Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for DEVOTED DUAL PLUS 055 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 055 FL (HMO D-SNP) in 2026, please refer to our full plan details page.
DEVOTED DUAL PLUS 055 FL (HMO D-SNP) is a HMO D-SNP plan offered by Devoted Health, Inc. available for enrollment in 2025 to people living in Palm Beach County. This plan received an overall rating of 5 out of 5 stars in 2026.
It's important to know that DEVOTED DUAL PLUS 055 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 055 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.
Below are a few key facts and commonly-asked questions about DEVOTED DUAL PLUS 055 FL (HMO D-SNP).
The cost of a Medicare Advantage Plan is made up of four main parts.
For DEVOTED DUAL PLUS 055 FL (HMO D-SNP), 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 $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.
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The DEVOTED DUAL PLUS 055 FL (HMO D-SNP) Medicare plan has an annual drug deductible of $615. For prescription drugs in Tiers 1 through 4, which include preferred generic, generic, preferred brand, and non-preferred drugs, you will pay a 25% coinsurance for 1-month, 2-month, and 3-month supplies at standard pharmacies and standard mail order services. Specialty drugs in Tier 5 also require a 25% coinsurance for a 1-month supply through standard pharmacies and standard mail order. Beneficiaries enjoy no copay for Tier 6 select care drugs for 1-month, 2-month, and 3-month supplies at standard pharmacies and standard mail order. This summary of the DEVOTED DUAL PLUS 055 FL (HMO D-SNP) drug benefits helps you understand your out-of-pocket costs for prescriptions.
The DEVOTED DUAL PLUS 055 FL (HMO D-SNP) plan offers comprehensive medical coverage with no copays for primary care visits, preventive services, home health, and outpatient services, though specialist visits and some outpatient services require a 20% coinsurance. Inpatient hospital stays require a copay of $2,230 for acute care and $2,080 for psychiatric care, both with no coinsurance, while skilled nursing facility stays feature no copay for the first 20 days followed by a $218 daily copay. Emergency services are available with a $115 copay, which is waived if you are admitted to the hospital within 24 hours. For ancillary health needs, the plan provides dental benefits of up to $2,500 annually for preventive and comprehensive care with no copay and no coinsurance. Vision care features eyewear coverage up to a $400 annual limit with no copay or coinsurance, while hearing benefits cover up to two prescription hearing aids per year with copays ranging from $0 to $299. Additionally, members can access a $50 over-the-counter allowance every three months with no copay and no coinsurance to cover wellness essentials.
DEVOTED DUAL PLUS 055 FL (HMO D-SNP) covers inpatient hospital services with no coinsurance, requiring a $2,230 copay per stay for acute care and a $2,080 copay per stay for psychiatric care, both of which require prior authorization. This benefit is partially covered because hospital upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
DEVOTED DUAL PLUS 055 FL (HMO D-SNP) covers outpatient services with no copay, with coinsurance ranging from no coinsurance up to 20% for hospital, ambulatory surgical center, substance abuse, and blood services. Most of these covered outpatient services require prior authorization, and there is no deductible for outpatient blood services.
Partial hospitalization is covered by DEVOTED DUAL PLUS 055 FL (HMO D-SNP) with no copay and a 20% coinsurance. Prior authorization is required for these services.
Ambulance services are covered by DEVOTED DUAL PLUS 055 FL (HMO D-SNP) with no copay, requiring a 0% to 20% coinsurance for ground transport and a 20% coinsurance for air transport. While some transportation services are covered, trips to plan-approved or any health-related locations are not covered.
DEVOTED DUAL PLUS 055 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 feature no copay and a 0% to 20% coinsurance up to $40, while worldwide emergency, urgent, and transportation services are covered up to $25,000 with no copay and no coinsurance.
DEVOTED DUAL PLUS 055 FL (HMO D-SNP) offers primary care physician services with no copay and no coinsurance, while most specialist, therapy, and mental health services require no copay and 20% coinsurance. Chiropractic services are partially covered, offering up to 12 routine visits per year with no copay and 20% coinsurance, though other chiropractic services are not covered.
DEVOTED DUAL PLUS 055 FL (HMO D-SNP) offers preventive services with no copay and no coinsurance, including annual physical exams, fitness benefits, and alternative therapies. While many supplemental benefits are included, this coverage is partial, and services such as in-home safety assessments, personal emergency response systems (PERS), and therapeutic massages are not covered.
DEVOTED DUAL PLUS 055 FL (HMO D-SNP) provides partially covered hearing services, featuring exams with no copay (except routine exams which require 20% coinsurance) and up to two prescription hearing aids per year with no coinsurance and a $0 to $299 copay. OTC hearing aids, as well as inner ear, outer ear, and over-the-ear prescription hearing aids, are not covered under this plan.
DEVOTED DUAL PLUS 055 FL (HMO D-SNP) provides partially covered vision services, including one annual routine eye exam with no copay and 0% to 20% coinsurance, while other eye exam services are not covered. Eyewear is covered with no copay, no coinsurance, and a $400 yearly maximum allowance for contact lenses, eyeglasses, frames, and upgrades.
DEVOTED DUAL PLUS 055 FL (HMO D-SNP) partially covers dental services, offering up to $2,500 annually for preventive and comprehensive care with no copay and no coinsurance, while Medicare-covered dental has no copay and a 20% coinsurance. Other diagnostic dental services, other preventive dental services, maxillofacial prosthetics, implant services, and orthodontics are not covered.
DEVOTED DUAL PLUS 055 FL (HMO D-SNP) covers home infusion bundled services with no copay, though prior authorization and step therapy are required. Covered Medicare Part B insulin drugs require a $35 copay and no coinsurance to 20% coinsurance, while chemotherapy, radiation, and other Part B drugs are covered with no coinsurance to 20% coinsurance.
DEVOTED DUAL PLUS 055 FL (HMO D-SNP) covers dialysis services with no copay and a 20% coinsurance. Prior authorization is required for this covered benefit.
DEVOTED DUAL PLUS 055 FL (HMO D-SNP) covers medical equipment, including durable medical equipment (DME), prosthetics, and diabetic supplies, with no copay and prior authorization required. Durable medical equipment and diabetic equipment carry a 20% coinsurance, while prosthetics and medical supplies range from no coinsurance to 20% coinsurance.
DEVOTED DUAL PLUS 055 FL (HMO D-SNP) covers diagnostic and radiological services with prior authorization required and no copay. Diagnostic procedures and tests have no coinsurance, while lab services, diagnostic and therapeutic radiological services, and outpatient X-rays are subject to a 20% coinsurance.
Home Health Services are covered by DEVOTED DUAL PLUS 055 FL (HMO D-SNP) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services are covered under DEVOTED DUAL PLUS 055 FL (HMO D-SNP) with no copay and a 20% coinsurance, requiring prior authorization. While some services are covered, standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for peripheral artery disease (PAD) rehabilitation services are not covered.
Skilled Nursing Facility (SNF) services are covered by DEVOTED DUAL PLUS 055 FL (HMO D-SNP) with no coinsurance and require prior authorization, with no prior three-day hospital stay required. 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-covered limit are not covered.
Other services are partially covered by DEVOTED DUAL PLUS 055 FL (HMO D-SNP), featuring over-the-counter (OTC) items up to $50 every three months and additional preventive services, both with no copay and no coinsurance. Acupuncture, meal benefits, and highly integrated dual eligible SNP services are not covered.
SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
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* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
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