DEVOTED CHOICE 008 IN (PPO)
$0.00 /month
Monthly Premium
Among the lowest-premium plans in 2026
$0.00
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 | VAQTA hepatitis A vaccine, inactivated | Brand | Tier 1 | $0.00 | Details |
| 2 | Dexamethasone | Brand | Tier 3 | $0.00 | Details |
| 3 | ELIQUIS 30-Day Starter Pack 30-Day Starter Pack apixaban | Brand | Tier 3 | $0.00 | Details |
| 4 | Levothyroxine Sodium levothyroxine sodium | Brand | Tier 1 | $0.00 | Details |
| 5 | Dupixent Dupilumab | Brand | Tier 5 | $0.00 | Details |
| 6 | Cyclosporine Modified Modified Cyclosporine | Brand | Tier 4 | $0.00 | Details |
| 7 | Potassium Chloride | Brand | Tier 2 | $0.00 | Details |
| 8 | Trifluoperazine Hydrochloride trifluoperazine hydrochloride | Brand | Tier 3 | $0.00 | Details |
| 9 | Combivent Respimat ipratropium bromide and albuterol | Brand | Tier 4 | $0.00 | Details |
| 10 | Fiasp insulin aspart injection | Brand | Tier 3 | $0.00 | Details |
| 11 | TicoVac Tick-Borne Encephalitis Vaccine | Brand | Tier 1 | $0.00 | Details |
| 12 | ELIQUIS apixaban | Brand | Tier 3 | $0.00 | Details |
| 13 | Leucovorin Calcium | Brand | Tier 3 | $0.00 | Details |
| 14 | Nefazodone Hydrochloride | Brand | Tier 4 | $0.00 | Details |
| 15 | Diltiazem Hydrochloride | Brand | Tier 2 | $0.00 | Details |
| 16 | Xalkori CRIZOTINIB | Brand | Tier 5 | $0.00 | Details |
| 17 | Isosorbide Dinitrate | Brand | Tier 3 | $0.00 | Details |
| 18 | Fluphenazine Hydrochloride | Brand | Tier 4 | $0.00 | Details |
| 19 | PIQRAY alpelisib | Brand | Tier 5 | $0.00 | Details |
| 20 | VALPROIC ACID | Brand | Tier 3 | $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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