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DEVOTED DUAL PLUS 042 FL (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for DEVOTED DUAL PLUS 042 FL (HMO D-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on DEVOTED DUAL PLUS 042 FL (HMO D-SNP) in 2026, please refer to our full plan details page.
DEVOTED DUAL PLUS 042 FL (HMO D-SNP) is a HMO D-SNP plan offered by Devoted Health, Inc. available for enrollment in 2025 to people living in Escambia, Santa Rosa Counties. This plan received an overall rating of 5 out of 5 stars in 2026.
It's important to know that DEVOTED DUAL PLUS 042 FL (HMO D-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
DEVOTED DUAL PLUS 042 FL (HMO D-SNP)is a Special Needs Type (SNP) plan. This means you can only enroll in this plan if you meet specific criteria. See our full plan details page for more information.
Key Plan Facts
Below are a few key facts and commonly-asked questions about DEVOTED DUAL PLUS 042 FL (HMO D-SNP).
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 DUAL PLUS 042 FL (HMO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $3.10. 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 $9250.00 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 prescription drug coverage for the DEVOTED DUAL PLUS 042 FL (HMO D-SNP) plan features an annual drug deductible of $615. For Tiers 1 through 4, which include generic and brand-name medications, you will pay a 25% coinsurance at standard pharmacies and standard mail-order services. Tier 5 specialty drugs also carry a 25% coinsurance for a 1-month supply through standard retail and mail-order options. Members pay no copay for Tier 6 select care drugs, which applies to 1-month, 2-month, and 3-month supplies at standard pharmacies and standard mail order. This straightforward pricing structure helps dual-eligible individuals understand their out-of-pocket medication expenses.
Additional Benefits
The DEVOTED DUAL PLUS 042 FL (HMO D-SNP) offers comprehensive medical coverage with no copay for primary care visits, preventive services, and home health care. For hospital stays, members pay a copay of $2,230 per acute stay and $2,080 per psychiatric stay, with no coinsurance. Outpatient services and diagnostic tests also feature no copays, though coinsurance up to 20% may apply depending on the service. Specialist visits, routine vision exams, and dental care are available with no copays, while some of these services may require a 20% coinsurance. The plan provides additional value with no copay for eyewear up to a $400 annual limit and dental coverage up to a $3,000 annual limit. Additionally, members receive an over-the-counter benefit of $50 every three months with no copay and no coinsurance.
Inpatient Hospital See details
DEVOTED DUAL PLUS 042 FL (HMO D-SNP) covers inpatient acute hospital stays with a $2,230 copay per stay and inpatient psychiatric stays with a $2,080 copay per stay, both with no coinsurance and requiring prior authorization. Unlimited additional days are covered for acute stays, but upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Outpatient services are covered by DEVOTED DUAL PLUS 042 FL (HMO D-SNP) with no copays, though coinsurance ranging from 0% to 20% may apply depending on the service. Covered benefits including outpatient hospital, ambulatory surgical center, outpatient substance abuse, and outpatient blood services all feature no copay and coinsurance up to 20%.
Partial Hospitalization See details
DEVOTED DUAL PLUS 042 FL (HMO D-SNP) covers partial hospitalization services with no copay and a 20% coinsurance. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Ambulance services under DEVOTED DUAL PLUS 042 FL (HMO D-SNP) are covered with no copay, featuring a 20% coinsurance for air ambulance services and no coinsurance to 20% coinsurance for ground ambulance services, with prior authorization required. Transportation services are not covered under this plan.
Emergency Services See details
DEVOTED DUAL PLUS 042 FL (HMO D-SNP) covers emergency services with a $115 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services are covered with no copay and a 0% to 20% coinsurance, and worldwide emergency, urgent, and transportation services are covered with no copay or coinsurance up to a $25,000 limit.
Primary Care See details
DEVOTED DUAL PLUS 042 FL (HMO D-SNP) covers primary care physician services with no copay and no coinsurance. Specialist visits, therapies, mental health, and podiatry services feature no copay and a 20% coinsurance, while chiropractic services are partially covered since other chiropractic services are not covered.
Preventive Services See details
Preventive services under the DEVOTED DUAL PLUS 042 FL (HMO D-SNP) plan are available with no copay and no coinsurance, covering annual physicals, kidney disease education, and select screenings. Additional preventive services are partially covered with no copay or coinsurance, but do not cover in-home safety assessments, personal emergency response systems (PERS), medical nutrition therapy, post-discharge in-home medication reconciliation, re-admission prevention, wigs, therapeutic massage, adult day health, palliative care, in-home support, caregiver support, extra smoking cessation, enhanced disease management, telemonitoring, remote access, or counseling.
Hearing Services See details
DEVOTED DUAL PLUS 042 FL (HMO D-SNP) offers partially covered hearing services, featuring one routine hearing exam annually with no copay and a 20% coinsurance, alongside unlimited fitting evaluations with no copay and no coinsurance. Up to two prescription hearing aids per year are covered with a copay between $0 and $299 and no coinsurance, but OTC, inner ear, outer ear, and over the ear hearing aids are not covered.
Vision Services See details
Vision services are covered by DEVOTED DUAL PLUS 042 FL (HMO D-SNP), offering one routine eye exam per year with no copay and 0% to 20% coinsurance, though other eye exam services are not covered. Eyewear is covered with no copay, no coinsurance, and no deductible up to a $400 annual maximum for contacts, lenses, frames, and upgrades.
Dental Services See details
DEVOTED DUAL PLUS 042 FL (HMO D-SNP) offers dental services with no copay and a 20% coinsurance for Medicare-covered dental, and no copay and no coinsurance for other dental services up to a $3,000 annual limit. While many services like cleanings and fillings are included, this benefit is partially covered as it excludes implants, orthodontics, maxillofacial prosthetics, other diagnostic, and other preventive dental services.
Home Infusion bundled Services See details
Home infusion bundled services are covered by DEVOTED DUAL PLUS 042 FL (HMO D-SNP) with no copay, though prior authorization is required. Associated Medicare Part B chemotherapy, insulin, and other infusion drugs carry a coinsurance ranging from no coinsurance up to 20%, with Part B insulin also requiring a $35 copay.
Dialysis Services See details
Dialysis Services are covered under the DEVOTED DUAL PLUS 042 FL (HMO D-SNP) plan with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
DEVOTED DUAL PLUS 042 FL (HMO D-SNP) covers medical equipment, including durable medical equipment, prosthetics, and diabetic supplies, with no copays and prior authorization required. Durable medical equipment and diabetic supplies carry a 20% coinsurance, while prosthetic devices and medical supplies have a coinsurance ranging from no coinsurance to 20%.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by DEVOTED DUAL PLUS 042 FL (HMO D-SNP) with no copays, though prior authorization is required. Diagnostic procedures and tests carry no coinsurance, while lab services, diagnostic and therapeutic radiological services, and outpatient X-rays require a 20% coinsurance.
Home Health Services See details
DEVOTED DUAL PLUS 042 FL (HMO D-SNP) covers Home Health Services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are offered by DEVOTED DUAL PLUS 042 FL (HMO D-SNP) with no copay and prior authorization required, though some services are covered while standard cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation are not covered and require a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
DEVOTED DUAL PLUS 042 FL (HMO D-SNP) covers Skilled Nursing Facility (SNF) services with no coinsurance, offering no copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required, and while a prior 3-day hospital stay is not needed, additional days beyond the standard 100 days are not covered.
Other Services See details
Other services are partially covered by DEVOTED DUAL PLUS 042 FL (HMO D-SNP), featuring over-the-counter (OTC) items and additional preventive services with no copay and no coinsurance. Acupuncture, meal benefits, and highly integrated services are not covered, and the OTC benefit is limited to $50 every three months.
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