Skip to main content
Verified against CMS.gov · on Apr 1, 2026 Plan ID: H3660-050 Cross-check on Medicare.gov →

SummaCare Medicare Topaz (HMO)

Plan Year 2026
$0.00 /month
Monthly Premium
Among the lowest-premium plans in 2026
$300.00 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 Primaquine Phosphate Brand Tier 4 0.4% coinsurance Details
2 TRUQAP capivasertib Brand Tier 5 0.3% coinsurance Details
3 Amoxicillin and Clavulanate Potassium Brand Tier 3 0.2% coinsurance Details
4 Fluphenazine Hydrochloride Brand Tier 4 0.4% coinsurance Details
5 Fluphenazine Hydrochloride Brand Tier 4 0.4% coinsurance Details
6 Cilostazol Brand Tier 2 $0.00 Details
7 Nitroglycerin nitroglycerin Brand Tier 3 0.2% coinsurance Details
8 RETEVMO selpercatinib Brand Tier 5 0.3% coinsurance Details
9 TABRECTA capmatinib Brand Tier 5 0.3% coinsurance Details
10 KOSELUGO SELUMETINIB Brand Tier 5 0.3% coinsurance Details
11 PedvaxHIB Haemophilus b Conjugate Vaccine (Meningococcal Protein Conjugate) Brand Tier 3 0.2% coinsurance Details
12 ISENTRESS RALTEGRAVIR Brand Tier 3 0.2% coinsurance Details
13 Linzess linaclotide Brand Tier 3 0.2% coinsurance Details
14 Everolimus Brand Tier 5 0.3% coinsurance Details
15 Ibrance palbociclib Brand Tier 5 0.3% coinsurance Details
16 Vizimpro dacomitinib Brand Tier 5 0.3% coinsurance Details
17 Diazepam Brand Tier 1 $0.00 Details
18 NOVOLOG insulin aspart Brand Tier 3 0.2% coinsurance Details
19 PredniSONE Brand Tier 1 $0.00 Details
20 Fetzima LEVOMILNACIPRAN HYDROCHLORIDE Brand Tier 4 0.4% coinsurance Details

Showing 20 of 1,057 covered drugs.

Compare this plan against others for your medications Enter your drugs and ZIP to see personalized out-of-pocket costs.
Compare Plans →

States Served (1)

This plan is available to Medicare beneficiaries in the following states.

Find Your Best Medicare Plan for 2026

Compare plans side-by-side with the help of a licensed Medicare specialist. Free service — no obligation.

Compare Medicare Plans Free
  • ✓ Compare all plans in your area
  • ✓ Licensed agents available 7 days a week
  • ✓ No cost, no obligation

We may receive a referral fee if you enroll through this link. DrugCovered is not affiliated with Medicare or any government agency. Plan availability and costs vary by ZIP code. Not all plans may be available in your area.