DEVOTED C-SNP CHOICE PLUS 016 GA (PPO C-SNP)
Available to residents of Upson County, GA for 2026. Contract H5453, plan 016, segment 0.
Plan details
| Monthly drug premium | $25.40 |
|---|---|
| Drug deductible | $615.00Tier 6 exempt |
| Plan type | Chronic-condition SNP |
| Special needs plan | Chronic-condition SNP |
| Contract / plan | H5453-016-0 |
| Offered by | Devoted Health |
| Parent organization | Devoted Health, Inc. |
| Formulary drugs | 3,377 |
CMS star ratings
- Overall
- —
- Health plan (Part C)
- —
- Drug plan (Part D)
- —
Published per contract — every plan under contract H5453 shares this rating.
Drug tiers — preferred pharmacy, initial coverage
| Tier | Cost-sharing |
|---|---|
| Tier 1 | $18.00 |
| Tier 2 | $19.00 |
| Tier 3 | 25% |
| Tier 4 | 31% |
| Tier 5 | 25% |
| Tier 6 | $0.00 |
Also available in 112 other GA counties
- Appling
- Atkinson
- Bacon
- Baldwin
- Barrow
- Bartow
- Ben Hill
- Berrien
- Brooks
- Bryan
- Bulloch
- Burke
- Butts
- Camden
- Candler
- Catoosa
- Charlton
- Chatham
- Chattahoochee
- Chattooga
- Cherokee
- Clayton
- Clinch
- Cobb
- Colquitt
- Columbia
- Cook
- Coweta
- Crawford
- Dade
- Dawson
- DeKalb
- Dodge
- Dooly
- Douglas
- Echols
- Effingham
- Elbert
- Emanuel
- Evans
- Fannin
- Fayette
- Forsyth
- Franklin
- Fulton
- Gilmer
- Glascock
- Greene
- Gwinnett
- Hancock
- Haralson
- Harris
- Hart
- Heard
- Henry
- Irwin
- Jasper
- Jeff Davis
- Jefferson
- Jenkins
Plan facts come from the CMS quarterly prescription drug plan public use files.