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Verified against CMS.gov · on Oct 1, 2026 Plan ID: H5015-001 Cross-check on Medicare.gov →

Texas Independence Health Plan, Inc. (HMO I-SNP)

Plan Year 2026
$4.80 /month
Monthly Premium
Among the lowest-premium plans in 2026
$615.00 Annual Deductible
985 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 Neomycin Sulfate Brand Tier 1 $0.00 Details
2 Potassium Chloride Brand Tier 1 $0.00 Details
3 Jardiance Empagliflozin Brand Tier 1 $0.00 Details
4 Combivent Respimat ipratropium bromide and albuterol Brand Tier 1 $0.00 Details
5 Clonidine Hydrochloride Brand Tier 1 $0.00 Details
6 PredniSONE Brand Tier 1 $0.00 Details
7 Trelegy Ellipta fluticasone furoate, umeclidinium bromide and vilanterol trifenatate Brand Tier 1 $0.00 Details
8 Atomoxetine Brand Tier 1 $0.00 Details
9 Fetzima LEVOMILNACIPRAN HYDROCHLORIDE Brand Tier 1 $0.00 Details
10 Metoprolol Tartrate metoprolol tartrate Brand Tier 1 $0.00 Details
11 Balsalazide Disodium Brand Tier 1 $0.00 Details
12 Lorbrena lorlatinib Brand Tier 1 $0.00 Details
13 Amoxicillin Brand Tier 1 $0.00 Details
14 Methotrexate Brand Tier 1 $0.00 Details
15 Dexamethasone Brand Tier 1 $0.00 Details
16 Risperidone Brand Tier 1 $0.00 Details
17 ZYKADIA ceritinib Brand Tier 1 $0.00 Details
18 Spiriva Respimat tiotropium bromide inhalation spray Brand Tier 1 $0.00 Details
19 Fludrocortisone Acetate FLUDROCORTISONE ACETATE Brand Tier 1 $0.00 Details
20 Estradiol Brand Tier 1 $0.00 Details

Showing 20 of 985 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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