A non-government entity
DEVOTED DUAL 023 FL (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for DEVOTED DUAL 023 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 023 FL (HMO D-SNP) in 2026, please refer to our full plan details page.
DEVOTED DUAL 023 FL (HMO D-SNP) is a HMO D-SNP plan offered by Devoted Health, Inc. available for enrollment in 2025 to people living in Clay, Duval, Nassau, and St. Johns Counties. This plan received an overall rating of 5 out of 5 stars in 2026.
It's important to know that DEVOTED DUAL 023 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 023 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 023 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 023 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 $4900.00 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:
Sign up for DEVOTED DUAL 023 FL (HMO D-SNP)
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 DUAL 023 FL (HMO D-SNP) Medicare plan features an annual prescription drug deductible of $615. Under this plan, standard pharmacies and standard mail-order services require a 25% coinsurance for Tier 1 preferred generics, Tier 2 generics, Tier 3 preferred brands, and Tier 4 non-preferred drugs. Tier 5 specialty drugs also incur a 25% coinsurance for a one-month supply when filled through standard pharmacy or standard mail-order channels. Beneficiaries pay no copay for Tier 6 select care drugs, which applies to one-month, two-month, and three-month supplies at standard pharmacies and standard mail order. This plan offers structured cost-sharing options to help you manage your out-of-pocket prescription medication expenses in Florida.
Additional Benefits
The DEVOTED DUAL 023 FL (HMO D-SNP) Medicare plan offers affordable coverage with no copay and no coinsurance for primary care visits and home health services. For inpatient hospital stays, members pay no coinsurance and a $175 copay for days 1 through 5, while days 6 through 90 have no copay. Specialist visits, dental care, and routine vision exams are highly accessible with low copays starting at just $10 or no copay at all. This plan also includes valuable extra benefits, such as a $400 annual allowance for eyewear and up to $2,500 in yearly preventive and comprehensive dental care with no copay. Members can access over-the-counter items with no copay up to $50 every three months, while routine hearing exams require only a $10 copay. Although most medical equipment requires a 20% to 30% coinsurance, many diagnostic services and lab tests are available with no copay.
Inpatient Hospital See details
DEVOTED DUAL 023 FL (HMO D-SNP) partially covers inpatient hospital services with no coinsurance, requiring a $175 copay for days 1 to 5 and no copay for days 6 to 90 per stay. While unlimited additional acute care days are covered, upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
DEVOTED DUAL 023 FL (HMO D-SNP) covers outpatient services with no coinsurance, offering ambulatory surgical center and blood services with no copay. Outpatient hospital services have a copay ranging from $0 to $175, observation services require a $175 copay per stay, and outpatient substance abuse sessions carry a $10 copay.
Partial Hospitalization See details
DEVOTED DUAL 023 FL (HMO D-SNP) covers partial hospitalization services with a $55.00 copay and no coinsurance. Prior authorization is required to access this covered benefit.
Ambulance and Transportation Services See details
DEVOTED DUAL 023 FL (HMO D-SNP) covers ambulance services with prior authorization, requiring a copay of $0 to $325 (with no coinsurance) for ground transport and a 20% coinsurance (with no copay) for air transport. Routine transportation services to health-related locations are not covered under this plan.
Emergency Services See details
DEVOTED DUAL 023 FL (HMO D-SNP) covers emergency services with a $130 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 $25,000 with a $130 copay and no coinsurance for care, and a $325 copay and 20% coinsurance for transportation.
Primary Care See details
DEVOTED DUAL 023 FL (HMO D-SNP) offers primary care physician services with no copay and no coinsurance, while specialist, mental health, podiatry, and psychiatric services have a $10 copay and no coinsurance. Physical, occupational, and speech therapy require a $10 to $50 copay and no coinsurance, telehealth ranges from a $0 to $45 copay with no coinsurance, and chiropractic care is partially covered with a $10 copay and no coinsurance, though other chiropractic services are not covered.
Preventive Services See details
Preventive services are partially covered by DEVOTED DUAL 023 FL (HMO D-SNP) with no copay and no coinsurance for covered benefits like annual physicals, fitness programs, and nutritional counseling. Non-covered sub-services include in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, readmission prevention, chemotherapy wigs, therapeutic massage, adult day health, home-based palliative care, in-home support, caregiver support, additional smoking cessation counseling, enhanced disease management, telemonitoring, remote access technologies, and counseling.
Hearing Services See details
Hearing Services are partially covered by DEVOTED DUAL 023 FL (HMO D-SNP), featuring a $10 copay and no coinsurance for routine exams, and prescription hearing aids with a copay of $399 to $699 and no coinsurance. OTC hearing aids, along with inner ear, outer ear, and over-the-ear prescription hearing aids, are not covered.
Vision Services See details
DEVOTED DUAL 023 FL (HMO D-SNP) partially covers vision services, offering one routine eye exam per year with a $0 to $10 copay and no coinsurance, while other eye exam services are not covered. Eyewear is covered with no copay and no coinsurance up to a $400 annual maximum for contacts, lenses, frames, and upgrades.
Dental Services See details
DEVOTED DUAL 023 FL (HMO D-SNP) offers dental services with a $10 copay and no coinsurance for Medicare-covered dental, and no copay or coinsurance for preventive and comprehensive care up to a $2,500 annual limit. The benefit is partially covered, as other diagnostic and preventive services, maxillofacial prosthetics, implants, and orthodontics are not covered.
Home Infusion bundled Services See details
DEVOTED DUAL 023 FL (HMO D-SNP) covers home infusion bundled services with no copay, subject to prior authorization and step therapy requirements. Associated Medicare Part B chemotherapy, radiation, and other drugs carry no coinsurance to 20% coinsurance, while Medicare Part B insulin is covered with a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered by the DEVOTED DUAL 023 FL (HMO D-SNP) plan with no copay and a 20% coinsurance. Prior authorization is required to receive these covered services.
Medical Equipment See details
DEVOTED DUAL 023 FL (HMO D-SNP) covers medical equipment with no copays, but prior authorization is required and coinsurance applies to most items. Durable medical equipment requires 20% to 30% coinsurance, prosthetics and medical supplies range from no coinsurance to 20% coinsurance, and diabetic supplies range from no coinsurance to 30% coinsurance, though diabetic therapeutic shoes and inserts are not covered.
Diagnostic and Radiological Services See details
DEVOTED DUAL 023 FL (HMO D-SNP) covers diagnostic and radiological services with prior authorization required. Lab services, outpatient X-rays, and diagnostic radiological services feature no copay, diagnostic procedures and tests have a copay of $0 to $95 with no coinsurance, and coinsurance applies to X-rays and therapeutic radiological services (minimum 20% coinsurance).
Home Health Services See details
Home Health Services are covered under the DEVOTED DUAL 023 FL (HMO D-SNP) plan with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
DEVOTED DUAL 023 FL (HMO D-SNP) covers some Cardiac Rehabilitation Services with no coinsurance and prior authorization required, but cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by DEVOTED DUAL 023 FL (HMO D-SNP) with no coinsurance, requiring no copay for days 1 to 20 and a $218 daily copay for days 21 to 100. Prior authorization is required and a prior three-day inpatient hospital stay is not needed, though additional days beyond the standard 100-day Medicare-covered limit are not covered.
Other Services See details
DEVOTED DUAL 023 FL (HMO D-SNP) partially covers other services, offering no copay and no coinsurance for over-the-counter items up to $50 every three months and additional preventive services. Acupuncture, meal benefits, and highly integrated dual eligible services are not covered.
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