Devoted GA MAPD Summary of Benefits

DEVOTED CHOICE MA ONLY 003 GA (PPO) - H5453-003-000 - ENG

DEVOTED CHOICE GIVEBACK 011 GA (PPO) - H5453-011-000 - ENG

DEVOTED CHOICE GIVEBACK 005 GA (PPO) - H5453-005-000 - ENG

DEVOTED CHOICE GIVEBACK 002 GA (PPO) - H5453-002-000 - ENG

DEVOTED CHOICE 010 GA (PPO) - H5453-010-000 - ENG

DEVOTED CHOICE 004 GA (PPO) - H5453-004-000 - ENG

DEVOTED CHOICE 001 GA (PPO) - H5453-001-000 - ENG

DEVOTED C-SNP CHOICE PREMIUM 018 GA (PPO C-SNP) - H5453-018-000 - ENG

DEVOTED C-SNP CHOICE PREMIUM 017 GA (PPO C-SNP) - H5453-017-000 - ENG

DEVOTED C-SNP CHOICE PREMIUM 015 GA (PPO C-SNP) - H5453-015-000 - ENG