Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for DEVOTED C-SNP CHOICE PLUS 003 DE (PPO C-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on DEVOTED C-SNP CHOICE PLUS 003 DE (PPO C-SNP) in 2026, please refer to our full plan details page.
DEVOTED C-SNP CHOICE PLUS 003 DE (PPO C-SNP) is a PPO C-SNP 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 C-SNP CHOICE PLUS 003 DE (PPO C-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
DEVOTED C-SNP CHOICE PLUS 003 DE (PPO C-SNP)is a Special Needs Type (SNP) plan. This means you can only enroll in this plan if you meet specific criteria. See our full plan details page for more information.
Below are a few key facts and commonly-asked questions about DEVOTED C-SNP CHOICE PLUS 003 DE (PPO C-SNP).
The cost of a Medicare Advantage Plan is made up of four main parts.
For DEVOTED C-SNP CHOICE PLUS 003 DE (PPO C-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $31.20. 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 has a $675.00 health deductible. This means, every calendar year, you pay this amount towards covered services before your insurance coverage kicks in.
This plan has a $615.00 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 $13900.00 (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 $13900.00 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.
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
The DEVOTED C-SNP CHOICE PLUS 003 DE (PPO C-SNP) prescription drug plan features an annual drug deductible of $615. Under this plan, Tier 1 preferred generic drugs have an $18 copay for a 1-month standard fill, while Tier 2 generics carry a $19 copay. Beneficiaries will also benefit from no copay on Tier 6 select care drugs for 1-month, 2-month, or 3-month supplies through standard pharmacies and mail order. For higher-tier medications, costs transition to a percentage of the drug's price rather than a flat copayment. Tier 3 preferred brands and Tier 5 specialty drugs require a 25% coinsurance, while Tier 4 non-preferred drugs require a 31% coinsurance. These standard pharmacy and mail-order rates apply throughout the initial coverage phase of your Medicare plan.
The DEVOTED C-SNP CHOICE PLUS 003 DE (PPO C-SNP) plan offers comprehensive medical coverage featuring no copay and no coinsurance for primary care visits and home health services. Inpatient hospital stays require a copay of $2,230 for acute care and $2,080 for psychiatric care, both with no coinsurance, while outpatient services feature no copays but carry coinsurance up to 50%. Emergency room visits have a $115 copay which is waived if admitted, and skilled nursing facility stays have no copay for the first 20 days followed by a $218 daily copay. For supplemental care, the plan provides dental services with no copay or coinsurance up to a $3,000 annual limit, alongside up to $300 for eyewear and prescription hearing aids with copays ranging from $399 to $699. Diagnostic, laboratory, and radiological services require no copays, though coinsurance ranges from 0% to 50% depending on the specific service. Additionally, patients benefit from no copays on medical equipment and dialysis, though these services are subject to coinsurance of up to 20%.
DEVOTED C-SNP CHOICE PLUS 003 DE (PPO C-SNP) provides partially covered inpatient hospital benefits with no coinsurance, featuring a $2,230 copay per stay for acute care and a $2,080 copay per stay for psychiatric care. Unlimited additional days are covered for acute stays, but non-Medicare-covered stays, upgrades, and additional psychiatric days are not covered.
DEVOTED C-SNP CHOICE PLUS 003 DE (PPO C-SNP) covers outpatient services with no copays, though prior authorization is required for most services. Coinsurance ranges up to 50% for outpatient hospital and ambulatory surgical center services, while observation services carry a 50% coinsurance, and outpatient substance abuse and blood services require a 30% coinsurance.
Partial hospitalization services are covered by DEVOTED C-SNP CHOICE PLUS 003 DE (PPO C-SNP) with no copay and a 20% coinsurance. Prior authorization is required to access this benefit.
DEVOTED C-SNP CHOICE PLUS 003 DE (PPO C-SNP) covers ground ambulance services with no copay and a 0% to 50% coinsurance, and air ambulance services with no copay and a 50% coinsurance, with prior authorization required for both. Routine transportation services to health-related locations are not covered under this plan.
Emergency services are covered by DEVOTED C-SNP CHOICE PLUS 003 DE (PPO C-SNP) with a $115 copay and no coinsurance, with the copay waived if you are admitted to the hospital within 24 hours. Urgently needed services require no copay and a 0% to 20% coinsurance (maximum $40 per visit), while worldwide emergency, urgent, and transportation services are covered with no copay or coinsurance up to a $25,000 maximum.
DEVOTED C-SNP CHOICE PLUS 003 DE (PPO C-SNP) offers primary care physician services with no copay and no coinsurance, while chiropractic services are not covered in practice. Specialist visits, physical and occupational therapy, mental health, and podiatry services are covered with no copay and 30% coinsurance.
Preventive Services are partially covered by DEVOTED C-SNP CHOICE PLUS 003 DE (PPO C-SNP) with no copay and no coinsurance for covered options like annual physicals, fitness benefits, and nutritional therapy. However, several sub-services are not covered, including in-home safety assessments, personal emergency response systems, post-discharge medication reconciliation, re-admission prevention, chemotherapy wigs, therapeutic massage, adult day health, home-based palliative care, in-home support, caregiver support, extra smoking cessation, enhanced disease management, telemonitoring, remote access technologies, and counseling services.
DEVOTED C-SNP CHOICE PLUS 003 DE (PPO C-SNP) provides partially covered hearing services, with routine hearing exams requiring no copay and a 50% coinsurance, and prescription hearing aids requiring no coinsurance and a $399 to $699 copay. OTC hearing aids, as well as inner ear, outer ear, and over the ear prescription hearing aids, are not covered.
DEVOTED C-SNP CHOICE PLUS 003 DE (PPO C-SNP) offers partially covered vision services, including one routine eye exam per year with no copay and 0% to 50% coinsurance, though other eye exam services are not covered. Eyewear is covered with no copay or coinsurance, offering up to a $300 annual maximum for contacts, frames, lenses, and upgrades.
DEVOTED C-SNP CHOICE PLUS 003 DE (PPO C-SNP) offers partially covered dental services with no copay and no coinsurance up to a $3,000 annual maximum, while Medicare-covered dental has a 30% coinsurance and no copay. Non-covered services include other diagnostic dental, other preventive dental, maxillofacial prosthetics, implant services, and orthodontics.
DEVOTED C-SNP CHOICE PLUS 003 DE (PPO C-SNP) covers Home Infusion bundled services with no copay, though prior authorization and step therapy apply. Associated Medicare Part B chemotherapy, radiation, and other drugs require no coinsurance to 20% coinsurance, while Part B insulin drugs have a $35 copay and no coinsurance to 20% coinsurance that counts toward the plan deductible.
Dialysis Services are covered under the DEVOTED C-SNP CHOICE PLUS 003 DE (PPO C-SNP) plan with no copay and a 20% coinsurance, though prior authorization is required.
DEVOTED C-SNP CHOICE PLUS 003 DE (PPO C-SNP) covers medical equipment with no copay and coinsurance ranging from no coinsurance up to 20%, though prior authorization is required. This benefit is partially covered because durable medical equipment, prosthetics, and diabetic supplies are covered, while diabetic therapeutic shoes and inserts are not covered.
DEVOTED C-SNP CHOICE PLUS 003 DE (PPO C-SNP) covers diagnostic and radiological services with no copayments, though prior authorization is required. Patients will pay no coinsurance for diagnostic procedures and tests, a 20% coinsurance for therapeutic radiological services, and a 50% coinsurance for lab services, diagnostic radiological services, and outpatient X-rays.
Home Health Services are covered by DEVOTED C-SNP CHOICE PLUS 003 DE (PPO C-SNP) with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services are covered under the DEVOTED C-SNP CHOICE PLUS 003 DE (PPO C-SNP) plan with no copay and require prior authorization. Although some services are covered, specific services including cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation are not covered in practice and require a 30% coinsurance.
DEVOTED C-SNP CHOICE PLUS 003 DE (PPO C-SNP) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring prior authorization and no prior three-day inpatient hospital stay. There is no copay for days 1 through 20 and a $218 daily copay for days 21 through 100, though additional days beyond the standard Medicare-covered limit are not covered.
DEVOTED C-SNP CHOICE PLUS 003 DE (PPO C-SNP) partially covers other services with no copay and no coinsurance, including over-the-counter items up to $50 every three months, non-Medicare diabetic shoes, and additional preventive services. Acupuncture, meal benefits, and dual-eligible highly integrated services are not covered under this plan.
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* 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.
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