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DEVOTED CORE 036 FL (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for DEVOTED CORE 036 FL (HMO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on DEVOTED CORE 036 FL (HMO) in 2026, please refer to our full plan details page.
DEVOTED CORE 036 FL (HMO) is a HMO 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 CORE 036 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 CORE 036 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 CORE 036 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.
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 $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 CORE 036 FL (HMO) Medicare plan features an annual prescription drug deductible of $615. For Tier 1 preferred generic and Tier 2 generic medications, members pay no copay for one-month, two-month, or three-month supplies filled at standard pharmacies or through standard mail order. This coverage ensures that common generic prescriptions remain highly affordable. For higher-tier medications, including Tier 3 preferred brand, Tier 4 non-preferred, and Tier 5 specialty drugs, members are responsible for a 25% coinsurance. This 25% cost share applies to standard pharmacy and standard mail order fills, with Tier 5 specialty drugs limited to a one-month supply. Reviewing these cost-sharing tiers can help you accurately project your annual out-of-pocket drug expenses under this plan.
Additional Benefits
The DEVOTED CORE 036 FL (HMO) plan offers affordable medical coverage with no copay for primary care visits, preventive screenings, and home health care. Specialist visits and mental health services require a low $10 copay, while inpatient hospital stays cost a $195 daily copay for the first five days and no copay for subsequent days. Emergency room visits carry a $130 copay, which is completely waived if you are admitted to the hospital. For extra wellness needs, the plan features a $1,500 annual maximum allowance for dental care and up to $150 yearly for eyewear with no copay. Routine hearing exams require a $10 copay, and prescription hearing aids are covered with copays ranging from $399 to $699. While most standard services avoid coinsurance, medical equipment and dialysis require coinsurance ranging from 20% to 50%.
Inpatient Hospital See details
DEVOTED CORE 036 FL (HMO) covers inpatient acute and psychiatric hospital stays with no coinsurance, requiring a $195 daily copay for days 1 through 5 and no copay for days 6 through 90. Unlimited additional days are covered for acute care, but psychiatric additional days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
DEVOTED CORE 036 FL (HMO) covers outpatient services with no coinsurance, offering no copays for ambulatory surgical center and blood services. Outpatient hospital services require a copay of $0 to $195, observation services cost $195 per stay, and outpatient substance abuse sessions have a $10 copay.
Partial Hospitalization See details
Partial hospitalization is covered by DEVOTED CORE 036 FL (HMO) for a $55.00 copay and no coinsurance, though prior authorization is required.
Ambulance and Transportation Services See details
Ambulance services are covered under the DEVOTED CORE 036 FL (HMO) plan with prior authorization, requiring a copay of $0 to $275 and no coinsurance for ground transport, and a 20% coinsurance plus a copay for air transport. Additional transportation services to health-related locations are not covered under this plan.
Emergency Services See details
DEVOTED CORE 036 FL (HMO) covers emergency services with a $130 copay and no coinsurance, with the copay waived if admitted to the hospital within 24 hours. Urgently needed services require no copay to a $45 copay and no coinsurance, while worldwide emergency services are covered up to $25,000 with a $130 copay for emergency or urgent care and a $275 copay plus 20% coinsurance for emergency transportation.
Primary Care See details
DEVOTED CORE 036 FL (HMO) covers primary care physician services with no copay and no coinsurance, while specialist visits, mental health, psychiatric, and opioid treatment services require a $10 copay and no coinsurance. Physical, occupational, and speech therapy services range from a $10 to $50 copay with no coinsurance, telehealth has a $0 to $45 copay with no coinsurance, and chiropractic and podiatry services are not covered.
Preventive Services See details
DEVOTED CORE 036 FL (HMO) covers preventive services, including annual physical exams, kidney disease education, and screenings, with no copay and no coinsurance. Additional preventive benefits are partially covered with no copay and no coinsurance, but exclude in-home safety assessments, personal emergency response systems (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, smoking cessation, enhanced disease management, telemonitoring, remote access technologies, and counseling.
Hearing Services See details
Hearing services are covered by DEVOTED CORE 036 FL (HMO) with no coinsurance, featuring a $10 copay for one routine exam per year and unlimited fitting evaluations. Prescription hearing aids are partially covered with no coinsurance and copays ranging from $399 to $699 for up to two devices per year, though OTC hearing aids and inner ear, outer ear, or over-the-ear prescription models are not covered.
Vision Services See details
Vision Services are partially covered by DEVOTED CORE 036 FL (HMO), which offers routine eye exams with a $0 to $10 copay and no coinsurance, though other eye exam services are not covered. Eyewear is covered with no copay and no coinsurance up to a $150 annual maximum, with no deductibles applying to these benefits.
Dental Services See details
DEVOTED CORE 036 FL (HMO) offers partially covered dental services with a $1,500 annual maximum, featuring a $10 copay and no coinsurance for Medicare-covered dental. Other covered preventive and comprehensive services have no copay and 0% to 50% coinsurance, though orthodontics, implants, and maxillofacial prosthetics are not covered.
Home Infusion bundled Services See details
DEVOTED CORE 036 FL (HMO) covers home infusion bundled services with no copay, although prior authorization is required. Associated Medicare Part B drugs, including chemotherapy, radiation, and other drugs, carry no copay and a 0% to 20% coinsurance, while Part B insulin has a $35 copay and a 0% to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered by DEVOTED CORE 036 FL (HMO) with no copay and a 20% coinsurance. Prior authorization is required for these services.
Medical Equipment See details
DEVOTED CORE 036 FL (HMO) partially covers medical equipment with no copays, though prior authorization is required and coinsurance rates apply. Members pay 20% to 50% coinsurance 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
DEVOTED CORE 036 FL (HMO) covers diagnostic services with no coinsurance, offering lab services with no copay and diagnostic procedures with a $0 to $95 copay. Radiological services are also covered with prior authorization, featuring outpatient X-rays with no copay (coinsurance applies), diagnostic radiology with copays starting at $0, and therapeutic radiology with a minimum 20% coinsurance.
Home Health Services See details
Home Health Services are covered by DEVOTED CORE 036 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 CORE 036 FL (HMO) with no copay and no coinsurance, though prior authorization is required. While some services are covered, standard cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is partially covered by DEVOTED CORE 036 FL (HMO) with no coinsurance and no prior three-day hospital stay required, though prior authorization is necessary. There is no copay for days 1 through 20 and a $218 daily copay for days 21 through 100, but additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
DEVOTED CORE 036 FL (HMO) partially covers other services, offering additional preventive services not covered by Medicare with no copay and no coinsurance. However, acupuncture, over-the-counter (OTC) items, meal benefits, and highly integrated services for dual-eligible SNPs are not covered.
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