UHC Dual Complete IN-D001 (PPO D-SNP)
$38.40 /month
Monthly Premium
$615.00
Annual Deductible
1,021
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 | Leucovorin Calcium | Brand | Tier 4 | $0.00 | Details |
| 2 | TicoVac Tick-Borne Encephalitis Vaccine | Brand | Tier 3 | $0.00 | Details |
| 3 | Jardiance Empagliflozin | Brand | Tier 3 | $0.00 | Details |
| 4 | Fluphenazine Hydrochloride | Brand | Tier 3 | $0.00 | Details |
| 5 | Methylphenidate Hydrochloride | Brand | Tier 3 | $0.00 | Details |
| 6 | Haloperidol | Brand | Tier 2 | $0.00 | Details |
| 7 | Acarbose | Brand | Tier 1 | $0.00 | Details |
| 8 | Cefuroxime | Brand | Tier 4 | $0.00 | Details |
| 9 | Verzenio abemaciclib | Brand | Tier 5 | $0.00 | Details |
| 10 | Ibrance palbociclib | Brand | Tier 5 | $0.00 | Details |
| 11 | RotaTeq Rotavirus Vaccine, Live, Oral, Pentavalent | Brand | Tier 3 | $0.00 | Details |
| 12 | KOSELUGO SELUMETINIB | Brand | Tier 5 | $0.00 | Details |
| 13 | Warfarin Sodium | Brand | Tier 1 | $0.00 | Details |
| 14 | Levothyroxine Sodium levothyroxine sodium | Brand | Tier 1 | $0.00 | Details |
| 15 | Amoxapine | Brand | Tier 3 | $0.00 | Details |
| 16 | NITROGLYCERIN nitroglycerin | Brand | Tier 4 | $0.00 | Details |
| 17 | Medroxyprogesterone Acetate | Brand | Tier 1 | $0.00 | Details |
| 18 | JAYPIRCA pirtobrutinib | Brand | Tier 5 | $0.00 | Details |
| 19 | Levothyroxine Sodium levothyroxine sodium | Brand | Tier 1 | $0.00 | Details |
| 20 | Exemestane | Brand | Tier 4 | $0.00 | Details |
Showing 20 of 1,021 covered drugs.
States Served (1)
This plan is available to Medicare beneficiaries in the following states.
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