Wellpoint Kidney Care (HMO-POS C-SNP)
$0.00 /month
Monthly Premium
Among the lowest-premium plans in 2026
$275.00
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 | PIQRAY alpelisib | Brand | Tier 5 | 0.3% coinsurance | Details |
| 2 | Xalkori CRIZOTINIB | Brand | Tier 5 | 0.3% coinsurance | Details |
| 3 | Pyridostigmine Bromide PYRIDOSTIGMINE BROMIDE | Brand | Tier 3 | 0.2% coinsurance | Details |
| 4 | Lenalidomide | Brand | Tier 5 | 0.3% coinsurance | Details |
| 5 | Chlorpromazine Hydrochloride | Brand | Tier 4 | 0.3% coinsurance | Details |
| 6 | Levothyroxine Sodium levothyroxine sodium | Brand | Tier 6 | $0.00 | Details |
| 7 | BOSULIF Bosutinib | Brand | Tier 5 | 0.3% coinsurance | Details |
| 8 | Dicyclomine Hydrochloride | Brand | Tier 1 | $0.00 | Details |
| 9 | SCEMBLIX asciminib | Brand | Tier 5 | 0.3% coinsurance | Details |
| 10 | Danazol | Brand | Tier 4 | 0.3% coinsurance | Details |
| 11 | Carbidopa and levodopa | Brand | Tier 2 | $0.00 | Details |
| 12 | Diazepam | Brand | Tier 2 | $0.00 | Details |
| 13 | MERCAPTOPURINE | Brand | Tier 5 | 0.3% coinsurance | Details |
| 14 | Sulfasalazine | Brand | Tier 2 | $0.00 | Details |
| 15 | Scopolamine scopolamine | Brand | Tier 4 | 0.3% coinsurance | Details |
| 16 | RETEVMO selpercatinib | Brand | Tier 5 | 0.3% coinsurance | Details |
| 17 | Diazepam Intensol | Brand | Tier 2 | $0.00 | Details |
| 18 | Haloperidol | Brand | Tier 2 | $0.00 | Details |
| 19 | Atomoxetine | Brand | Tier 4 | 0.3% coinsurance | Details |
| 20 | Amoxapine | Brand | Tier 2 | $0.00 | Details |
Showing 20 of 1,022 covered drugs.
States Served (1)
This plan is available to Medicare beneficiaries in the following states.
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