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Verified against CMS.gov · on Apr 1, 2026 Plan ID: H0111-004 Cross-check on Medicare.gov →

Wellcare Dual Access Open (PPO D-SNP)

Plan Year 2026
$0.00 /month
Monthly Premium
Among the lowest-premium plans in 2026
$615.00 Annual Deductible
947 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 Risperidone Brand Tier 5 0.3% coinsurance Details
2 SCEMBLIX asciminib Brand Tier 5 0.3% coinsurance Details
3 Haloperidol Brand Tier 4 $100.00 Details
4 Ofev nintedanib Brand Tier 5 0.3% coinsurance Details
5 Trelegy Ellipta fluticasone furoate, umeclidinium bromide and vilanterol trifenatate Brand Tier 3 0.2% coinsurance Details
6 Cobenfy xanomeline and trospium chloride Brand Tier 3 0.2% coinsurance Details
7 Carbidopa and levodopa Brand Tier 2 $19.00 Details
8 Everolimus Brand Tier 5 0.3% coinsurance Details
9 Nitroglycerin nitroglycerin Brand Tier 2 $19.00 Details
10 Chlorpromazine Hydrochloride Brand Tier 4 $100.00 Details
11 Loxapine Brand Tier 4 $100.00 Details
12 ZEJULA niraparib Brand Tier 5 0.3% coinsurance Details
13 Valsartan valsartan Brand Tier 6 $0.00 Details
14 Chlorpromazine Hydrochloride Brand Tier 4 $100.00 Details
15 Medroxyprogesterone Acetate Brand Tier 1 $5.00 Details
16 Thioridazine Hydrochloride thioridazine hydrochloride Brand Tier 4 $100.00 Details
17 Ceftriaxone Sodium Brand Tier 4 $100.00 Details
18 PIQRAY alpelisib Brand Tier 5 0.3% coinsurance Details
19 Calcipotriene Brand Tier 4 $100.00 Details
20 Verzenio abemaciclib Brand Tier 5 0.3% coinsurance Details

Showing 20 of 947 covered drugs.

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States Served (1)

This plan is available to Medicare beneficiaries in the following states.

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