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Verified against CMS.gov · on Apr 1, 2026 Plan ID: H1290-083 Cross-check on Medicare.gov →

DEVOTED DUAL FULL 083 FL (HMO D-SNP)

Plan Year 2026
$0.00 /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 Amoxicillin Brand Tier 1 $0.00 Details
2 Diazepam Brand Tier 2 $0.00 Details
3 Xalkori CRIZOTINIB Brand Tier 5 $0.00 Details
4 Mercaptopurine Brand Tier 3 $0.00 Details
5 Morphine Sulfate Brand Tier 3 $0.00 Details
6 TRUQAP capivasertib Brand Tier 5 $0.00 Details
7 Baclofen baclofen Brand Tier 2 $0.00 Details
8 Spiriva Respimat tiotropium bromide inhalation spray Brand Tier 4 $0.00 Details
9 Xospata gilteritinib Brand Tier 5 $0.00 Details
10 Cyclosporine Modified Modified Cyclosporine Brand Tier 4 $0.00 Details
11 Efavirenz, Emtricitabine and Tenofovir Disoproxil Fumarate Brand Tier 4 $0.00 Details
12 Xtandi enzalutamide Brand Tier 5 $0.00 Details
13 Tacrolimus Brand Tier 4 $0.00 Details
14 Medroxyprogesterone Acetate Brand Tier 1 $0.00 Details
15 Warfarin Sodium Brand Tier 1 $0.00 Details
16 Enoxaparin Sodium Enoxaparin sodium Brand Tier 4 $0.00 Details
17 Fluphenazine Hydrochloride Brand Tier 4 $0.00 Details
18 Chlorpromazine Hydrochloride Brand Tier 4 $0.00 Details
19 Amoxicillin and Clavulanate Potassium Brand Tier 3 $0.00 Details
20 Cefuroxime Brand Tier 3 $0.00 Details

Showing 20 of 995 covered drugs.

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States Served (1)

This plan is available to Medicare beneficiaries in the following states.

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