Wellpoint Chronic Care (HMO-POS C-SNP)
$0.00 /month
Monthly Premium
Among the lowest-premium plans in 2026
$75.00
Annual Deductible
959
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 | Aptivus tipranavir | Brand | Tier 5 | 0.3% coinsurance | Details |
| 2 | Amoxicillin | Brand | Tier 2 | $0.00 | Details |
| 3 | Diazepam | Brand | Tier 2 | $0.00 | Details |
| 4 | VAQTA hepatitis A vaccine, inactivated | Brand | Tier 6 | $0.00 | Details |
| 5 | Dexamethasone | Brand | Tier 2 | $0.00 | Details |
| 6 | Erlotinib | Brand | Tier 5 | 0.3% coinsurance | Details |
| 7 | Xalkori CRIZOTINIB | Brand | Tier 5 | 0.3% coinsurance | Details |
| 8 | Acarbose | Brand | Tier 2 | $0.00 | Details |
| 9 | Fosamprenavir Calcium fosamprenavir calcium | Brand | Tier 4 | 0.3% coinsurance | Details |
| 10 | Fetzima LEVOMILNACIPRAN HYDROCHLORIDE | Brand | Tier 4 | 0.3% coinsurance | Details |
| 11 | Clozapine | Brand | Tier 4 | 0.3% coinsurance | Details |
| 12 | Ibrance palbociclib | Brand | Tier 5 | 0.3% coinsurance | Details |
| 13 | Dicloxacillin Sodium | Brand | Tier 2 | $0.00 | Details |
| 14 | Amoxapine | Brand | Tier 2 | $0.00 | Details |
| 15 | Carbidopa and levodopa | Brand | Tier 2 | $0.00 | Details |
| 16 | Clozapine | Brand | Tier 4 | 0.3% coinsurance | Details |
| 17 | Everolimus | Brand | Tier 5 | 0.3% coinsurance | Details |
| 18 | Balsalazide Disodium | Brand | Tier 2 | $0.00 | Details |
| 19 | Ipratropium Bromide | Brand | Tier 2 | $0.00 | Details |
| 20 | PredniSONE | Brand | Tier 1 | $0.00 | Details |
Showing 20 of 959 covered drugs.
States Served (1)
This plan is available to Medicare beneficiaries in the following states.
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