UPMC for Life Complete Care (HMO D-SNP)
$0.00 /month
Monthly Premium
Among the lowest-premium plans in 2026
$615.00
Annual Deductible
1,044
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 | RECOMBIVAX HB Hepatitis B Vaccine (Recombinant) | Brand | Tier 1 | $0.00 | Details |
| 2 | Emtricitabine, Rilpivirine, Tenofovir Disoproxil Fumarate | Brand | Tier 5 | $0.00 | Details |
| 3 | Ampicillin | Brand | Tier 2 | $0.00 | Details |
| 4 | Norvir Ritonavir | Brand | Tier 4 | $0.00 | Details |
| 5 | Diazepam | Brand | Tier 3 | $0.00 | Details |
| 6 | Pilocarpine Hydrochloride | Brand | Tier 4 | $0.00 | Details |
| 7 | PIQRAY alpelisib | Brand | Tier 5 | $0.00 | Details |
| 8 | ENTRESTO Sacubitril and Valsartan | Brand | Tier 3 | $0.00 | Details |
| 9 | Buprenorphine | Brand | Tier 2 | $0.00 | Details |
| 10 | Buspirone Hydrochloride | Brand | Tier 2 | $0.00 | Details |
| 11 | HYDROCODONE BITARTRATE AND ACETAMINOPHEN | Brand | Tier 3 | $0.00 | Details |
| 12 | RECOMBIVAX HB Hepatitis B Vaccine (Recombinant) | Brand | Tier 1 | $0.00 | Details |
| 13 | PREVYMIS LETERMOVIR | Brand | Tier 5 | $0.00 | Details |
| 14 | Phenobarbital | Brand | Tier 2 | $0.00 | Details |
| 15 | Chlorpromazine Hydrochloride | Brand | Tier 4 | $0.00 | Details |
| 16 | Combivent Respimat ipratropium bromide and albuterol | Brand | Tier 3 | $0.00 | Details |
| 17 | Ibrance palbociclib | Brand | Tier 5 | $0.00 | Details |
| 18 | ELIQUIS apixaban | Brand | Tier 3 | $0.00 | Details |
| 19 | Teflaro ceftaroline fosamil | Brand | Tier 4 | $0.00 | Details |
| 20 | Medroxyprogesterone Acetate | Brand | Tier 2 | $0.00 | Details |
Showing 20 of 1,044 covered drugs.
States Served (1)
This plan is available to Medicare beneficiaries in the following states.
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