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Verified against CMS.gov · on Apr 1, 2026 Plan ID: H0351-054 Cross-check on Medicare.gov →

Wellcare Giveback (HMO)

Plan Year 2026
$0.00 /month
Monthly Premium
Among the lowest-premium plans in 2026
$615.00 Annual Deductible
930 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 Clozapine Brand Tier 4 0.4% coinsurance Details
2 Haloperidol Brand Tier 2 $0.00 Details
3 Venclexta Venetoclax Brand Tier 3 0.3% coinsurance Details
4 NITROGLYCERIN nitroglycerin Brand Tier 4 0.4% coinsurance Details
5 Medroxyprogesterone Acetate Brand Tier 1 $0.00 Details
6 Aptivus tipranavir Brand Tier 5 0.3% coinsurance Details
7 Teflaro ceftaroline fosamil Brand Tier 5 0.3% coinsurance Details
8 Cefuroxime Brand Tier 2 $0.00 Details
9 ENTRESTO Sacubitril and Valsartan Brand Tier 3 0.3% coinsurance Details
10 Metoprolol Tartrate metoprolol tartrate Brand Tier 1 $0.00 Details
11 RECOMBIVAX HB Hepatitis B Vaccine (Recombinant) Brand Tier 6 $0.00 Details
12 Xalkori CRIZOTINIB Brand Tier 5 0.3% coinsurance Details
13 Lenalidomide Brand Tier 5 0.3% coinsurance Details
14 JANUVIA sitagliptin Brand Tier 3 0.3% coinsurance Details
15 KISQALI ribociclib Brand Tier 5 0.3% coinsurance Details
16 Bromocriptine mesylate Brand Tier 2 $0.00 Details
17 PIFELTRO doravirine Brand Tier 5 0.3% coinsurance Details
18 Levothyroxine Sodium levothyroxine sodium Brand Tier 1 $0.00 Details
19 ELIQUIS apixaban Brand Tier 3 0.3% coinsurance Details
20 Clozapine Brand Tier 4 0.4% coinsurance Details

Showing 20 of 930 covered drugs.

Compare this plan against others for your medications Enter your drugs and ZIP to see personalized out-of-pocket costs.
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States Served (1)

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

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