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DEVOTED PREMIUM 037 FL (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for DEVOTED PREMIUM 037 FL (HMO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on DEVOTED PREMIUM 037 FL (HMO) in 2026, please refer to our full plan details page.
DEVOTED PREMIUM 037 FL (HMO) is a HMO plan offered by Devoted Health, Inc. available for enrollment in 2025 to people living in South & Central Florida. This plan received an overall rating of 5 out of 5 stars in 2026.
It's important to know that DEVOTED PREMIUM 037 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 PREMIUM 037 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 PREMIUM 037 FL (HMO), 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 Premium 037 FL (HMO) medicare plan features an annual drug deductible of $615. Under this plan, you will pay no copay for Tier 1 (Preferred Generic) and Tier 2 (Generic) prescription drugs. This no-copay benefit applies to 1-month, 2-month, and 3-month supplies filled at standard pharmacies or through standard mail order. For higher-tier medications, the plan requires a 25% coinsurance rather than a flat copayment. This 25% coinsurance rate applies to Tier 3 (Preferred Brand), Tier 4 (Non-Preferred Drug), and Tier 5 (Specialty Tier) drugs filled at standard pharmacies or standard mail order. While Tier 3 and Tier 4 prescriptions are available for up to a 3-month supply, Tier 5 specialty drugs are limited to a 1-month supply.
Additional Benefits
The DEVOTED PREMIUM 037 FL (HMO) plan offers robust medical coverage with no copay and no coinsurance for primary care, specialist visits, and preventive services. For hospital stays, members pay no coinsurance, but inpatient care requires a $175 daily copay for the first five days and no copay for days six through ninety. Outpatient hospital services feature no coinsurance and copays ranging from no copay up to $175, while emergency care has a $150 copay that is waived if you are admitted within twenty-four hours. Additional benefits include comprehensive dental coverage up to $1,500 annually with no copay for preventive care and up to 50% coinsurance for restorative services. Vision and hearing benefits feature routine exams with no copay, along with a $150 annual eyewear allowance and prescription hearing aid copays between $199 and $499. Home health care and cardiac rehabilitation are covered with no copay, while durable medical equipment requires 20% to 50% coinsurance.
Inpatient Hospital See details
DEVOTED PREMIUM 037 FL (HMO) offers partially covered inpatient hospital benefits with no coinsurance, featuring a $175 daily copay for days 1 through 5 and no copay for days 6 through 90 for acute and psychiatric stays. Prior authorization is required, and upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
DEVOTED PREMIUM 037 FL (HMO) covers outpatient hospital services with no coinsurance and a copay of $0 to $175, as well as ambulatory surgical center and blood services with no copay and no coinsurance. Observation services require a $175 copay per stay with no coinsurance, and while outpatient substance abuse services have no copay and no coinsurance, individual and group sessions are not covered.
Partial Hospitalization See details
Partial hospitalization is covered by DEVOTED PREMIUM 037 FL (HMO) with a $50.00 copay and no coinsurance. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Ambulance and transportation services under DEVOTED PREMIUM 037 FL (HMO) cover ground ambulance services with no copay to a $300 copay and no coinsurance, and air ambulance services with a 20% coinsurance and no copay. Prior authorization is required for ambulance services, while transportation services to plan-approved or any other health-related locations are not covered.
Emergency Services See details
DEVOTED PREMIUM 037 FL (HMO) covers emergency services with a $150 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services feature no copay to a $45 copay and no coinsurance, while worldwide emergency services are covered up to $25,000 with copays ranging from $150 to $300 and a 20% coinsurance for worldwide emergency transportation.
Primary Care See details
DEVOTED PREMIUM 037 FL (HMO) provides primary care, specialist, other healthcare professional, and opioid treatment services with no copay and no coinsurance. Occupational, physical, and speech therapies require a $0 to $50 copay and no coinsurance, while telehealth benefits have a $0 to $45 copay and no coinsurance. Podiatry, chiropractic, mental health specialty, and psychiatric services are not covered.
Preventive Services See details
Preventive services are covered by DEVOTED PREMIUM 037 FL (HMO) with no copay and no coinsurance, including annual physical exams, kidney disease education, and diabetes self-management. Additional preventive benefits are partially covered with no copay and no coinsurance, offering fitness and nutritional programs but excluding services like in-home support, therapeutic massage, and personal emergency response systems.
Hearing Services See details
Hearing Services are partially covered by the DEVOTED PREMIUM 037 FL (HMO) plan, which offers routine hearing exams and fitting evaluations with no copay and no coinsurance. Prescription hearing aids are covered with no coinsurance and a copay between $199.00 and $499.00 for up to two aids per year, though inner ear, outer ear, over the ear, and OTC hearing aids are not covered.
Vision Services See details
Vision services are partially covered by DEVOTED PREMIUM 037 FL (HMO) with no copay, no coinsurance, and no deductible, as other eye exam services are not covered. Covered services include one routine eye exam per year (prior authorization required) and a $150 annual allowance for eyewear like contacts and eyeglasses.
Dental Services See details
DEVOTED PREMIUM 037 FL (HMO) dental services are covered up to a $1,500 annual limit, featuring no copay and no coinsurance for preventive care, exams, cleanings, periodontics, and oral surgery. Restorative, endodontic, and prosthodontic services are covered with no copay and 0% to 50% coinsurance, while maxillofacial prosthetics, implants, and orthodontics are not covered.
Home Infusion bundled Services See details
DEVOTED PREMIUM 037 FL (HMO) covers home infusion bundled services with no copay, though prior authorization is required. Associated Medicare Part B chemotherapy, radiation, and other drugs carry a 0% to 20% coinsurance, while Part B insulin is covered with a $35 copay and 0% to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered under the DEVOTED PREMIUM 037 FL (HMO) plan with no copay and a 20% coinsurance. Prior authorization is required to receive these covered services.
Medical Equipment See details
Medical Equipment benefits under the DEVOTED PREMIUM 037 FL (HMO) plan are partially covered with no copay, requiring 20% to 50% coinsurance for durable medical equipment and no coinsurance to 20% coinsurance for prosthetics and medical supplies. Diabetic supplies are also covered with no copay and no coinsurance to 50% coinsurance, but diabetic therapeutic shoes and inserts are not covered.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by DEVOTED PREMIUM 037 FL (HMO) with prior authorization required. Diagnostic tests and lab services feature no coinsurance, with lab work and outpatient X-rays requiring no copay, while diagnostic procedures range from no copay up to $95 and therapeutic radiology requires a minimum 20% coinsurance.
Home Health Services See details
Home Health Services are covered by DEVOTED PREMIUM 037 FL (HMO) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
DEVOTED PREMIUM 037 FL (HMO) covers Cardiac Rehabilitation Services with no copay and no coinsurance, though prior authorization is required. While some services are covered, specific sub-services including cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation are not covered.
Skilled Nursing Facility (SNF) See details
DEVOTED PREMIUM 037 FL (HMO) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring prior authorization but no prior three-day hospital stay. There is no copay for days 1 through 20 and a $218 daily copay for days 21 through 100, though additional days beyond the standard Medicare limit are not covered.
Other Services See details
DEVOTED PREMIUM 037 FL (HMO) partially covers other services, providing additional preventive services not covered by Medicare with no copay and no coinsurance. Acupuncture, over-the-counter (OTC) items, and meal benefits are not covered under this plan.
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