DEVOTED CHOICE GIVEBACK 005 TN (PPO)
Available to residents of Jackson County, TN for 2026. Contract H9231, plan 005, segment 0.
Plan details
| Monthly drug premium | $0.00 |
|---|---|
| Drug deductible | $605.00Tier 1 and 2 exempt |
| Plan type | Medicare Advantage |
| Contract / plan | H9231-005-0 |
| Offered by | Devoted Health |
| Parent organization | Devoted Health, Inc. |
| Formulary drugs | 3,513 |
CMS star ratings
- Overall
- 3.5 out of 5 stars for Overall
- Health plan (Part C)
- 3 out of 5 stars for Health plan (Part C)
- Drug plan (Part D)
- 3.5 out of 5 stars for Drug plan (Part D)
Published per contract — every plan under contract H9231 shares this rating.
Drug tiers — preferred pharmacy, initial coverage
| Tier | Cost-sharing |
|---|---|
| Tier 1 | $0.00 |
| Tier 2 | $3.00 |
| Tier 3 | 22% |
| Tier 4 | 25% |
| Tier 5 | 25% |
Also available in 27 other TN counties
Plan facts come from the CMS quarterly prescription drug plan public use files.