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Verified against CMS.gov · on Apr 1, 2026 Plan ID: H2593-045 Cross-check on Medicare.gov →

Wellpoint Full Dual Advantage Aligned (HMO D-SNP)

Plan Year 2026
$0.00 /month
Monthly Premium
Among the lowest-premium plans in 2026
$550.00 Annual Deductible
1,022 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 Phenobarbital Brand Tier 2 $0.00 Details
2 Dexamethasone Brand Tier 2 $0.00 Details
3 Fludrocortisone Acetate FLUDROCORTISONE ACETATE Brand Tier 2 $0.00 Details
4 Cobenfy xanomeline and trospium chloride Brand Tier 5 $0.00 Details
5 Lorbrena lorlatinib Brand Tier 5 $0.00 Details
6 PedvaxHIB Haemophilus b Conjugate Vaccine (Meningococcal Protein Conjugate) Brand Tier 6 $0.00 Details
7 Baclofen baclofen Brand Tier 2 $0.00 Details
8 Omeprazole Brand Tier 6 $0.00 Details
9 Diazepam Brand Tier 2 $0.00 Details
10 Loxapine Brand Tier 4 $0.00 Details
11 Metoclopramide Brand Tier 1 $0.00 Details
12 Depo-SubQ Provera medroxyprogesterone acetate Brand Tier 3 $0.00 Details
13 Buprenorphine Brand Tier 2 $0.00 Details
14 Estradiol Brand Tier 1 $0.00 Details
15 Talzenna talazoparib Brand Tier 5 $0.00 Details
16 Midodrine Hydrochloride midodrine hydrochloride Brand Tier 4 $0.00 Details
17 Aptivus tipranavir Brand Tier 5 $0.00 Details
18 RECOMBIVAX HB Hepatitis B Vaccine (Recombinant) Brand Tier 6 $0.00 Details
19 Enoxaparin Sodium Enoxaparin sodium Brand Tier 4 $0.00 Details
20 Emtricitabine and Tenofovir Disoproxil Fumarate Brand Tier 4 $0.00 Details

Showing 20 of 1,022 covered drugs.

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States Served (1)

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

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