2025 Listas de Medicamentos

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Alabama

• Devoted CHOICE Alabama (PPO)
• Devoted CHOICE GIVEBACK Alabama (PPO)
• Devoted CORE Alabama (HMO)
• Devoted DUAL Alabama (HMO D-SNP)
• Devoted DUAL PLUS Alabama (HMO D-SNP)
• Devoted GIVEBACK Alabama (HMO)

Arizona

• Devoted BE WELL Arizona (HMO C-SNP)
• Devoted BE WELL PLUS Arizona (HMO C-SNP)
• Devoted CHOICE Arizona (PPO) - Condados de Cochise, Coconino, Graham, La Paz, Pima, Santa Cruz, Yavapai, y Yuma
• Devoted CHOICE Arizona (PPO) - Condados de Maricopa y Pinal
• Devoted CHOICE GIVEBACK Arizona (PPO)
• Devoted CORE Arizona (HMO) - Condados de Coconino, Pima, y Yavapai
• Devoted CORE Arizona (HMO) - Condados de Maricopa y Pinal
• Devoted EXTRA Arizona (HMO)
• Devoted GIVEBACK Arizona (HMO)
• Devoted PRIME Arizona (HMO)
• Devoted SELECT Arizona (HMO)

Arkansas

• Devoted CHOICE Arkansas (PPO)
• Devoted CHOICE DUAL Arkansas (PPO D-SNP)
• Devoted CHOICE DUAL PLUS Arkansas (PPO D-SNP)
• Devoted CHOICE GIVEBACK Arkansas (PPO)

Colorado

• Devoted CHOICE Colorado (PPO)
• Devoted CHOICE GIVEBACK Colorado (PPO)
• Devoted CORE Colorado (HMO)
• Devoted DUAL Colorado (HMO D-SNP)
• Devoted DUAL PLUS Colorado (HMO D-SNP)
• Devoted GIVEBACK Colorado (HMO)

Florida

• Devoted CHOICE Florida (PPO)
• Devoted CHOICE GIVEBACK Florida (PPO) - todos los condados excepto Pensacola
• Devoted CHOICE GIVEBACK Florida (PPO) - Condado de Pensacola
• Devoted CORE Florida (HMO)
• Devoted DUAL Florida (HMO D-SNP) - todos los condados excepto Pensacola
• Devoted DUAL Florida (HMO D-SNP) - Condado de Pensacola
• Devoted DUAL PLUS Florida (HMO D-SNP) - todos los condados excepto Pensacola
• Devoted DUAL PLUS Florida (HMO D-SNP) - Condado de Pensacola
• Devoted EXTRA Florida (HMO)
• Devoted GIVEBACK Florida (HMO)
• Devoted PREMIUM Florida (HMO)
• Devoted SELECT Florida (HMO)

Georgia

• Devoted CHOICE Georgia (PPO)
• Devoted CHOICE GIVEBACK Georgia (PPO)

Hawaii

• Devoted CHOICE Hawaii (PPO) - Honolulu & Kauai
• Devoted CHOICE Hawaii (PPO) - Hawaii & Maui
• Devoted CHOICE GIVEBACK Hawaii (PPO) - Honolulu & Kauai
• Devoted CHOICE GIVEBACK Hawaii (PPO) - Hawaii & Maui
• Devoted CHOICE PLUS Hawaii (PPO) - Honolulu & Kauai
• Devoted CHOICE PLUS Hawaii (PPO) - Hawaii & Maui

Illinois

• Devoted CHOICE Illinois (PPO)
• Devoted CHOICE GIVEBACK Illinois (PPO)
• Devoted CORE Illinois (HMO)
• Devoted GIVEBACK Illinois (HMO)

Indiana

• Devoted CHOICE Indiana (PPO)
• Devoted CHOICE GIVEBACK Indiana (PPO)
• Devoted CHOICE PLUS Indiana (PPO)

Kentucky

• Devoted CHOICE Kentucky (PPO)
• Devoted CHOICE GIVEBACK Kentucky (PPO)

Mississippi

• Devoted CHOICE Mississippi (PPO)
• Devoted CHOICE DUAL Mississippi (PPO D-SNP)
• Devoted CHOICE DUAL PLUS Mississippi (PPO D-SNP)
• Devoted CHOICE GIVEBACK Mississippi (PPO)

Missouri

• Devoted CORE Missouri (HMO)
• Devoted DUAL Missouri (HMO D-SNP)
• Devoted DUAL PLUS Missouri (HMO D-SNP)
• Devoted GIVEBACK Missouri (HMO)

North Carolina

• Devoted CHOICE North Carolina (PPO)
• Devoted CHOICE GIVEBACK North Carolina (PPO)
• Devoted CORE North Carolina (HMO)
• Devoted DUAL North Carolina (HMO D-SNP)
• Devoted DUAL PLUS North Carolina (HMO D-SNP)
• Devoted GIVEBACK North Carolina (HMO)

Ohio

• Devoted CHOICE Ohio (PPO)
• Devoted CHOICE EXTRA Ohio (PPO)
• Devoted CORE Ohio (HMO)
• Devoted DUAL Ohio (HMO D-SNP)
• Devoted DUAL PLUS Ohio (HMO D-SNP)
• Devoted GIVEBACK Ohio (HMO)
• Devoted PREMIUM Ohio (HMO)

Oregon

• Devoted CHOICE Oregon (PPO)
• Devoted CHOICE PLUS Oregon (PPO)
• Devoted CORE Oregon (HMO) - Condados de Clackamas, Columbia, Multnomah, y Washington
• Devoted CORE Oregon (HMO) - Condados de Lane, Lincoln, y Linn
• Devoted GIVEBACK Oregon (HMO)
• Devoted PREMIUM Oregon (HMO)

Pennsylvania

• Devoted CHOICE Pennsylvania (PPO) - Condados de Berks, Bucks, Chester, Delaware, Lehigh, Montgomery, Northampton, y Philadelphia
• Devoted CHOICE Pennsylvania (PPO) - Condados de Armstrong, Bedford, Blair, Carbon, Clarion, Clearfield, Clinton, Crawford, Elk, Forest, Fulton, Huntingdon, Jefferson, Lackawanna, Lawrence, Luzeme, Monroe, Somerset, Susquehanna, y Wyoming
• Devoted CHOICE GIVEBACK Pennsylvania (PPO) - Condados de Berks, Bucks, Chester, Delaware, Lehigh, Montgomery, Northampton, y Philadelphia
• Devoted CHOICE GIVEBACK Pennsylvania (PPO) - Condados de Armstrong, Bedford, Blair, Carbon, Clarion, Clearfield, Clinton, Crawford, Elk, Forest, Fulton, Huntingdon, Jefferson, Lackawanna, Lawrence, Luzeme, Monroe, Somerset, Susquehanna, y Wyoming
• Devoted CHOICE PLUS Pennsylvania (PPO)
• Devoted CORE Pennsylvania (HMO)
• Devoted DUAL PLUS Pennsylvania (HMO D-SNP)
• Devoted GIVEBACK Pennsylvania (HMO)

South Carolina

• Devoted CHOICE South Carolina (PPO)
• Devoted CHOICE GIVEBACK South Carolina (PPO)
• Devoted CORE South Carolina (HMO)
• Devoted PREMIUM South Carolina (HMO)

Tennessee

• Devoted BE WELL PLUS Tennessee (HMO C-SNP)
• Devoted CHOICE Tennessee (PPO) - Condados de Fayette, Hardeman, Haywood, y Shelby
• Devoted CHOICE Tennessee (PPO) - todos los condados excepto Fayette, Hardeman, Haywood, y Shelby
• Devoted CHOICE GIVEBACK Tennessee (PPO) - Condados de Fayette, Hardeman, Haywood, y Shelby
• Devoted CHOICE GIVEBACK Tennessee (PPO) - todos los condados excepto Fayette, Hardeman, Haywood, y Shelby
• Devoted CORE Tennessee (HMO)
• Devoted GIVEBACK Tennessee (HMO)

Texas

• Devoted BE WELL San Antonio (HMO C-SNP)
• Devoted CHOICE Austin (PPO)
• Devoted CHOICE GIVEBACK Austin (PPO)
• Devoted CORE Austin (HMO)
• Devoted CORE El Paso (HMO)
• Devoted CORE Greater Houston (HMO)
• Devoted CORE San Antonio (HMO)
• Devoted DUAL PLUS Austin (HMO D-SNP)
• Devoted DUAL PLUS El Paso (HMO D-SNP)
• Devoted DUAL PLUS Greater Houston (HMO D-SNP)
• Devoted DUAL PLUS San Antonio (HMO D-SNP)
• Devoted EXTRA Greater Houston (HMO)
• Devoted EXTRA San Antonio (HMO)
• Devoted GIVEBACK El Paso (HMO)
• Devoted GIVEBACK Greater Houston (HMO)
• Devoted GIVEBACK San Antonio (HMO)
• Devoted PREMIUM Greater Houston (HMO)

Washington

• Devoted CHOICE Washington (PPO)
• Devoted CHOICE GIVEBACK Washington (PPO)