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DEVOTED CORE 050 FL (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for DEVOTED CORE 050 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 050 FL (HMO) in 2026, please refer to our full plan details page.
DEVOTED CORE 050 FL (HMO) is a HMO plan offered by Devoted Health, Inc. available for enrollment in 2025 to people living in Flagler and Volusia Counties. This plan received an overall rating of 5 out of 5 stars in 2026.
It's important to know that DEVOTED CORE 050 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 050 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 050 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 $595.00 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 $4900.00 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 050 FL (HMO) prescription drug plan has an annual drug deductible of $595. Beneficiaries will pay no copay for Tier 1 preferred generic and Tier 2 generic drugs when using standard pharmacies or standard mail order. This applies to one-month, two-month, and three-month supplies of these generic medications. For higher-tier medications, cost-sharing is based on coinsurance rather than flat copays. Tier 3 preferred brand drugs require a 24% coinsurance, while Tier 4 non-preferred drugs and Tier 5 specialty drugs require a 25% coinsurance. These coinsurance rates apply to standard pharmacy and standard mail order fills, with specialty medications limited to a one-month supply.
Additional Benefits
The DEVOTED CORE 050 FL (HMO) plan offers comprehensive medical coverage with affordable out-of-pocket costs, including no copay for primary care visits and a low $10 copay for specialists. If you require hospital care, inpatient stays feature a $295 daily copay for the first five days and no copay for days six through ninety, while emergency room visits carry a $130 copay. Outpatient services and preventive care are also highly accessible, with many services requiring no copay or coinsurance. For everyday wellness, the plan provides robust dental coverage up to a $1,500 yearly limit with no copay for preventive care, alongside routine vision exams and a $150 annual allowance for eyewear. Routine hearing exams require a $10 copay, and prescription hearing aids are covered with copays between $399 and $699. Additionally, home health services feature no copay, and skilled nursing facility stays are covered with no copay for the first 20 days.
Inpatient Hospital See details
DEVOTED CORE 050 FL (HMO) partially covers inpatient hospital services with no coinsurance, requiring a $295 copay per day for days 1 through 5 and no copay for days 6 through 90 for acute and psychiatric stays. Non-Medicare-covered stays, upgrades, and additional psychiatric days are not covered.
Outpatient Services See details
Outpatient services covered by DEVOTED CORE 050 FL (HMO) feature no coinsurance, with copays ranging from no copay for ambulatory surgical center and blood services to a $10 copay for substance abuse sessions and up to $295 for hospital and observation services. Prior authorization is required for most outpatient services, and substance abuse services also require a referral.
Partial Hospitalization See details
DEVOTED CORE 050 FL (HMO) covers partial hospitalization services with a $60 copay and no coinsurance. Prior authorization is required for this covered benefit.
Ambulance and Transportation Services See details
DEVOTED CORE 050 FL (HMO) covers ground ambulance services with a copay ranging from no copay to $350 and no coinsurance, while air ambulance services require a 20% coinsurance and no copay. Prior authorization is required for ambulance services, and transportation services to health-related or plan-approved locations are not covered.
Emergency Services See details
DEVOTED CORE 050 FL (HMO) covers emergency services with a $130 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 a $130 copay (no coinsurance) for care and a $350 copay plus 20% coinsurance for emergency transportation.
Primary Care See details
DEVOTED CORE 050 FL (HMO) covers primary care physician services with no copay and no coinsurance, and specialist visits with a $10 copay and no coinsurance. Other covered benefits, such as therapy and mental health services, carry copays ranging from $10 to $50 with no coinsurance, while chiropractic and podiatry services are not covered.
Preventive Services See details
DEVOTED CORE 050 FL (HMO) covers preventive services, such as annual physical exams and kidney disease education, with no copay and no coinsurance. Additional preventive services are partially covered with no copay and no coinsurance, though sub-services like in-home safety assessments, personal emergency response systems, medical nutrition therapy, therapeutic massage, adult day health, home-based palliative care, in-home support, caregiver support, and counseling are not covered.
Hearing Services See details
Hearing services are covered by DEVOTED CORE 050 FL (HMO), featuring a $10 copay and no coinsurance for one routine exam per year, plus unlimited fitting evaluations. Prescription hearing aids are partially covered with no coinsurance and a copay between $399 and $699 for up to two aids per year, while inner ear, outer ear, over the ear, and OTC hearing aids are not covered.
Vision Services See details
DEVOTED CORE 050 FL (HMO) partially covers vision services, offering one routine eye exam per year with a $0 to $10 copay, no coinsurance, and no deductible, while other eye exam services are not covered. Eyewear is covered with no copay, no coinsurance, and no deductible up to a $150 annual maximum for contacts, eyeglasses, and upgrades.
Dental Services See details
Dental services are partially covered by DEVOTED CORE 050 FL (HMO) with a $1,500 yearly limit, featuring no copay and no coinsurance for preventive care, and no copay with 0% to 50% coinsurance for restorative and endodontic services. Medicare-covered dental services require a $10 copay and no coinsurance, but maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by DEVOTED CORE 050 FL (HMO) with no copay and no coinsurance, though prior authorization is required. Associated Medicare Part B chemotherapy, radiation, and other drugs carry no copay and 0% to 20% coinsurance, while Part B insulin requires a $35 copay and 0% to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered under the DEVOTED CORE 050 FL (HMO) plan with no copay and a 20% coinsurance. Prior authorization is required for these services.
Medical Equipment See details
DEVOTED CORE 050 FL (HMO) covers medical equipment with no copay, requiring 20% to 50% coinsurance for durable medical equipment, no coinsurance to 20% coinsurance for prosthetics and medical supplies, and no coinsurance to 50% coinsurance for diabetic supplies. This benefit is partially covered because diabetic therapeutic shoes and inserts are not covered, and prior authorization is required.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered under DEVOTED CORE 050 FL (HMO), with prior authorization required. Diagnostic lab services and outpatient X-rays feature no copay, diagnostic procedures range from a $0 to $95 copay with no coinsurance, and therapeutic radiological services require a 20% coinsurance.
Home Health Services See details
Home Health Services are covered by DEVOTED CORE 050 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 050 FL (HMO) with no coinsurance, though prior authorization is required. 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 and require a $10 copay.
Skilled Nursing Facility (SNF) See details
DEVOTED CORE 050 FL (HMO) 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, no prior 3-day inpatient hospital stay is required, and additional days beyond the Medicare-covered limit are not covered.
Other Services See details
DEVOTED CORE 050 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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