UHC Dual Complete MI-S002 (HMO-POS D-SNP)
$0.00 /month
Monthly Premium
Among the lowest-premium plans in 2026
$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 | Levothyroxine Sodium levothyroxine sodium | Brand | Tier 1 | $0.00 | Details |
| 2 | Amoxapine | Brand | Tier 3 | $0.00 | Details |
| 3 | NITROGLYCERIN nitroglycerin | Brand | Tier 4 | $0.00 | Details |
| 4 | Medroxyprogesterone Acetate | Brand | Tier 1 | $0.00 | Details |
| 5 | JAYPIRCA pirtobrutinib | Brand | Tier 5 | $0.00 | Details |
| 6 | Levothyroxine Sodium levothyroxine sodium | Brand | Tier 1 | $0.00 | Details |
| 7 | Exemestane | Brand | Tier 4 | $0.00 | Details |
| 8 | SOMAVERT pegvisomant | Brand | Tier 5 | $0.00 | Details |
| 9 | Everolimus | Brand | Tier 5 | $0.00 | Details |
| 10 | Risperidone | Brand | Tier 4 | $0.00 | Details |
| 11 | Budesonide | Brand | Tier 4 | $0.00 | Details |
| 12 | Diazepam | Brand | Tier 2 | $0.00 | Details |
| 13 | Linzess linaclotide | Brand | Tier 3 | $0.00 | Details |
| 14 | amiloride hydrochloride | Brand | Tier 2 | $0.00 | Details |
| 15 | Verzenio abemaciclib | Brand | Tier 5 | $0.00 | Details |
| 16 | Diltiazem Hydrochloride | Brand | Tier 2 | $0.00 | Details |
| 17 | ISENTRESS RALTEGRAVIR | Brand | Tier 3 | $0.00 | Details |
| 18 | Emtricitabine, Rilpivirine, Tenofovir Disoproxil Fumarate | Brand | Tier 5 | $0.00 | Details |
| 19 | Doxepin Hydrochloride doxepin hydrochloride | Brand | Tier 4 | $0.00 | Details |
| 20 | Tacrolimus | Brand | Tier 3 | $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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