DEVOTED CHOICE PREMIUM 006 HI (PPO)
$8.70 /month
Monthly Premium
Among the lowest-premium plans in 2026
$615.00
Annual Deductible
995
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 | Potassium Chloride potassium chloride | Brand | Tier 2 | $0.00 | Details |
| 2 | Trifluoperazine Hydrochloride trifluoperazine hydrochloride | Brand | Tier 3 | $0.00 | Details |
| 3 | Haloperidol | Brand | Tier 3 | $0.00 | Details |
| 4 | Xalkori CRIZOTINIB | Brand | Tier 5 | $0.00 | Details |
| 5 | Nicotrol nicotine | Brand | Tier 4 | $0.00 | Details |
| 6 | Risperidone | Brand | Tier 4 | $0.00 | Details |
| 7 | Enoxaparin Sodium Enoxaparin sodium | Brand | Tier 4 | $0.00 | Details |
| 8 | JANUVIA sitagliptin | Brand | Tier 3 | $0.00 | Details |
| 9 | Amoxicillin | Brand | Tier 1 | $0.00 | Details |
| 10 | Diazepam | Brand | Tier 2 | $0.00 | Details |
| 11 | Xalkori CRIZOTINIB | Brand | Tier 5 | $0.00 | Details |
| 12 | Mercaptopurine | Brand | Tier 3 | $0.00 | Details |
| 13 | Morphine Sulfate | Brand | Tier 3 | $0.00 | Details |
| 14 | TRUQAP capivasertib | Brand | Tier 5 | $0.00 | Details |
| 15 | Baclofen baclofen | Brand | Tier 2 | $0.00 | Details |
| 16 | Spiriva Respimat tiotropium bromide inhalation spray | Brand | Tier 4 | $0.00 | Details |
| 17 | Xospata gilteritinib | Brand | Tier 5 | $0.00 | Details |
| 18 | Cyclosporine Modified Modified Cyclosporine | Brand | Tier 4 | $0.00 | Details |
| 19 | Efavirenz, Emtricitabine and Tenofovir Disoproxil Fumarate | Brand | Tier 4 | $0.00 | Details |
| 20 | Xtandi enzalutamide | Brand | Tier 5 | $0.00 | Details |
Showing 20 of 995 covered drugs.
States Served (1)
This plan is available to Medicare beneficiaries in the following states.
Find Your Best Medicare Plan for 2026
Compare plans side-by-side with the help of a licensed Medicare specialist. Free service — no obligation.
Compare Medicare Plans Free- ✓ Compare all plans in your area
- ✓ Licensed agents available 7 days a week
- ✓ No cost, no obligation
We may receive a referral fee if you enroll through this link. DrugCovered is not affiliated with Medicare or any government agency. Plan availability and costs vary by ZIP code. Not all plans may be available in your area.