DEVOTED C-SNP PLUS 027 AZ (HMO C-SNP)
$17.00 /month
Monthly Premium
Among the lowest-premium plans in 2026
$615.00
Annual Deductible
964
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 | LACTULOSE Lactulose | Brand | Tier 2 | $0.00 | Details |
| 2 | PODOFILOX | Brand | Tier 3 | $0.00 | Details |
| 3 | Xalkori CRIZOTINIB | Brand | Tier 5 | $0.00 | Details |
| 4 | Kaletra Lopinavir and Ritonavir | Brand | Tier 4 | $0.00 | Details |
| 5 | Prochlorperazine | Brand | Tier 4 | $0.00 | Details |
| 6 | Venlafaxine Hydrochloride | Brand | Tier 3 | $0.00 | Details |
| 7 | Fetzima LEVOMILNACIPRAN HYDROCHLORIDE | Brand | Tier 4 | $0.00 | Details |
| 8 | ProQuad Measles, Mumps, Rubella and Varicella Virus Vaccine Live | Brand | Tier 1 | $0.00 | Details |
| 9 | REYATAZ ATAZANAVIR | Brand | Tier 5 | $0.00 | Details |
| 10 | Emtricitabine, Rilpivirine, Tenofovir Disoproxil Fumarate | Brand | Tier 5 | $0.00 | Details |
| 11 | Sulfasalazine | Brand | Tier 2 | $0.00 | Details |
| 12 | Ampicillin | Brand | Tier 2 | $0.00 | Details |
| 13 | TRUQAP capivasertib | Brand | Tier 5 | $0.00 | Details |
| 14 | Linzess linaclotide | Brand | Tier 3 | $0.00 | Details |
| 15 | SCEMBLIX asciminib | Brand | Tier 5 | $0.00 | Details |
| 16 | Spiriva Respimat tiotropium bromide inhalation spray | Brand | Tier 4 | $0.00 | Details |
| 17 | Jardiance Empagliflozin | Brand | Tier 3 | $0.00 | Details |
| 18 | Xospata gilteritinib | Brand | Tier 5 | $0.00 | Details |
| 19 | EVOTAZ atazanavir and cobicistat | Brand | Tier 5 | $0.00 | Details |
| 20 | TABRECTA capmatinib | Brand | Tier 5 | $0.00 | Details |
Showing 20 of 964 covered drugs.
States Served (1)
This plan is available to Medicare beneficiaries in the following states.
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