Wellpoint Premium Savings (HMO)
Available to residents of Pima County, AZ for 2026. Contract H1423, plan 005, segment 0.
Plan details
| Monthly drug premium | $0.00 |
|---|---|
| Drug deductible | $125.00Tier 1, 2 and 6 exempt |
| Plan type | Medicare Advantage |
| Contract / plan | H1423-005-0 |
| Offered by | Wellpoint |
| Parent organization | Elevance Health, Inc. |
| Formulary drugs | 3,280 |
CMS star ratings
- Overall
- 3 out of 5 stars for Overall
- Health plan (Part C)
- 3 out of 5 stars for Health plan (Part C)
- Drug plan (Part D)
- 3 out of 5 stars for Drug plan (Part D)
Published per contract — every plan under contract H1423 shares this rating.
Drug tiers — preferred pharmacy, initial coverage
| Tier | Cost-sharing |
|---|---|
| Tier 1 | $0.00 |
| Tier 2 | $0.00 |
| Tier 3 | 25% |
| Tier 4 | 30% |
| Tier 5 | 31% |
| Tier 6 | $0.00 |
Plan facts come from the CMS quarterly prescription drug plan public use files.