridazine Hydrochloride thioridazine hydrochloride Brand Tier 2 $0.00 Details
12 Ceftriaxone Sodium Brand Tier 2 $0.00 Details
13 Ibrance palbociclib Brand Tier 5 $0.00 Details
14 VAQTA hepatitis A vaccine, inactivated Brand Tier 1 $0.00 Details
15 Xalkori CRIZOTINIB Brand Tier 5 $0.00 Details
16 Chlorpromazine Hydrochloride Brand Tier 2 $0.00 Details
17 Warfarin Sodium Brand Tier 1 $0.00 Details
18 Metoclopramide Brand Tier 1 $0.00 Details
19 JAYPIRCA pirtobrutinib Brand Tier 5 $0.00 Details
20 Talzenna talazoparib Brand Tier 5 $0.00 Details

Showing 20 of 1,025 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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