A non-government entity
DEVOTED CORE 003 FL (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for DEVOTED CORE 003 FL (HMO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on DEVOTED CORE 003 FL (HMO) in 2026, please refer to our full plan details page.
DEVOTED CORE 003 FL (HMO) is a HMO plan offered by Devoted Health, Inc. available for enrollment in 2025 to people living in Palm Beach County. This plan received an overall rating of 5 out of 5 stars in 2026.
It's important to know that DEVOTED CORE 003 FL (HMO) 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 CORE 003 FL (HMO).
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 CORE 003 FL (HMO), 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 $595.00 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 Maximum Out-Of-Pocket cost of $3900.00 for out-of-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $0.00 for in-network covered services, the plan will pay 100% of in-network covered costs for the rest of the year.
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:
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Drug Coverage
The DEVOTED CORE 003 FL (HMO) plan features an annual drug deductible of $595. Under this plan, you will pay no copay for Tier 1 (Preferred Generic) and Tier 2 (Generic) medications filled at standard pharmacies or through standard mail order. This cost-saving benefit applies to one-month, two-month, and three-month supplies. For higher-tier medications, costs are determined by coinsurance rather than flat copays. You will pay a 24% coinsurance for Tier 3 (Preferred Brand) drugs and a 25% coinsurance for Tier 4 (Non-Preferred) drugs. Tier 5 (Specialty) drugs also require a 25% coinsurance for a one-month supply at standard pharmacies or through standard mail order.
Additional Benefits
The DEVOTED CORE 003 FL (HMO) Medicare plan offers comprehensive medical coverage with no copays or coinsurance for primary care, specialist visits, home health, and preventive services. Inpatient hospital stays require a $200 daily copay for days 1 through 5 and no copay for days 6 through 90, while outpatient hospital services feature copays ranging from no copay up to $195. Emergency room care is covered with a $150 copay, which is waived if you are admitted to the hospital. Supplemental benefits include dental coverage up to a $1,500 annual limit with no copay for preventive care, alongside a $150 annual eyewear allowance and no copay for annual routine vision and hearing exams. Prescription hearing aids are covered with copays ranging from $399 to $699, and skilled nursing facility stays feature no copay for the first 20 days. Some services, including transportation, cardiac rehabilitation, and over-the-counter items, are not covered under this plan.
Inpatient Hospital See details
DEVOTED CORE 003 FL (HMO) inpatient hospital services are partially covered, featuring no coinsurance and a $200 daily copay for days 1 through 5, with no copay for days 6 through 90. Upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
DEVOTED CORE 003 FL (HMO) outpatient services are covered with no coinsurance, featuring copays ranging from $0 to $195 for hospital services, a $195 copay per stay for observation services, and no copay for ambulatory surgical center and blood services. For outpatient substance abuse, some services are covered with no copay or coinsurance, but individual and group sessions are not covered.
Partial Hospitalization See details
Partial hospitalization is covered under the DEVOTED CORE 003 FL (HMO) plan with a $50.00 copay and no coinsurance, though prior authorization is required.
Ambulance and Transportation Services See details
DEVOTED CORE 003 FL (HMO) covers ground ambulance services with a copay ranging from no copay to $300 and no coinsurance, while air ambulance services require a 20% coinsurance and no copay. Prior authorization is required for ambulance services, and transportation services are not covered.
Emergency Services See details
Emergency services are covered by DEVOTED CORE 003 FL (HMO) with a $150 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services range from no copay to a $45 copay with no coinsurance, while worldwide emergency services are covered up to a $25,000 maximum with a $150 copay and no coinsurance for emergency or urgent care, and a $300 copay with 20% coinsurance for transportation.
Primary Care See details
DEVOTED CORE 003 FL (HMO) offers primary care, specialist, and opioid treatment services with no copay and no coinsurance, while occupational, physical, and speech therapy services require a $0 to $50 copay and no coinsurance. Although some chiropractic, mental health, and psychiatric services are covered, routine and other chiropractic care, individual and group sessions for mental health and psychiatry, and podiatry services are not covered.
Preventive Services See details
Preventive services under the DEVOTED CORE 003 FL (HMO) plan are covered with no copay and no coinsurance, including annual physical exams, kidney disease education, and diabetes self-management training. Additional preventive benefits are partially covered with no copay and no coinsurance, excluding services such as in-home support, caregiver support, therapeutic massage, telemonitoring, and counseling.
Hearing Services See details
DEVOTED CORE 003 FL (HMO) covers hearing services with no copay and no coinsurance for one routine hearing exam per year and unlimited fitting evaluations. Prescription hearing aids are partially covered with no coinsurance and a copay of $399 to $699 for up to two aids per year, though OTC hearing aids as well as inner ear, outer ear, and over the ear prescription aids are not covered.
Vision Services See details
DEVOTED CORE 003 FL (HMO) offers partially covered vision services with no copay, no coinsurance, and no deductible. The plan covers one routine eye exam per year (prior authorization required; other eye exam services are not covered) and provides a $150 annual allowance for eyewear, including contacts, eyeglasses, frames, lenses, and upgrades.
Dental Services See details
DEVOTED CORE 003 FL (HMO) offers partially covered dental services up to a $1,500 annual limit, with no copay and no coinsurance for Medicare dental, preventive care, periodontics, and oral surgery. Restorative services, endodontics, and prosthodontics are covered with no copay and 0% to 50% coinsurance, while maxillofacial prosthetics, implants, and orthodontics are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by DEVOTED CORE 003 FL (HMO) with no copay, requiring prior authorization. Associated Medicare Part B chemotherapy and other drugs have no copay and no coinsurance to 20% coinsurance, while covered Part B insulin drugs have a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered by DEVOTED CORE 003 FL (HMO) with no copay and a 20% coinsurance. Prior authorization is required for these services.
Medical Equipment See details
DEVOTED CORE 003 FL (HMO) covers durable medical equipment with no copay and 20% to 50% coinsurance, and prosthetics or medical supplies with no copay and no coinsurance to 20% coinsurance. Diabetic equipment is partially covered with no copay and no coinsurance to 50% coinsurance for supplies, but diabetic therapeutic shoes and inserts are not covered.
Diagnostic and Radiological Services See details
DEVOTED CORE 003 FL (HMO) covers diagnostic and radiological services with prior authorization, offering lab services, outpatient X-rays, and diagnostic radiological services with no copays. Diagnostic procedures and tests have no coinsurance with a copay ranging from $0 to $95, while therapeutic radiological services require a minimum 20% coinsurance.
Home Health Services See details
DEVOTED CORE 003 FL (HMO) covers Home Health Services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
DEVOTED CORE 003 FL (HMO) does not cover Cardiac Rehabilitation Services, which includes cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services. Because these services are not covered by the plan, members are responsible for the full cost of these treatments.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by DEVOTED CORE 003 FL (HMO) with no coinsurance, requiring prior authorization but no prior three-day inpatient hospital stay. There is no copay for days 1 through 20, followed by a $218 daily copay for days 21 through 100, with no coverage provided for additional days.
Other Services See details
Other Services are partially covered by DEVOTED CORE 003 FL (HMO), which provides additional preventive services not covered by Medicare with no copay and no coinsurance. Acupuncture, over-the-counter (OTC) items, and meal benefits are not covered.
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