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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) prescription drug coverage includes an annual drug deductible of $615. For Tier 1 (Preferred Generic) and Tier 2 (Generic) medications, there is no copay for 1-month, 2-month, or 3-month supplies filled at standard pharmacies or through standard mail order. This plan provides affordable access to common maintenance medications with zero out-of-pocket costs for these lower tiers. For higher-tier medications, including Tier 3 (Preferred Brand) and Tier 4 (Non-Preferred Drug), members pay a 25% coinsurance for all supply durations. Tier 5 (Specialty Tier) prescription drugs also carry a 25% coinsurance for a 1-month supply through standard pharmacies and mail order. This clear structure helps you easily project your healthcare expenses when enrolling in this Medicare Advantage plan.
Additional Benefits
The DEVOTED PREMIUM 037 FL (HMO) plan offers affordable healthcare coverage with no copay for primary care visits and a low $5 copay for specialist appointments. For hospital stays, inpatient care requires a $175 daily copay for the first five days and no copay for days six through 90, while outpatient hospital services range from no copay to a $175 copay. Emergency room visits carry a $150 copay, which is waived if you are admitted to the hospital within 24 hours. This plan also provides valuable supplemental benefits, including preventive dental care with no copay and comprehensive dental coverage up to a $1,500 annual limit. Beneficiaries can take advantage of routine eye exams with a $0 to $5 copay, a $150 annual allowance for eyewear, and prescription hearing aid coverage with copays between $199 and $499. Additionally, there is no copay for home health services and no copay for over-the-counter items up to $48 every three months.
Inpatient Hospital See details
DEVOTED PREMIUM 037 FL (HMO) covers inpatient acute and psychiatric hospital stays with no coinsurance, requiring a $175 daily copay for days 1 through 5 and no copay for days 6 through 90. Prior authorization is required, and while additional acute stay days are unlimited, upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
DEVOTED PREMIUM 037 FL (HMO) covers outpatient services with no coinsurance, offering ambulatory surgical center and blood services with no copay. Outpatient hospital services carry a $0 to $175 copay, observation services require a $175 copay per stay, and outpatient substance abuse sessions have a $5 copay.
Partial Hospitalization See details
Partial hospitalization services are covered by the DEVOTED PREMIUM 037 FL (HMO) plan with a $55.00 copay and no coinsurance. Prior authorization is required to access this benefit.
Ambulance and Transportation Services See details
Ambulance services are covered under DEVOTED PREMIUM 037 FL (HMO) with prior authorization, featuring ground ambulance services with a copay of no copay to $300 plus coinsurance, and air ambulance services with a 20% coinsurance and no copay. While some transportation services are covered, trips 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 and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services range from no copay to a $45 copay with no coinsurance, while worldwide emergency services are covered up to a $25,000 limit with a $150 copay and no coinsurance for emergency or urgent care, and a $300 copay plus 20% coinsurance for emergency transportation.
Primary Care See details
DEVOTED PREMIUM 037 FL (HMO) provides primary care physician services with no copay and no coinsurance, and specialist visits with a $5 copay and no coinsurance. Therapy, mental health, and telehealth services are also covered with copays ranging from $0 to $50 and no coinsurance, while chiropractic and podiatry services are not covered.
Preventive Services See details
DEVOTED PREMIUM 037 FL (HMO) provides coverage for Medicare-covered preventive services, annual physical exams, and kidney disease education with no copay and no coinsurance. Additional preventive benefits are partially covered with no copay and no coinsurance, excluding services such as in-home safety assessments, personal emergency response systems, therapeutic massages, and telemonitoring.
Hearing Services See details
Hearing services are partially covered by DEVOTED PREMIUM 037 FL (HMO), with routine hearing exams requiring a $5 copay and no coinsurance. Prescription hearing aids are covered with no coinsurance and a copay ranging from $199 to $499, but OTC, inner ear, outer ear, and over the ear hearing aids are not covered.
Vision Services See details
DEVOTED PREMIUM 037 FL (HMO) offers vision services with no deductibles, including partially covered eye exams with a $0 to $5 copay and no coinsurance, while other eye exam services are not covered. Eyewear is covered with no copay and no coinsurance up to a $150 annual maximum for contacts, frames, lenses, and upgrades.
Dental Services See details
DEVOTED PREMIUM 037 FL (HMO) partially covers dental services up to a $1,500 annual limit, offering preventive care with no copay and no coinsurance. Medicare-covered dental services require a $5 copay and no coinsurance, and covered comprehensive services feature no copay and 0% to 50% coinsurance, though maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
DEVOTED PREMIUM 037 FL (HMO) covers home infusion bundled services with no copay, subject to prior authorization. Associated Medicare Part B chemotherapy and other drugs have no copay and coinsurance ranging from no coinsurance to 20%, while Part B insulin drugs require a $35 copay and coinsurance ranging from no coinsurance to 20%.
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 for these services.
Medical Equipment See details
DEVOTED PREMIUM 037 FL (HMO) partially covers medical equipment, as diabetic therapeutic shoes and inserts are not covered. Covered items—including durable medical equipment, prosthetics, and diabetic supplies—require no copay, with coinsurance ranging from no coinsurance up to 50% depending on the equipment.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by DEVOTED PREMIUM 037 FL (HMO), with prior authorization required. Outpatient diagnostic procedures have no coinsurance and a copay of $0 to $95, while lab services feature no copay and no coinsurance. Outpatient X-ray services have no copay but require coinsurance, and therapeutic radiological services require a minimum 20% coinsurance.
Home Health Services See details
Home Health Services are covered under the DEVOTED PREMIUM 037 FL (HMO) plan with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by DEVOTED PREMIUM 037 FL (HMO) with a $5 copay and no coinsurance, subject to prior authorization. While some services are covered, standard cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy for symptomatic peripheral artery disease 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 and no prior three-day inpatient hospital stay. There is no copay for days 1 through 20, followed by a $218 daily copay for days 21 through 100, though additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Other Services are partially covered by DEVOTED PREMIUM 037 FL (HMO), offering over-the-counter (OTC) items with no copay and no coinsurance up to $48 every three months, as well as additional preventive services with no copay and no coinsurance. Acupuncture, meal benefits, and dual-eligible SNP services are not covered under this plan.
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