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Verified against CMS.gov · on Apr 1, 2026 Plan ID: H1587-003 Cross-check on Medicare.gov →

Tribute Select (HMO-POS I-SNP)

Plan Year 2026
$8.90 /month
Monthly Premium
Among the lowest-premium plans in 2026
$615.00 Annual Deductible
925 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 Nortriptyline Hydrochloride Brand Tier 1 $0.00 Details
2 ZEJULA niraparib Brand Tier 1 $0.00 Details
3 Vigabatrin Brand Tier 1 $0.00 Details
4 INLYTA axitinib Brand Tier 1 $0.00 Details
5 Aptivus tipranavir Brand Tier 1 $0.00 Details
6 Amoxapine Brand Tier 1 $0.00 Details
7 Cefuroxime Brand Tier 1 $0.00 Details
8 Venlafaxine Hydrochloride Brand Tier 1 $0.00 Details
9 Amoxapine Brand Tier 1 $0.00 Details
10 Rufinamide Brand Tier 1 $0.00 Details
11 Daurismo glasdegib Brand Tier 1 $0.00 Details
12 Tafinlar dabrafenib Brand Tier 1 $0.00 Details
13 Haloperidol Brand Tier 1 $0.00 Details
14 Phenobarbital Brand Tier 1 $0.00 Details
15 Haloperidol Brand Tier 1 $0.00 Details
16 Mefloquine Hydrochloride Brand Tier 1 $0.00 Details
17 Nefazodone Hydrochloride Brand Tier 1 $0.00 Details
18 Teflaro ceftaroline fosamil Brand Tier 1 $0.00 Details
19 Atomoxetine Brand Tier 1 $0.00 Details
20 Fetzima LEVOMILNACIPRAN HYDROCHLORIDE Brand Tier 1 $0.00 Details

Showing 20 of 925 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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