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Devoted GIVEBACK Florida (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Devoted GIVEBACK Florida (HMO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Devoted GIVEBACK Florida (HMO) in 2025, please refer to our full plan details page.
Devoted GIVEBACK Florida (HMO) is a HMO plan offered by Devoted Health, Inc. available for enrollment in 2025 to people living in Miami-Dade County. This plan received an overall rating of 4.5 out of 5 stars in 2025.
It's important to know that Devoted GIVEBACK Florida (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 GIVEBACK Florida (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 GIVEBACK Florida (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. Additionally, this plan comes with a Part B Premium reduction of $174.70. You must continue to pay paying your reduced 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 $590.00 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 $6750.00 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 GIVEBACK Florida (HMO) plan has a $590.00 deductible for prescription drugs. After the deductible, you'll pay a copay or coinsurance depending on the drug tier and pharmacy type. For example, you will pay a $5 copay for preferred generic drugs at a standard or mail-order pharmacy. For standard generic drugs, preferred brand drugs, and non-preferred drugs, you will pay 25% coinsurance. Once your total drug costs reach $2000.00, you enter the catastrophic coverage phase where you pay nothing for covered drugs.
Additional Benefits
The Devoted GIVEBACK Florida (HMO) plan offers a range of benefits, including coverage for inpatient and outpatient hospital services, with varying copays. You'll have access to primary care, preventive services, hearing, vision, and dental services, as well as ambulance and emergency services. This plan includes coverage for home health, skilled nursing, and dialysis services, with specific copays and coinsurance amounts. Coverage for additional services includes medical equipment, diagnostic and radiological services, and home infusion bundled services.
Inpatient Hospital See details
Inpatient Hospital coverage, including acute and psychiatric, is covered. For Inpatient Hospital-Acute, you pay a \$395 copay for days 1-6 and no copay for days 7-90; for Inpatient Hospital Psychiatric, you pay a \$395 copay for days 1-5 and no copay for days 6-90. Additional days for Inpatient Hospital-Acute are covered, while non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute and additional days and non-Medicare-covered stays for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services with a copay between $0 and $395, observation services with a $395 copay, and ambulatory surgical center services with no copay. Outpatient substance abuse services are covered, with individual and group sessions having a copay between $45 and $45. Outpatient blood services are also covered.
Partial Hospitalization See details
Partial Hospitalization is covered by the Devoted GIVEBACK Florida (HMO) plan, with a $55 copay. Prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, with prior authorization required for all ambulance services. Ground ambulance services have a copay between $0 and $350, and air ambulance services have a 20% coinsurance, while transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by the Devoted GIVEBACK Florida (HMO) plan. Emergency Services have a $125 copay and no coinsurance. Urgently Needed Services have a copay between $0 and $55, and no coinsurance. Worldwide Emergency Coverage and Worldwide Urgent Coverage have a $125 copay, and no coinsurance. Worldwide Emergency Transportation has a $350 copay and a 20% coinsurance.
Primary Care See details
Primary Care benefits include coverage for Primary Care Physician Services, Chiropractic Services, Occupational Therapy Services, Physician Specialist Services, Mental Health Specialty Services, Other Health Care Professional, Psychiatric Services, Physical Therapy and Speech-Language Pathology Services, Additional Telehealth Benefits, and Opioid Treatment Program Services. Chiropractic Services have a $20 copay. Occupational Therapy Services, Physician Specialist Services, and Additional Telehealth Benefits have copays that range from $0 to $45. Mental Health Specialty Services, Psychiatric Services, and Opioid Treatment Program Services have a $45 copay. Physical Therapy and Speech-Language Pathology Services have copays that range from $0 to $65.
Preventive Services See details
The Devoted GIVEBACK Florida (HMO) plan covers preventive services, including annual physical exams, health education, weight management programs, alternative therapies, nutritional/dietary benefits, fitness benefits, home and bathroom safety devices and modifications, kidney disease education services, glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKG following Welcome Visit. In-home safety assessment, personal emergency response systems, medical nutrition therapy, post-discharge in-home medication reconciliation, re-admission prevention, wigs for hair loss, therapeutic massage, adult day health services, home-based palliative care, in-home support services, support for caregivers of enrollees, additional sessions of smoking and tobacco cessation counseling, enhanced disease management, telemonitoring services, remote access technologies, and counseling services are not covered.
Hearing Services See details
Hearing services include coverage for hearing exams with a $40 copay, routine hearing exams, and fitting/evaluation for hearing aids, but prescription hearing aids are partially covered with a copay between $0 and $299, and OTC hearing aids are not covered. Prescription hearing aids - inner ear, outer ear, and over the ear are also not covered.
Vision Services See details
The Devoted GIVEBACK Florida (HMO) plan covers vision services including eye exams with a $40 copay, eyewear with a combined maximum benefit of $900 per year, and contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades. Routine eye exams are limited to one per year.
Dental Services See details
The Devoted GIVEBACK Florida (HMO) plan covers Medicare Dental Services with a $45 copay and other dental services, including oral exams, dental x-rays, other diagnostic dental services, fluoride treatment, other preventive dental services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), and oral and maxillofacial surgery. Prophylaxis (cleaning) is covered for 2 visits per year. Orthodontic services are covered up to $900 per year. Maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services, including Medicare Part B Insulin Drugs, Medicare Part B Chemotherapy/Radiation Drugs, and Other Medicare Part B Drugs, are covered. For Medicare Part B Insulin Drugs, there is a $35 copay and 20% coinsurance; for Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, the coinsurance is between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by the Devoted GIVEBACK Florida (HMO) plan, with a coinsurance between 20% and 20%.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with a coinsurance between 20% and 25%, Prosthetic Devices with a coinsurance between 0% and 20%, and Medical Supplies with a 20% coinsurance. Durable Medical Equipment for use outside the home, Diabetic Supplies, and Diabetic Therapeutic Shoes/Inserts are not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services includes coverage for all diagnostic services with a copay that ranges from $0 to $125, and lab services with no copay. Radiological services are covered with a copay up to $300 for diagnostic services and a 20% coinsurance for therapeutic services, while outpatient X-ray services have no copay.
Home Health Services See details
Home Health Services are covered by the Devoted GIVEBACK Florida (HMO) plan with no copay and no coinsurance, but additional hours of care and personal care services are not covered. Prior authorization is required for this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the Devoted GIVEBACK Florida (HMO) plan. The plan also does not cover Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, or SET for PAD Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Devoted GIVEBACK Florida (HMO) plan, but require prior authorization. You will have no copay for days 1-20, and a $214 copay for days 21-100. Additional days beyond Medicare-covered and non-Medicare-covered stays for SNF are not covered.
Other Services See details
Other Services are not covered, including acupuncture, over-the-counter items, and meal benefits. Additionally, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, and many other services are not covered.
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