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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 prescription drug deductible of $615. Under this plan, Tier 1 preferred generic and Tier 2 generic medications are covered with no copay for 1-month, 2-month, or 3-month supplies at standard pharmacies and through standard mail order. This budget-friendly benefit helps keep everyday prescription costs low for plan members. For higher-tier medications, members are responsible for a 25% coinsurance. This 25% coinsurance applies to Tier 3 preferred brand and Tier 4 non-preferred drugs for 1-month, 2-month, and 3-month supplies at standard pharmacies and standard mail order. Tier 5 specialty drugs also require a 25% coinsurance for a 1-month supply.
Additional Benefits
The DEVOTED PREMIUM 037 FL (HMO) plan offers comprehensive medical coverage with no copay or coinsurance for primary care visits, preventive services, and home health care. For inpatient hospital stays, members pay a $175 copay for days one through five and no copay thereafter, with no coinsurance required. Specialist visits, diagnostic services, and outpatient procedures are also highly affordable, typically featuring low copays and no coinsurance. Additional benefits include routine dental and vision care with no copay, a $150 annual eyewear allowance, and affordable copays for prescription hearing aids. Furthermore, the plan provides a $53 quarterly over-the-counter allowance and covers skilled nursing facility stays with no copay for the first 20 days.
Inpatient Hospital See details
DEVOTED PREMIUM 037 FL (HMO) partially covers inpatient hospital services with no coinsurance, requiring a $175 copay for days 1 through 5 and no copay for days 6 through 90 per stay. Prior authorization is required, and upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Outpatient services are covered by DEVOTED PREMIUM 037 FL (HMO) with no coinsurance across all categories, including ambulatory surgical center and blood services which feature no copay. Outpatient hospital services require a copay of $0 to $175 with no coinsurance, observation services cost a $175 copay per stay with no coinsurance, and outpatient substance abuse sessions have a $5 copay with no coinsurance.
Partial Hospitalization See details
DEVOTED PREMIUM 037 FL (HMO) covers partial hospitalization services with a $55.00 copay and no coinsurance. Prior authorization is required to access this benefit.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered by DEVOTED PREMIUM 037 FL (HMO), with ground ambulance services requiring a copay of $0 to $300 and no coinsurance, and air ambulance services requiring a 20% coinsurance and no copay. Prior authorization is required for ambulance services, and transportation services to plan-approved or any health-related locations are not covered.
Emergency Services See details
DEVOTED PREMIUM 037 FL (HMO) covers emergency services with a $150 copay, which is waived if you are admitted to the hospital within 24 hours, and no coinsurance. Urgently needed services feature no copay to a $45 copay with no coinsurance, while worldwide emergency and urgent services are covered up to $25,000 with a $150 copay and no coinsurance, except for worldwide emergency transportation which requires a $300 copay and 20% coinsurance.
Primary Care See details
DEVOTED PREMIUM 037 FL (HMO) covers primary care physician services with no copay and no coinsurance, while other services like specialist visits, mental health, and physical therapy feature copays ranging from $0 to $50 and no coinsurance. Chiropractic and podiatry 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, fitness benefits, and kidney disease education. This benefit is partially covered, as services such as in-home safety assessments, personal emergency response systems, medical nutrition therapy, therapeutic massage, and in-home support are not covered.
Hearing Services See details
DEVOTED PREMIUM 037 FL (HMO) partially covers hearing services with no deductibles, offering routine hearing exams for a $5 copay and no coinsurance, and up to two prescription hearing aids per year for a $199 to $499 copay and no coinsurance. However, OTC hearing aids and inner ear, outer ear, and over-the-ear prescription hearing aids are not covered.
Vision Services See details
Vision services are partially covered by DEVOTED PREMIUM 037 FL (HMO) because other eye exam services are not covered. Routine eye exams are covered once per year with no deductible, no coinsurance, and no copay to a $5 copay, while eyewear has no deductible, no copay, and no coinsurance up to a $150 annual maximum.
Dental Services See details
Dental services are partially covered under the DEVOTED PREMIUM 037 FL (HMO) plan, offering preventive services with no copay and no coinsurance, and Medicare-covered dental with a $5 copay and no coinsurance. Other covered comprehensive dental services feature no copay and 0% to 50% coinsurance up to a $1,500 annual limit, though maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by DEVOTED PREMIUM 037 FL (HMO) with no copay, while associated Medicare Part B chemotherapy, radiation, and other drugs have no copay and 0% to 20% coinsurance. Medicare Part B insulin drugs are covered with a $35 copay and 0% to 20% coinsurance, and prior authorization is required for these services.
Dialysis Services See details
Dialysis Services are covered under the DEVOTED PREMIUM 037 FL (HMO) plan with no copay and a 20% coinsurance, although prior authorization is required.
Medical Equipment See details
DEVOTED PREMIUM 037 FL (HMO) provides partial coverage for medical equipment with no copay and coinsurance ranging from no coinsurance up to 50%, with prior authorization required. While durable medical equipment, prosthetics, medical supplies, and diabetic supplies are covered, diabetic therapeutic shoes and inserts are not covered.
Diagnostic and Radiological Services See details
DEVOTED PREMIUM 037 FL (HMO) covers diagnostic and radiological services with prior authorization, offering no copay for lab services and outpatient X-rays, and no coinsurance for diagnostic services. Diagnostic procedures and tests have a copay ranging from $0 to $95, diagnostic radiological services have a minimum $0 copay, and therapeutic radiological services require a 20% coinsurance.
Home Health Services See details
Home health services are covered by DEVOTED PREMIUM 037 FL (HMO) with no copay and no coinsurance. Prior authorization is required to receive these services.
Cardiac Rehabilitation Services See details
DEVOTED PREMIUM 037 FL (HMO) offers coverage for Cardiac Rehabilitation Services with no coinsurance and a $5 copay, subject to prior authorization. While some services are covered, standard cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled nursing facility (SNF) services are covered by DEVOTED PREMIUM 037 FL (HMO) with no coinsurance and do not require a prior three-day hospital stay, though prior authorization is required. There is no copay for days 1 through 20, followed by a $218 daily copay for days 21 through 100, with no coverage provided for additional days beyond the Medicare-covered limit.
Other Services See details
DEVOTED PREMIUM 037 FL (HMO) partially covers other services with no copay and no coinsurance, including additional preventive services and up to $53 every three months for over-the-counter items. Acupuncture and meal benefits are not covered under this plan.
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