SummaCare Medicare Garnet (HMO)
$35.00 /month
Monthly Premium
$250.00
Annual Deductible
1,057
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 | TABRECTA capmatinib | Brand | Tier 5 | 0.3% coinsurance | Details |
| 2 | Diltiazem Hydrochloride | Brand | Tier 2 | $0.00 | Details |
| 3 | Verzenio abemaciclib | Brand | Tier 5 | 0.3% coinsurance | Details |
| 4 | Risperidone | Brand | Tier 5 | 0.3% coinsurance | Details |
| 5 | Prograf Tacrolimus | Brand | Tier 4 | 0.4% coinsurance | Details |
| 6 | Chlorpromazine Hydrochloride | Brand | Tier 4 | 0.4% coinsurance | Details |
| 7 | Talzenna talazoparib | Brand | Tier 5 | 0.3% coinsurance | Details |
| 8 | Amoxapine | Brand | Tier 3 | 0.2% coinsurance | Details |
| 9 | Amoxapine | Brand | Tier 3 | 0.2% coinsurance | Details |
| 10 | Venlafaxine Hydrochloride | Brand | Tier 2 | $0.00 | Details |
| 11 | Cabergoline | Brand | Tier 3 | 0.2% coinsurance | Details |
| 12 | Everolimus | Brand | Tier 5 | 0.3% coinsurance | Details |
| 13 | Thioridazine Hydrochloride thioridazine hydrochloride | Brand | Tier 3 | 0.2% coinsurance | Details |
| 14 | Ibrance palbociclib | Brand | Tier 5 | 0.3% coinsurance | Details |
| 15 | Nitroglycerin nitroglycerin | Brand | Tier 3 | 0.2% coinsurance | Details |
| 16 | Dexamethasone | Brand | Tier 2 | $0.00 | Details |
| 17 | Chlorpromazine Hydrochloride | Brand | Tier 4 | 0.4% coinsurance | Details |
| 18 | Warfarin Sodium | Brand | Tier 1 | $0.00 | Details |
| 19 | Fluphenazine Hydrochloride | Brand | Tier 4 | 0.4% coinsurance | Details |
| 20 | Sodium Chloride | Brand | Tier 3 | 0.2% coinsurance | Details |
Showing 20 of 1,057 covered drugs.
States Served (1)
This plan is available to Medicare beneficiaries in the following states.
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