Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP)
$0.00 /month
Monthly Premium
Among the lowest-premium plans in 2026
$615.00
Annual Deductible
1,089
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 | Nitroglycerin nitroglycerin | Brand | Tier 2 | $0.00 | Details |
| 2 | Teflaro ceftaroline fosamil | Brand | Tier 5 | $0.00 | Details |
| 3 | BOSULIF Bosutinib | Brand | Tier 5 | $0.00 | Details |
| 4 | Imatinib Mesylate | Brand | Tier 2 | $0.00 | Details |
| 5 | Spiriva Respimat tiotropium bromide inhalation spray | Brand | Tier 3 | $0.00 | Details |
| 6 | TAGRISSO osimertinib | Brand | Tier 5 | $0.00 | Details |
| 7 | TicoVac Tick-Borne Encephalitis Vaccine | Brand | Tier 6 | $0.00 | Details |
| 8 | Fluphenazine Hydrochloride | Brand | Tier 2 | $0.00 | Details |
| 9 | Fosamprenavir Calcium fosamprenavir calcium | Brand | Tier 5 | $0.00 | Details |
| 10 | Paxlovid nirmatrelvir and ritonavir | Brand | Tier 3 | $0.00 | Details |
| 11 | Gentamicin Sulfate | Brand | Tier 1 | $0.00 | Details |
| 12 | Warfarin Sodium | Brand | Tier 1 | $0.00 | Details |
| 13 | Trifluoperazine Hydrochloride trifluoperazine hydrochloride | Brand | Tier 2 | $0.00 | Details |
| 14 | Warfarin Sodium | Brand | Tier 1 | $0.00 | Details |
| 15 | Exemestane | Brand | Tier 2 | $0.00 | Details |
| 16 | Fiasp insulin aspart injection | Brand | Tier 3 | $0.00 | Details |
| 17 | CALQUENCE acalabrutinib | Brand | Tier 5 | $0.00 | Details |
| 18 | Chlorpromazine Hydrochloride | Brand | Tier 2 | $0.00 | Details |
| 19 | SCEMBLIX asciminib | Brand | Tier 5 | $0.00 | Details |
| 20 | Cyclosporine Modified Modified Cyclosporine | Brand | Tier 2 | $0.00 | Details |
Showing 20 of 1,089 covered drugs.
States Served (1)
This plan is available to Medicare beneficiaries in the following states.
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