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DEVOTED DUAL 024 FL (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for DEVOTED DUAL 024 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 024 FL (HMO D-SNP) in 2026, please refer to our full plan details page.
DEVOTED DUAL 024 FL (HMO D-SNP) is a HMO D-SNP plan offered by Devoted Health, Inc. available for enrollment in 2025 to people living in Greater Tampa Bay. This plan received an overall rating of 5 out of 5 stars in 2026.
It's important to know that DEVOTED DUAL 024 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 024 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 024 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 024 FL (HMO D-SNP), 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 $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 024 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 generic, Tier 2 generic, Tier 3 preferred brand, and Tier 4 non-preferred drugs across 1-month, 2-month, and 3-month supplies. For Tier 5 specialty drugs, members pay a 25% coinsurance for a 1-month supply at standard pharmacies and standard mail order. Tier 6 select care drugs are fully covered with no copay for 1-month, 2-month, and 3-month supplies through standard pharmacies and standard mail order channels.
Additional Benefits
DEVOTED DUAL 024 FL (HMO D-SNP) offers robust coverage with low out-of-pocket costs, featuring no copay and no coinsurance for primary care visits, home health services, and preventive care. Specialist visits, mental health services, and Medicare-covered dental care require a low $5 copay with no coinsurance. Inpatient hospital stays require a $175 copay for the first five days, followed by no copay for days 6 through 90, while emergency services carry a $150 copay that is waived upon admission. Supplemental benefits include a $2,500 annual dental maximum with no copay for most covered services, alongside up to a $400 yearly allowance for eyewear with no copay. Members also benefit from a $50 quarterly allowance for over-the-counter items with no copay and a $5 copay for routine hearing exams. Specialized care such as home infusion and dialysis is covered, though some medical equipment and Part B drugs require coinsurance ranging from 0% to 30%.
Inpatient Hospital See details
Inpatient hospital care is partially covered by DEVOTED DUAL 024 FL (HMO D-SNP) with no coinsurance, requiring a $175 copay for days 1 through 5 and no copay for days 6 through 90 of a stay. Upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
DEVOTED DUAL 024 FL (HMO D-SNP) covers outpatient services with no coinsurance, featuring a $0 to $175 copay for outpatient hospital services and a $175 copay per stay for observation services. Ambulatory surgical center and outpatient blood services are covered with no copay and no coinsurance, while outpatient substance abuse individual and group sessions require a $5 copay.
Partial Hospitalization See details
DEVOTED DUAL 024 FL (HMO D-SNP) covers partial hospitalization services with a $55.00 copay and no coinsurance. Prior authorization is required for these covered services.
Ambulance and Transportation Services See details
Ambulance services are covered by DEVOTED DUAL 024 FL (HMO D-SNP) with prior authorization, requiring a copay of $0 to $300 and coinsurance for ground transport, and a 20% coinsurance plus a copay for air transport. Routine transportation services to health-related locations are not covered under this plan.
Emergency Services See details
DEVOTED DUAL 024 FL (HMO D-SNP) covers emergency services with a $150 copay and no coinsurance, which is waived if admitted to the hospital within 24 hours, and urgently needed services with a $0 to $45 copay and no coinsurance. Worldwide emergency and urgent services are covered up to $25,000 with a $150 copay and no coinsurance, while worldwide emergency transportation requires a $300 copay and 20% coinsurance.
Primary Care See details
DEVOTED DUAL 024 FL (HMO D-SNP) covers primary care physician services with no copay and no coinsurance, while specialist, mental health, and podiatry services require a $5 copay and no coinsurance. Chiropractic services are partially covered, offering routine care for a $5 copay and no coinsurance, while other chiropractic services are not covered. Physical, occupational, and speech therapy services have a $5 to $50 copay and no coinsurance, and telehealth benefits carry a $0 to $45 copay and no coinsurance.
Preventive Services See details
Preventive services are partially covered under the DEVOTED DUAL 024 FL (HMO D-SNP) plan with no copay and no coinsurance for covered options like annual physicals, fitness benefits, weight management, alternative therapies, and kidney disease education. However, sub-services such as in-home safety assessments, PERS, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, wigs, therapeutic massage, adult day health, home-based palliative care, in-home support, caregiver support, additional tobacco cessation, enhanced disease management, telemonitoring, remote access technologies, and counseling are not covered.
Hearing Services See details
Hearing services covered by the DEVOTED DUAL 024 FL (HMO D-SNP) plan include one annual routine exam for a $5.00 copay and no coinsurance, as well as unlimited fitting evaluations. Prescription hearing aids are partially covered with no coinsurance and copays ranging from $399.00 to $699.00 for up to two aids yearly, but OTC, inner ear, outer ear, and over the ear models are not covered.
Vision Services See details
Vision services covered under the DEVOTED DUAL 024 FL (HMO D-SNP) plan include one annual routine eye exam with a $0 to $5 copay and no coinsurance, although other eye exam services are not covered. Eyewear is covered with no copay or coinsurance, offering up to a $400 yearly allowance for contacts, eyeglasses, lenses, frames, and upgrades.
Dental Services See details
DEVOTED DUAL 024 FL (HMO D-SNP) partially covers dental services up to a $2,500 annual maximum, offering Medicare-covered dental services for a $5 copay and no coinsurance, and other covered dental services with no copay and no coinsurance. However, other diagnostic and preventive services, maxillofacial prosthetics, implant services, and orthodontics are not covered under this plan.
Home Infusion bundled Services See details
DEVOTED DUAL 024 FL (HMO D-SNP) covers home infusion bundled services with no copay, though prior authorization and step therapy are required. Associated Medicare Part B drugs, including chemotherapy and radiation, carry a coinsurance ranging from 0% (no coinsurance) to 20%, while Part B insulin drugs require a $35 copay and 0% (no coinsurance) to 20% coinsurance.
Dialysis Services See details
DEVOTED DUAL 024 FL (HMO D-SNP) covers dialysis services with no copay and a 20% coinsurance. Prior authorization is required to receive these covered services.
Medical Equipment See details
DEVOTED DUAL 024 FL (HMO D-SNP) covers medical equipment with no copays, featuring a 20% to 30% coinsurance for durable medical equipment, and no coinsurance to 20% coinsurance for prosthetics and medical supplies. This benefit is partially covered because diabetic therapeutic shoes and inserts are not covered, though diabetic supplies are covered with no coinsurance to 30% coinsurance.
Diagnostic and Radiological Services See details
DEVOTED DUAL 024 FL (HMO D-SNP) covers diagnostic and radiological services with prior authorization, offering diagnostic tests and lab services with no coinsurance and copays ranging from no copay to $95. Radiological services feature no copay for diagnostic and outpatient X-ray services, with coinsurance applying to X-rays and a minimum 20% coinsurance and copay required for therapeutic services.
Home Health Services See details
DEVOTED DUAL 024 FL (HMO D-SNP) covers Home Health Services with no copay and no coinsurance. Prior authorization is required for these services.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by DEVOTED DUAL 024 FL (HMO D-SNP) with no coinsurance and a $5 copay, requiring prior authorization. While some services are covered, cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) are not covered.
Skilled Nursing Facility (SNF) See details
DEVOTED DUAL 024 FL (HMO D-SNP) covers Skilled Nursing Facility (SNF) services 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 hospital stay is not required, additional days beyond the standard 100-day Medicare limit are not covered.
Other Services See details
Other Services under the DEVOTED DUAL 024 FL (HMO D-SNP) plan are partially covered, featuring no copay and no coinsurance for additional preventive services and Over-the-Counter (OTC) items up to $50 every three months. Acupuncture and meal benefits are not covered.
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