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DEVOTED GIVEBACK 032 FL (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for DEVOTED GIVEBACK 032 FL (HMO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on DEVOTED GIVEBACK 032 FL (HMO) in 2026, please refer to our full plan details page.
DEVOTED GIVEBACK 032 FL (HMO) is a HMO plan offered by Devoted Health, Inc. available for enrollment in 2025 to people living in Manatee. This plan received an overall rating of 5 out of 5 stars in 2026.
It's important to know that DEVOTED GIVEBACK 032 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 GIVEBACK 032 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 GIVEBACK 032 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. Additionally, this plan comes with a Part B Premium reduction of $184.70. 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 $605.00 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 032 FL (HMO) Medicare plan features a $605 annual prescription drug deductible. For Tier 1 preferred generic drugs, members pay no copay for one-, two-, or three-month supplies at standard pharmacies and through standard mail order. Tier 2 generic drugs require a low $5 copay for a one-month supply, with three-month supplies costing $15 at standard retail pharmacies and $12.50 through standard mail order. Brand-name and specialty medications are subject to coinsurance rather than flat copays. Tier 3 preferred brand drugs carry a 24% coinsurance for one-, two-, or three-month supplies. Tier 4 non-preferred drugs and Tier 5 specialty drugs require a 25% coinsurance, with specialty drug coverage limited to a one-month supply.
Additional Benefits
The DEVOTED GIVEBACK 032 FL (HMO) plan offers robust coverage with no copay for primary care visits, annual physicals, home health services, and routine lab work or x-rays. For more specialized medical services, members can expect a $45 copay for specialist visits and a $130 copay for emergency room care, which is waived upon hospital admission. Inpatient hospital stays require a daily copay of $395 for the first few days, after which there is no copay for the remainder of the stay. Dental, vision, and hearing benefits are also partially covered, featuring no copay for preventive dental care and eyewear up to a $350 annual limit, alongside hearing aid copays ranging from $599 to $899. Additionally, members benefit from a $100 quarterly allowance for over-the-counter items and no copay for skilled nursing facility care during the first 20 days. Most diagnostic services, home infusions, and preventive care are covered with no coinsurance, ensuring affordable access to essential healthcare.
Inpatient Hospital See details
DEVOTED GIVEBACK 032 FL (HMO) covers inpatient hospital services with no coinsurance, but prior authorization is required. Acute stays require a $395 daily copay for days 1 through 6 and no copay for days 7 through 90, while psychiatric stays require a $395 daily copay for days 1 through 5 and no copay for days 6 through 90. Upgrades and non-Medicare-covered stays are not covered under this plan.
Outpatient Services See details
DEVOTED GIVEBACK 032 FL (HMO) covers outpatient services with no coinsurance, including outpatient hospital services with a copay of $0 to $395 and observation services at a $395 copay per stay. Ambulatory surgical center and blood services are covered with no copay and no coinsurance, while outpatient substance abuse sessions require a $45 copay and no coinsurance.
Partial Hospitalization See details
DEVOTED GIVEBACK 032 FL (HMO) covers partial hospitalization services with a $55.00 copay and no coinsurance. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Ambulance services are covered by DEVOTED GIVEBACK 032 FL (HMO) with prior authorization, requiring a copay of up to $350 and coinsurance for ground transport, and a 20% coinsurance plus a copay for air transport. Routine transportation services to plan-approved or health-related locations are not covered.
Emergency Services See details
DEVOTED GIVEBACK 032 FL (HMO) covers emergency services with a $130 copay and no coinsurance, which is waived if admitted to the hospital within 24 hours, and urgently needed services with no copay to a $50 copay and no coinsurance. Worldwide emergency and urgent care are covered up to $25,000 with a $130 copay and no coinsurance, while worldwide emergency transportation carries a $350 copay and 20% coinsurance.
Primary Care See details
DEVOTED GIVEBACK 032 FL (HMO) offers primary care physician services with no copay and no coinsurance, while specialist visits require a $45 copay and no coinsurance. Other covered services, including physical therapy, telehealth, and mental health care, feature copays ranging from $0 to $65 and no coinsurance, though podiatry and routine chiropractic services are not covered.
Preventive Services See details
DEVOTED GIVEBACK 032 FL (HMO) provides partially covered preventive services with no copay and no coinsurance for covered care like annual physicals, fitness benefits, and kidney disease education. Uncovered sub-services include in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, chemotherapy 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 services.
Hearing Services See details
Hearing services are covered by DEVOTED GIVEBACK 032 FL (HMO), including one annual routine exam with a $45 copay and no coinsurance, plus unlimited fitting evaluations. Prescription hearing aids are partially covered with no coinsurance and a copay of $599 to $899 for up to two devices per year, though inner ear, outer ear, over the ear, and OTC hearing aids are not covered.
Vision Services See details
DEVOTED GIVEBACK 032 FL (HMO) offers partially covered vision services, including one routine eye exam per year with a $0 to $45 copay, no coinsurance, and no deductible, while other eye exam services are not covered. Eyewear is covered with no copay, no coinsurance, and no deductible, providing up to a $350 annual maximum for contact lenses, eyeglasses, and upgrades.
Dental Services See details
Dental services are partially covered by DEVOTED GIVEBACK 032 FL (HMO), offering preventive and comprehensive care with no copay and 0% to 50% coinsurance up to a $1,250 annual limit. Medicare-covered dental services require a $45 copay and no coinsurance, while maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by DEVOTED GIVEBACK 032 FL (HMO) with no copay, subject to prior authorization and step therapy. Under this benefit, Medicare Part B chemotherapy, radiation, and other drugs have no copay and no coinsurance to 20% coinsurance, while Part B insulin is covered with a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
DEVOTED GIVEBACK 032 FL (HMO) covers dialysis services with no copay and a 20% coinsurance. Prior authorization is required to receive these covered services.
Medical Equipment See details
DEVOTED GIVEBACK 032 FL (HMO) medical equipment benefits are partially covered with no copays, although prior authorization is required. Coinsurance ranges from 20% to 50% for durable medical equipment, no coinsurance to 20% for prosthetics and medical supplies, and no coinsurance to 50% for diabetic supplies, while diabetic therapeutic shoes and inserts are not covered.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by DEVOTED GIVEBACK 032 FL (HMO) with prior authorization required, featuring no coinsurance for diagnostic services, no copay for lab services or outpatient x-rays, and a $0 to $125 copay for diagnostic procedures. Diagnostic radiological services have a $0 minimum copay, while therapeutic radiological services require a copay and a minimum 20% coinsurance.
Home Health Services See details
Home Health Services are covered by DEVOTED GIVEBACK 032 FL (HMO) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by DEVOTED GIVEBACK 032 FL (HMO) with no coinsurance, though prior authorization is required. Under this plan, members pay a $40 copay for cardiac and intensive cardiac rehabilitation, a $35 copay for pulmonary rehabilitation, and a $25 copay for supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD).
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is covered by DEVOTED GIVEBACK 032 FL (HMO) with no coinsurance and does not require a prior three-day hospital stay, though prior authorization is required. There is no copay for days 1 through 20 and a $218 daily copay for days 21 through 100, but additional days beyond the Medicare-covered limit are not covered.
Other Services See details
DEVOTED GIVEBACK 032 FL (HMO) partially covers other services, offering over-the-counter (OTC) items up to $100 every three months and additional preventive services with no copay and no coinsurance. However, acupuncture, meal benefits, and certain other supplemental services are not covered under this plan.
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