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Devoted EXTRA Florida (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Devoted EXTRA Florida (HMO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Devoted EXTRA Florida (HMO) in 2025, please refer to our full plan details page.
Devoted EXTRA Florida (HMO) is a HMO plan offered by Devoted Health, Inc. available for enrollment in 2025 to people living in Osceola, Seminole, and Orange Counties. This plan received an overall rating of 4.5 out of 5 stars in 2025.
It's important to know that Devoted EXTRA Florida (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 EXTRA Florida (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 EXTRA Florida (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 $590.00 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 EXTRA Florida (HMO) plan has an enhanced alternative drug benefit. The plan has a deductible of $590.00. In the initial coverage phase, after the deductible is met, you will pay either a 25% coinsurance or no copay, depending on the drug tier and whether you use a preferred or standard pharmacy. Once your total drug costs reach $2000.00, you enter the catastrophic coverage phase where you will pay nothing for your drugs.
Additional Benefits
The Devoted EXTRA Florida (HMO) plan offers a wide range of benefits with varying costs. It covers inpatient hospital stays, outpatient services, and emergency services with copays, as well as primary care, preventive, hearing, vision, and dental services, also with copays. The plan also includes coverage for home health, skilled nursing, and medical equipment, with some services requiring prior authorization or having coinsurance. This plan provides additional benefits like hearing aids, eyewear, and a yearly maximum for dental services. It also covers home infusion, dialysis, and diagnostic services, with some services having no copay. However, certain services such as acupuncture, over-the-counter items, and some types of therapy are not covered.
Inpatient Hospital See details
Inpatient Hospital-Acute has a $175 copay for days 1-5, and no copay for days 6-90, while Inpatient Hospital Psychiatric has a $175 copay for days 1-5, and no copay for days 6-90. Additional days for Inpatient Hospital-Acute are covered, but Non-Medicare-covered stays and Upgrades for Inpatient Hospital-Acute are not covered, and Additional days and Non-Medicare-covered stays for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services are covered, including outpatient hospital services with a copay between $0 and $175, observation services with a $175 copay, ambulatory surgical center (ASC) services with no copay, and outpatient substance abuse services with a $5 copay for both individual and group sessions. Outpatient blood services are also covered, with a waived three-pint deductible.
Partial Hospitalization See details
Partial Hospitalization is covered, but requires prior authorization. You will pay a $55 copay for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Devoted EXTRA Florida (HMO) plan, with prior authorization required for all ambulance services. Ground Ambulance Services have a copay of $0-$300, while Air Ambulance Services have a 20% coinsurance. Transportation Services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by the Devoted EXTRA Florida (HMO) plan. Emergency Services have a $140 copay, while Urgently Needed Services have a copay of $0-$45. Worldwide Emergency Coverage and Worldwide Urgent Coverage have a $140 copay, and Worldwide Emergency Transportation has a $300 copay and 20% coinsurance.
Primary Care See details
The Devoted EXTRA Florida (HMO) plan covers primary care physician services, chiropractic services, occupational therapy, physician specialist services, mental health specialty services, other health care professional services, psychiatric services, physical therapy and speech-language pathology services, additional telehealth benefits, and opioid treatment program services. Chiropractic services have a $5 copay, occupational therapy services have a copay between $5 and $50, and physician specialist services, mental health, and psychiatric services have a $5 copay. Other health care professional services have a copay between $0 and $5, physical therapy and speech-language pathology services have a copay between $5 and $50, and opioid treatment program services have a $5 copay. Routine chiropractic care and podiatry services are not covered.
Preventive Services See details
Preventive Services, including Medicare-covered services and annual physical exams, are covered by the Devoted EXTRA Florida (HMO) plan. Additional services covered include Health Education, Weight Management Programs, Alternative Therapies, Nutritional/Dietary Benefits, Fitness Benefit, Home and Bathroom Safety Devices and Modifications, Glaucoma Screenings, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit, while In-Home Safety Assessment, Personal Emergency Response System (PERS), Medical Nutrition Therapy (MNT), Post discharge In-Home Medication Reconciliation, Re-admission Prevention, Wigs for Hair Loss Related to Chemotherapy, Therapeutic Massage, Adult Day Health Services, Home-Based Palliative Care, In-Home Support Services, Support for Caregivers of Enrollees, Additional Sessions of Smoking and Tobacco Cessation Counseling, Enhanced Disease Management, Telemonitoring Services, Remote Access Technologies (including Web/Phone-based technologies and Nursing Hotline), and Counseling Services are not covered.
Hearing Services See details
Hearing services include routine hearing exams with a $5 copay, fitting/evaluation for hearing aids, and prescription hearing aids with a copay between $399 and $699; however, prescription hearing aids are limited to 2 per year. Inner ear, outer ear, and over the ear prescription hearing aids, and OTC hearing aids are not covered.
Vision Services See details
Vision Services include coverage for eye exams with a $5 copay. Eyewear is covered with a combined maximum benefit of $1250 every year, and contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades are also covered.
Dental Services See details
Dental services include a $5 copay for Medicare Dental Services, with coverage for oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatment, other preventive dental services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), and oral and maxillofacial surgery. Other services such as maxillofacial prosthetics, implant services, and orthodontics are not covered. The plan has a maximum benefit of $1250 per year for dental services.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, with prior authorization required. For Medicare Part B Insulin Drugs, there is a $35 copay and 20% coinsurance. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, there is between 0% and 20% coinsurance.
Dialysis Services See details
Dialysis services are covered by the Devoted EXTRA Florida (HMO) plan. The coinsurance for these services is between 20% and 20%.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with a coinsurance between 0% and 25% and no copay, though Durable Medical Equipment for use outside the home is not covered. Prosthetics/Medical Supplies have a coinsurance, and Medical Supplies have a 20% coinsurance, with no copay. Diabetic Equipment is covered, though Diabetic Supplies and Diabetic Therapeutic Shoes/Inserts are not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including Diagnostic Procedures/Tests with a copay between $0 and $95, Lab Services with no copay, Diagnostic Radiological Services with a copay up to $300, Therapeutic Radiological Services with a coinsurance of at least 20%, and Outpatient X-Ray Services with no copay. All services require prior authorization.
Home Health Services See details
Home Health Services are covered by the Devoted EXTRA Florida (HMO) plan with no copay and no coinsurance, but require authorization. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by the Devoted EXTRA Florida (HMO) plan. However, Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, and Additional Cardiac Rehabilitation Services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Devoted EXTRA Florida (HMO) plan, but require prior authorization. For days 1-20, there is no copay, and for days 21-100, the copay is $214.
Other Services See details
The Devoted EXTRA Florida (HMO) plan's "Other Services" benefit does not cover acupuncture, over-the-counter items, or meal benefits, and it also does not cover Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, or Self-Directed Personal Assistance Services. Other services, such as $0 Preventive Services, are covered with no copay.
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