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DEVOTED C-SNP PREMIUM 067 FL (HMO C-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for DEVOTED C-SNP PREMIUM 067 FL (HMO C-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on DEVOTED C-SNP PREMIUM 067 FL (HMO C-SNP) in 2026, please refer to our full plan details page.
DEVOTED C-SNP PREMIUM 067 FL (HMO C-SNP) is a HMO C-SNP plan offered by Devoted Health, Inc. available for enrollment in 2026 to people living in Miami-Dade County. This plan received an overall rating of 5 out of 5 stars in 2026.
It's important to know that DEVOTED C-SNP PREMIUM 067 FL (HMO C-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
DEVOTED C-SNP PREMIUM 067 FL (HMO C-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 C-SNP PREMIUM 067 FL (HMO C-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 C-SNP PREMIUM 067 FL (HMO C-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 $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 C-SNP PREMIUM 067 FL (HMO C-SNP) prescription drug plan has an annual drug deductible of $615. For standard pharmacy and standard mail-order services, Tier 6 select care drugs are covered with no copay for one-, two-, and three-month supplies. Tier 1 preferred generics require an $18 copay for a one-month supply, while Tier 2 generics have a $20 copay for a one-month supply. Brand-name and specialty medications on this plan are subject to coinsurance rather than flat copays. Standard pharmacy and mail-order costs include a 23% coinsurance for Tier 3 preferred brands, a 26% coinsurance for Tier 4 non-preferred drugs, and a 25% coinsurance for Tier 5 specialty drugs. These straightforward cost-sharing tiers help you easily project your out-of-pocket prescription expenses.
Additional Benefits
The DEVOTED C-SNP PREMIUM 067 FL (HMO C-SNP) plan offers comprehensive medical coverage featuring no copay for primary care visits and preventive services, while specialist visits require a low $5 copay. For hospital care, inpatient stays require a $130 daily copay for the first five days and no copay for days six through 90, with no coinsurance. Emergency room visits carry a $150 copay, which is waived if you are admitted to the hospital. Additionally, this plan provides valuable supplemental benefits, including dental coverage with no copay for most covered services up to a $2,500 annual maximum and vision care with a $300 annual eyewear allowance. Routine hearing exams require a $5 copay, while home health services are covered with no copay and no coinsurance. Members also receive a $50 allowance every three months for over-the-counter items.
Inpatient Hospital See details
DEVOTED C-SNP PREMIUM 067 FL (HMO C-SNP) covers inpatient hospital stays with no coinsurance, requiring a $130 daily copay for days 1 through 5 and no copay for days 6 through 90. While unlimited additional acute hospital days are covered, this benefit is partially covered as upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Outpatient services are covered by DEVOTED C-SNP PREMIUM 067 FL (HMO C-SNP) with no coinsurance, featuring a $0 to $130 copay for outpatient hospital services and a $130 copay per stay for observation services. Ambulatory surgical center and outpatient blood services are covered with no copay and no coinsurance, while individual and group outpatient substance abuse sessions require a $5 copay.
Partial Hospitalization See details
Partial hospitalization is covered by DEVOTED C-SNP PREMIUM 067 FL (HMO C-SNP) with a $50.00 copay and no coinsurance. Prior authorization is required to receive this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are partially covered by DEVOTED C-SNP PREMIUM 067 FL (HMO C-SNP), as transportation to plan-approved or any health-related locations is not covered. Medicare-covered ground ambulance services require a copay of $0 to $245 and no coinsurance, while air ambulance services require a 20% coinsurance and no copay. Prior authorization is required for ambulance services, and these costs are not waived if you are admitted to the hospital.
Emergency Services See details
Emergency services under the DEVOTED C-SNP PREMIUM 067 FL (HMO C-SNP) are covered 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, and worldwide emergency services are covered up to $25,000 with a $150 copay and no coinsurance for emergency or urgent care, and a $245 copay with 20% coinsurance for emergency transportation.
Primary Care See details
DEVOTED C-SNP PREMIUM 067 FL (HMO C-SNP) covers primary care physician services with no copay and no coinsurance, and specialist visits with a $5 copay and no coinsurance. Physical and occupational therapy services have copays ranging from $5 to $50 with no coinsurance, while chiropractic services are only partially covered since routine and other chiropractic services are not covered.
Preventive Services See details
Preventive services are covered by DEVOTED C-SNP PREMIUM 067 FL (HMO C-SNP) with no copay and no coinsurance, though additional preventive benefits are only partially covered. Excluded services under this benefit include in-home safety assessments, PERS, post-discharge medication reconciliation, re-admission prevention, chemotherapy wigs, therapeutic massage, adult day health, home-based palliative care, in-home support, caregiver support, additional smoking cessation, enhanced disease management, telemonitoring, remote access technologies, and counseling.
Hearing Services See details
DEVOTED C-SNP PREMIUM 067 FL (HMO C-SNP) partially covers hearing services, providing routine hearing exams for a $5.00 copay and no coinsurance, and up to two prescription hearing aids per year with no coinsurance and a copay ranging from $399.00 to $699.00. However, OTC hearing aids and inner ear, outer ear, and over the ear prescription hearing aids are not covered under this benefit.
Vision Services See details
Vision services are partially covered by DEVOTED C-SNP PREMIUM 067 FL (HMO C-SNP), as other eye exam services are not covered. Covered routine eye exams carry a $0 to $5 copay and no coinsurance, while eyewear is available with no copay, no coinsurance, and a $300 annual maximum.
Dental Services See details
Dental services are partially covered by DEVOTED C-SNP PREMIUM 067 FL (HMO C-SNP), featuring a $5.00 copay and no coinsurance for Medicare-covered dental, and no copay or coinsurance for other covered dental services up to a $2,500 annual maximum. Excluded from coverage are other diagnostic and preventive services, maxillofacial prosthetics, implants, and orthodontics.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by DEVOTED C-SNP PREMIUM 067 FL (HMO C-SNP) with no copay, though prior authorization is required. Associated Medicare Part B chemotherapy, insulin, and other drugs require a coinsurance ranging from no coinsurance up to 20%, with insulin also requiring a $35 copay.
Dialysis Services See details
Dialysis Services are covered under the DEVOTED C-SNP PREMIUM 067 FL (HMO C-SNP) plan with no copay and a 20% coinsurance. Prior authorization is required for these services.
Medical Equipment See details
DEVOTED C-SNP PREMIUM 067 FL (HMO C-SNP) covers medical equipment with no copays, though prior authorization is required for these benefits. Durable medical equipment has a 20% to 30% coinsurance, prosthetic devices and medical supplies carry no coinsurance to 20% coinsurance, and diabetic supplies range from no coinsurance to 35% coinsurance, while diabetic therapeutic shoes and inserts are not covered.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by DEVOTED C-SNP PREMIUM 067 FL (HMO C-SNP), with prior authorization required. Diagnostic services feature no coinsurance, offering lab services with no copay and procedures with a $0 to $95 copay, while radiological services feature no copay for outpatient X-rays and a minimum 20% coinsurance for therapeutic services.
Home Health Services See details
Home health services are covered by DEVOTED C-SNP PREMIUM 067 FL (HMO C-SNP) with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
DEVOTED C-SNP PREMIUM 067 FL (HMO C-SNP) provides cardiac rehabilitation services with no coinsurance and a $5 copay, subject to prior authorization. While some services are covered, standard cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered.
Skilled Nursing Facility (SNF) See details
DEVOTED C-SNP PREMIUM 067 FL (HMO C-SNP) covers Skilled Nursing Facility (SNF) services with no coinsurance and does not require a prior three-day inpatient hospital stay. There is no copay for days 1 through 20 and a $218 daily copay for days 21 through 100, with prior authorization required and no coverage for additional days beyond the Medicare-covered limit.
Other Services See details
Other services are partially covered by DEVOTED C-SNP PREMIUM 067 FL (HMO C-SNP), offering over-the-counter (OTC) items up to $50 every three months, non-Medicare covered diabetic shoes, and additional preventive services with no copay and no coinsurance. Acupuncture, meal benefits, and highly integrated dual-eligible services are not covered.
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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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