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DEVOTED DUAL 021 FL (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for DEVOTED DUAL 021 FL (HMO D-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on DEVOTED DUAL 021 FL (HMO D-SNP) in 2026, please refer to our full plan details page.
DEVOTED DUAL 021 FL (HMO D-SNP) is a HMO D-SNP 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 DUAL 021 FL (HMO D-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
DEVOTED DUAL 021 FL (HMO D-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.
Key Plan Facts
Below are a few key facts and commonly-asked questions about DEVOTED DUAL 021 FL (HMO D-SNP).
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 DUAL 021 FL (HMO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $4.80. 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 $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 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 DUAL 021 FL (HMO D-SNP) Medicare plan features an annual drug deductible of $615. For prescription drug tiers 1 through 4, standard pharmacies and standard mail-order services require a 25% coinsurance for 1-month, 2-month, and 3-month supplies. Tier 5 specialty drugs also carry a 25% coinsurance for a 1-month supply when using standard pharmacies or standard mail-order. In contrast, Tier 6 select care drugs are available with no copay for 1-month, 2-month, and 3-month supplies at standard pharmacies and through standard mail order. This plan structure helps beneficiaries understand their exact out-of-pocket costs for various medication tiers.
Additional Benefits
The DEVOTED DUAL 021 FL (HMO D-SNP) plan offers comprehensive healthcare coverage with no copay for primary care visits, specialist consultations, and routine preventive services. For hospital stays, members pay a $175 daily copay for the first five days of inpatient care and no copay for days six through 90, while outpatient hospital services range from no copay up to a $175 copay. Emergency care is covered with a $150 copay, which is waived if you are admitted, alongside home health services at no cost. This plan also features valuable supplemental benefits, including a $2,500 annual dental allowance with no copay, a $400 annual eyewear allowance, and a $50 quarterly over-the-counter benefit. While routine hearing exams have no copay, prescription hearing aids require a copay of $399 to $699. Additionally, services such as durable medical equipment and dialysis require a 20% to 30% coinsurance, and routine transportation is not covered.
Inpatient Hospital See details
DEVOTED DUAL 021 FL (HMO D-SNP) covers inpatient acute and psychiatric hospital services with no coinsurance, requiring a $175 copay per day for days 1 through 5 and no copay for days 6 through 90. This benefit is partially covered, as upgrades, non-Medicare-covered stays, and additional days for psychiatric stays are not covered.
Outpatient Services See details
Outpatient services are covered by DEVOTED DUAL 021 FL (HMO D-SNP) with no coinsurance, featuring a $0 to $175 copay for outpatient hospital services, a $175 copay per stay for observation services, and no copay for ambulatory surgical center and outpatient blood services. For outpatient substance abuse services, some services are covered with no copay or coinsurance, but individual sessions and group sessions are not covered.
Partial Hospitalization See details
Partial hospitalization services are covered by the DEVOTED DUAL 021 FL (HMO D-SNP) plan with a $50.00 copay and no coinsurance. Prior authorization is required to receive this benefit.
Ambulance and Transportation Services See details
DEVOTED DUAL 021 FL (HMO D-SNP) covers ground ambulance services with a copay ranging from no copay to $300, and air ambulance services with a 20% coinsurance, both requiring prior authorization. Transportation services to plan-approved or any other health-related locations are not covered.
Emergency Services See details
DEVOTED DUAL 021 FL (HMO D-SNP) covers emergency services with a $150 copay and no coinsurance, with the copay waived if you are admitted to the hospital within 24 hours. Urgently needed services have no coinsurance and a copay ranging from no copay to $45, while worldwide emergency services are covered up to a $25,000 limit with a $150 copay for emergency or urgent care, and a $300 copay plus 20% coinsurance for emergency transportation.
Primary Care See details
Primary care services under the DEVOTED DUAL 021 FL (HMO D-SNP) plan are covered with no copay and no coinsurance for primary care, specialist, and podiatry visits, while physical, occupational, and speech therapies have a $0 to $50 copay and no coinsurance. Some services are covered but have exclusions, as other chiropractic services and individual or group sessions for mental health and psychiatric services are not covered.
Preventive Services See details
DEVOTED DUAL 021 FL (HMO D-SNP) covers preventive services with no copay and no coinsurance, including annual physical exams, kidney disease education, and diabetes self-management. Additional preventive services are partially covered, offering fitness benefits, alternative therapies, and nutritional counseling, while excluding services such as in-home support, therapeutic massage, counseling, and personal emergency response systems.
Hearing Services See details
DEVOTED DUAL 021 FL (HMO D-SNP) covers annual routine hearing exams and fitting evaluations with no copay and no coinsurance. Prescription hearing aids are partially covered with no coinsurance and a $399 to $699 copay for up to two devices per year, though OTC hearing aids and inner, outer, or over the ear prescription models are not covered.
Vision Services See details
DEVOTED DUAL 021 FL (HMO D-SNP) offers partially covered vision services with no copay and no coinsurance, including one routine eye exam per year and a $400 annual allowance for eyewear like contacts, eyeglasses, and upgrades. Other eye exam services are not covered under this plan.
Dental Services See details
Dental services are partially covered by DEVOTED DUAL 021 FL (HMO D-SNP) with no copay and no coinsurance up to a maximum benefit of $2,500 per year. Covered services include exams, cleanings, x-rays, fillings, and dentures, while implants, orthodontics, maxillofacial prosthetics, and other diagnostic or preventive services are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by DEVOTED DUAL 021 FL (HMO D-SNP) with no copay, though prior authorization is required. Medicare Part B insulin drugs require a $35 copay and up to 20% coinsurance, while chemotherapy, radiation, and other Part B drugs feature no copay and up to 20% coinsurance.
Dialysis Services See details
DEVOTED DUAL 021 FL (HMO D-SNP) covers dialysis services with no copay and a 20% coinsurance. Prior authorization is required to receive these services.
Medical Equipment See details
DEVOTED DUAL 021 FL (HMO D-SNP) covers medical equipment with no copay and prior authorization required, featuring 20% to 30% coinsurance for durable medical equipment and no coinsurance to 20% coinsurance for prosthetics and medical supplies. Diabetic equipment is partially covered with no coinsurance to 30% coinsurance for diabetic supplies, but diabetic therapeutic shoes or inserts are not covered.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by DEVOTED DUAL 021 FL (HMO D-SNP) with prior authorization required. Diagnostic services have no coinsurance, featuring no copay for lab services and a $0 to $95 copay for procedures, while radiological services offer no copay for X-rays and a minimum 20% coinsurance for therapeutic services.
Home Health Services See details
Home health services are covered by DEVOTED DUAL 021 FL (HMO D-SNP) with no copay and no coinsurance. Prior authorization is required to access this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the DEVOTED DUAL 021 FL (HMO D-SNP) plan. This exclusion applies to all related sub-services, including standard cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and SET for PAD services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is covered by DEVOTED DUAL 021 FL (HMO D-SNP) with no coinsurance, featuring no copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required, and while a prior three-day inpatient hospital stay is not required for admission, additional days beyond the standard 100-day limit are not covered.
Other Services See details
Other services are partially covered by DEVOTED DUAL 021 FL (HMO D-SNP) with no copay and no coinsurance, which includes a $50 quarterly over-the-counter (OTC) allowance and additional preventive services. Acupuncture, meal benefits, and highly integrated dual-eligible services are not covered under this benefit.
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