DEVOTED DUAL CHOICE FULL 013 AL (PPO D-SNP)
$0.00 /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 | SCEMBLIX asciminib | Brand | Tier 5 | $0.00 | Details |
| 2 | Spiriva Respimat tiotropium bromide inhalation spray | Brand | Tier 4 | $0.00 | Details |
| 3 | Jardiance Empagliflozin | Brand | Tier 3 | $0.00 | Details |
| 4 | Xospata gilteritinib | Brand | Tier 5 | $0.00 | Details |
| 5 | EVOTAZ atazanavir and cobicistat | Brand | Tier 5 | $0.00 | Details |
| 6 | TABRECTA capmatinib | Brand | Tier 5 | $0.00 | Details |
| 7 | Valsartan valsartan | Brand | Tier 1 | $0.00 | Details |
| 8 | Nortriptyline Hydrochloride | Brand | Tier 2 | $0.00 | Details |
| 9 | RYDAPT | Brand | Tier 5 | $0.00 | Details |
| 10 | Fluvoxamine maleate | Brand | Tier 3 | $0.00 | Details |
| 11 | Gilotrif afatinib | Brand | Tier 5 | $0.00 | Details |
| 12 | CRESEMBA isavuconazonium sulfate | Brand | Tier 5 | $0.00 | Details |
| 13 | Doxepin Hydrochloride doxepin hydrochloride | Brand | Tier 3 | $0.00 | Details |
| 14 | Estradiol | Brand | Tier 2 | $0.00 | Details |
| 15 | GARDASIL 9 Human Papillomavirus 9-valent Vaccine, Recombinant | Brand | Tier 1 | $0.00 | Details |
| 16 | Venclexta Venetoclax | Brand | Tier 5 | $0.00 | Details |
| 17 | Fluphenazine Hydrochloride | Brand | Tier 4 | $0.00 | Details |
| 18 | Thioridazine Hydrochloride thioridazine hydrochloride | Brand | Tier 3 | $0.00 | Details |
| 19 | Nefazodone Hydrochloride | Brand | Tier 4 | $0.00 | Details |
| 20 | SOMAVERT pegvisomant | 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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