A non-government entity
DEVOTED CHOICE 001 DE (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for DEVOTED CHOICE 001 DE (PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on DEVOTED CHOICE 001 DE (PPO) in 2026, please refer to our full plan details page.
DEVOTED CHOICE 001 DE (PPO) is a PPO plan offered by Devoted Health, Inc. available for enrollment in 2026 to people living in Delaware. The overall rating for this plan is not yet available for 2026.
It's important to know that DEVOTED CHOICE 001 DE (PPO) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Key Plan Facts
Below are a few key facts and commonly-asked questions about DEVOTED CHOICE 001 DE (PPO).
Plan Costs:
The cost of a Medicare Advantage Plan is made up of four main parts.
- First, the monthly premium — the amount you pay every month.
- Second, the deductible — the amount you pay out of pocket for covered services before the plan starts paying.
- Third, the copayments and coinsurance — the amounts you pay out of pocket for covered services, usually after meeting the deductible (if applicable). Copays are fixed dollar amounts; coinsurance is a percentage of the cost.
- Fourth, the Out-of-Pocket Maximum — the maximum amount you could have to pay out of pocket in a year. This may be different for in-network and out-of-network services.
For DEVOTED CHOICE 001 DE (PPO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $0.00. This is the amount you must pay every month.
This plan does not come with a Part B Premium reduction. You must continue to pay your Part B premium.
Deductibles
This plan does not have a health deductible. Your insurance coverage on covered health services will start immediately.
This plan has a $375.00 drug deductible. You will need to pay this amount towards covered prescriptions before your insurance coverage for prescription medications kicks in.
Out-of-Pocket Maximums
This plan has a combined Maximum Out-Of-Pocket cost of $8700.00 (in-network or out-of-network combined). You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $8700.00 for covered services, the plan will pay 100% of covered costs for the rest of the year.
The plan may have separate out-pocket-maximums for in-network and out-of-network services. See our full plan details page for more information.
You can see below for the coinsurance and specific copayments for in the Additional Benefits section below, or refer to our Plan Details page for more details.
Common Services:
Doctor Visits:
Specialist Visits:
Emergency Room:
Urgent Care:
Sign up for DEVOTED CHOICE 001 DE (PPO)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
Drug Coverage
The DEVOTED CHOICE 001 DE (PPO) Medicare plan features an annual prescription drug deductible of $375. For Tier 1 preferred generic and Tier 2 generic drugs, members pay no copay for 1-month, 2-month, or 3-month supplies filled at standard pharmacies or through standard mail order. This ensures affordable access to common prescription medications. For higher-tier medications, costs are based on coinsurance rather than set copays. Tier 3 preferred brand drugs require a 19% coinsurance, while Tier 4 non-preferred drugs carry a 25% coinsurance for standard pharmacy and mail-order fills. Specialty drugs in Tier 5 require a 28% coinsurance for a 1-month supply.
Additional Benefits
The DEVOTED CHOICE 001 DE (PPO) plan offers comprehensive medical coverage featuring no copay for primary care physician visits, annual physical exams, and home health services. Specialist visits require a copay between $35 and $50 with no coinsurance, while emergency room visits carry a $130 copay that is waived if you are admitted. For inpatient hospital stays, members pay a $420 daily copay for the first 5 to 6 days and no copay for the remaining days of their stay. Supplemental benefits include dental coverage up to a $3,500 annual limit with a $35 copay for Medicare dental services, alongside an annual eyewear allowance of up to $350 with no copay. Routine hearing exams are available for a $35 copay, and members receive a $100 allowance every three months for over-the-counter items with no copay. Durable medical equipment is also covered with no copay and a 20% coinsurance.
Inpatient Hospital See details
DEVOTED CHOICE 001 DE (PPO) covers inpatient hospital services with no coinsurance, requiring a $420 daily copay for days 1 through 6 for acute stays and days 1 through 5 for psychiatric stays, followed by no copay for remaining days. This benefit is partially covered, as upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Outpatient services are covered by DEVOTED CHOICE 001 DE (PPO) with no coinsurance, featuring a $0 to $520 copay for outpatient hospital services, a $420 copay per stay for observation services, and a $35 copay for outpatient substance abuse sessions. Additionally, ambulatory surgical center and outpatient blood services are covered with no copay and no coinsurance.
Partial Hospitalization See details
DEVOTED CHOICE 001 DE (PPO) covers partial hospitalization services with a $105.00 copay and no coinsurance. Prior authorization is required to receive this covered benefit.
Ambulance and Transportation Services See details
DEVOTED CHOICE 001 DE (PPO) covers ambulance services with prior authorization, featuring no copay to a $275 copay for ground services and a 20% coinsurance for air services. Routine transportation services to health-related locations are not covered.
Emergency Services See details
Emergency services are covered under the DEVOTED CHOICE 001 DE (PPO) plan with a $130 copay and no coinsurance, which is waived if admitted to the hospital within 24 hours. Urgently needed services feature no copay to a $45 copay and no coinsurance, while worldwide emergency services are covered up to $25,000 with copays of $130 for emergency or urgent care (no coinsurance) and a $275 copay with 20% coinsurance for transportation.
Primary Care See details
DEVOTED CHOICE 001 DE (PPO) offers primary care physician services with no copay and no coinsurance, and telehealth benefits with copays ranging from $0 to $45 and no coinsurance. Specialist, therapy, psychiatric, mental health, and opioid treatment services require copays between $35 and $50 with no coinsurance, while chiropractic and podiatry services are not covered.
Preventive Services See details
Preventive Services are partially covered by DEVOTED CHOICE 001 DE (PPO) with no copay and no coinsurance for annual physical exams, kidney disease education, and select wellness benefits. However, several sub-services are not covered, including in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, wigs for hair loss, therapeutic massage, adult day health, home-based palliative care, in-home support, caregiver support, additional smoking cessation, enhanced disease management, telemonitoring, remote access technologies, and counseling.
Hearing Services See details
Hearing services covered by the DEVOTED CHOICE 001 DE (PPO) plan include one routine annual hearing exam for a $35 copay and no coinsurance, plus unlimited fitting evaluations. Prescription hearing aids are partially covered with no coinsurance and copays ranging from $399 to $699 for up to two devices per year, though OTC, inner ear, outer ear, and over the ear hearing aids are not covered.
Vision Services See details
DEVOTED CHOICE 001 DE (PPO) offers partially covered vision services, which include one routine eye exam per year with a $0 to $35 copay and no coinsurance, while other eye exam services are not covered. Eyewear is covered with no copay, no coinsurance, and no deductible, up to a $350 annual combined maximum benefit for contacts, frames, lenses, and upgrades.
Dental Services See details
DEVOTED CHOICE 001 DE (PPO) partially covers dental services up to a $3,500 annual limit, featuring a $35 copay and no coinsurance for Medicare dental services, and no copay and 0% to 50% coinsurance for other covered services. Maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
DEVOTED CHOICE 001 DE (PPO) covers home infusion bundled services with no copay, though prior authorization is required. Covered Medicare Part B drugs—including chemotherapy, insulin, and other infusion drugs—are subject to a coinsurance of no coinsurance to 20%, with insulin also requiring a $35 copay.
Dialysis Services See details
DEVOTED CHOICE 001 DE (PPO) covers dialysis services with no copay and a 20% coinsurance, although prior authorization is required.
Medical Equipment See details
DEVOTED CHOICE 001 DE (PPO) covers medical equipment with no copay, though prior authorization is required. Durable medical equipment has a 20% coinsurance, while prosthetics, medical supplies, and diabetic supplies range from no coinsurance to 20% coinsurance, with diabetic therapeutic shoes and inserts being excluded from coverage.
Diagnostic and Radiological Services See details
DEVOTED CHOICE 001 DE (PPO) covers diagnostic and radiological services with prior authorization required, offering diagnostic services with no coinsurance. Members will pay no copay for lab services and outpatient X-rays, between no copay and a $95 copay for diagnostic procedures, and a minimum 20% coinsurance for therapeutic radiological services.
Home Health Services See details
Home Health Services are covered under the DEVOTED CHOICE 001 DE (PPO) plan with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are offered by DEVOTED CHOICE 001 DE (PPO) with no copay and no coinsurance, though prior authorization is required. While some services are covered, standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for peripheral artery disease (PAD) rehabilitation services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is covered by DEVOTED CHOICE 001 DE (PPO) with no coinsurance, offering no copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required, no prior three-day hospital stay is necessary, and additional days beyond the Medicare-covered limit are not covered.
Other Services See details
DEVOTED CHOICE 001 DE (PPO) partially covers other services, offering select preventive services and over-the-counter (OTC) items up to $100 every three months with no copay and no coinsurance. However, acupuncture and meal benefits are not covered under this plan.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
*/SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
MedicareAdvantageRX.com is owned and operated by Dog Media Solutions LLC.
This is a promotional communication.
Every year, Medicare evaluates plans based on a 5-star rating system.
Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
Enrollment in Medicare/Medicare Advantage may be limited to certain times of the year unless you qualify for a Special Enrollment Period
We do not offer every plan available in your area. Currently, we represent 18 organizations, which offer 52,101 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
We represent Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan's contract renewal.
Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.
Please contact Medicare.gov ,1-800-MEDICARE , or your local State Health Insurance Program (SHIP) to get information on all of your options.
Medicare has neither approved nor endorsed any information on this site.
Speak with a licensed insurance agent: 1-877-649-2073 / TTY 711 | 8am - 11pm ET | 7 days a week
© 2023 Dog Media Solutions LLC. All rights reserved