Wellcare Simple Exclusive (HMO)
$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 | Leucovorin Calcium | Brand | Tier 2 | $0.00 | Details |
| 2 | Warfarin Sodium | Brand | Tier 1 | $0.00 | Details |
| 3 | Loxapine | Brand | Tier 2 | $0.00 | Details |
| 4 | BOSULIF Bosutinib | Brand | Tier 5 | 0.3% coinsurance | Details |
| 5 | PIQRAY alpelisib | Brand | Tier 5 | 0.3% coinsurance | Details |
| 6 | Loxapine | Brand | Tier 2 | $0.00 | Details |
| 7 | Venclexta Venetoclax | Brand | Tier 5 | 0.3% coinsurance | Details |
| 8 | Ofev nintedanib | Brand | Tier 5 | 0.3% coinsurance | Details |
| 9 | SOMAVERT pegvisomant | Brand | Tier 5 | 0.3% coinsurance | Details |
| 10 | Amoxapine | Brand | Tier 4 | 0.5% coinsurance | Details |
| 11 | ISENTRESS RALTEGRAVIR | Brand | Tier 4 | 0.5% coinsurance | Details |
| 12 | ZEJULA niraparib | Brand | Tier 5 | 0.3% coinsurance | Details |
| 13 | Nefazodone Hydrochloride | Brand | Tier 4 | 0.5% coinsurance | Details |
| 14 | Clozapine | Brand | Tier 4 | 0.5% coinsurance | Details |
| 15 | Haloperidol | Brand | Tier 2 | $0.00 | Details |
| 16 | Venclexta Venetoclax | Brand | Tier 3 | 0.3% coinsurance | Details |
| 17 | NITROGLYCERIN nitroglycerin | Brand | Tier 4 | 0.5% coinsurance | Details |
| 18 | Medroxyprogesterone Acetate | Brand | Tier 1 | $0.00 | Details |
| 19 | Aptivus tipranavir | Brand | Tier 5 | 0.3% coinsurance | Details |
| 20 | Teflaro ceftaroline fosamil | Brand | Tier 5 | 0.3% coinsurance | Details |
Showing 20 of 930 covered drugs.
States Served (1)
This plan is available to Medicare beneficiaries in the following states.
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