Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for DEVOTED C-SNP PREMIUM 068 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 068 FL (HMO C-SNP) in 2026, please refer to our full plan details page.
DEVOTED C-SNP PREMIUM 068 FL (HMO C-SNP) is a HMO C-SNP plan offered by Devoted Health, Inc. available for enrollment in 2026 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 C-SNP PREMIUM 068 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 068 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.
Below are a few key facts and commonly-asked questions about DEVOTED C-SNP PREMIUM 068 FL (HMO C-SNP).
The cost of a Medicare Advantage Plan is made up of four main parts.
For DEVOTED C-SNP PREMIUM 068 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.
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
The DEVOTED C-SNP PREMIUM 068 FL (HMO C-SNP) Medicare plan features an annual drug deductible of $615. For standard retail pharmacy and standard mail order services, Tier 1 preferred generics require an $18 copay for a one-month supply, while Tier 2 generics require a $20 copay. Two-month and three-month supplies are also available with proportional copays for these lower-tier generic medications. For higher-tier medications, standard coverage transitions to coinsurance, with Tier 3 preferred brands requiring 23% coinsurance and Tier 4 non-preferred drugs requiring 26% coinsurance. Tier 5 specialty drugs incur a 25% coinsurance for a one-month supply. Additionally, Tier 6 select care drugs are highly accessible, featuring no copay for one-, two-, or three-month supplies.
The DEVOTED C-SNP PREMIUM 068 FL (HMO C-SNP) plan offers healthcare coverage featuring no copays and no coinsurance for primary care visits, home health services, and routine preventive care. For specialist visits, mental health services, and Medicare-covered dental care, members will pay a low $5 copay with no coinsurance. Inpatient hospital stays require a $130 daily copay for the first five days and no copay thereafter, while outpatient hospital services range from no copay to a $130 copay. This plan also provides valuable supplemental benefits, including comprehensive dental coverage up to a $2,500 annual limit with no copay for most preventive and comprehensive services. Members also benefit from a $300 yearly eyewear allowance with no copay, routine hearing exams for a $5 copay, and a $50 quarterly allowance for over-the-counter items. Emergency care is available with a $150 copay, which is waived if you are admitted to the hospital within 24 hours.
Inpatient hospital services are covered by DEVOTED C-SNP PREMIUM 068 FL (HMO C-SNP) with no coinsurance, requiring a $130 daily copay for days 1 through 5 and no copay for days 6 through 90. This partially covered benefit includes unlimited additional days for acute care, but does not cover additional psychiatric days, upgrades, or non-Medicare-covered stays.
DEVOTED C-SNP PREMIUM 068 FL (HMO C-SNP) covers outpatient services with no coinsurance, featuring no copay for ambulatory surgical center and outpatient blood services. Outpatient hospital services require a copay ranging from no copay to $130, observation services have a $130 copay per stay, and outpatient substance abuse group and individual sessions cost a $5 copay.
DEVOTED C-SNP PREMIUM 068 FL (HMO C-SNP) covers partial hospitalization services with a $50 copay and no coinsurance. Prior authorization is required to access this benefit.
Ambulance services are covered by DEVOTED C-SNP PREMIUM 068 FL (HMO C-SNP) with prior authorization, requiring a copay of no copay to $275 with no coinsurance for ground transport, and a 20% coinsurance for air transport. Transportation services are not covered.
DEVOTED C-SNP PREMIUM 068 FL (HMO C-SNP) covers emergency services with a $150 copay (waived if admitted within 24 hours) and no coinsurance, and urgently needed services with no copay to a $45 copay and no coinsurance. Worldwide emergency and urgent care are covered up to $25,000 with a $150 copay and no coinsurance, while worldwide emergency transportation has a $275 copay and 20% coinsurance.
DEVOTED C-SNP PREMIUM 068 FL (HMO C-SNP) provides primary care physician services with no copay and no coinsurance, while specialist, psychiatric, mental health, podiatry, and opioid treatment services require a $5 copay and no coinsurance. Physical, occupational, and speech therapy services carry a $5 to $50 copay with no coinsurance, telehealth services have a $0 to $45 copay with no coinsurance, and chiropractic services are only partially covered.
Preventive services are partially covered by DEVOTED C-SNP PREMIUM 068 FL (HMO C-SNP) with no copay and no coinsurance for covered options like annual physicals, fitness benefits, and nutritional therapy. However, several sub-services are not covered, including personal emergency response systems, in-home support, therapeutic massage, caregiver support, and home-based palliative care.
Hearing Services are partially covered by DEVOTED C-SNP PREMIUM 068 FL (HMO C-SNP), featuring a $5.00 copay and no coinsurance for routine exams, and prescription hearing aids with a copay between $399.00 and $699.00 and no coinsurance. OTC hearing aids, along with inner ear, outer ear, and over the ear prescription hearing aids, are not covered.
Vision services are partially covered by DEVOTED C-SNP PREMIUM 068 FL (HMO C-SNP), featuring one routine eye exam per year with a $0 to $5 copay, no coinsurance, and no deductible, while other eye exam services are not covered. Eyewear is also covered with no copay, no coinsurance, and no deductible up to a $300 yearly maximum for contacts, frames, lenses, and upgrades.
Dental services are covered by DEVOTED C-SNP PREMIUM 068 FL (HMO C-SNP) with a $5 copay and no coinsurance for Medicare-covered care, and no copay and no coinsurance for other preventive and comprehensive services up to a $2,500 annual maximum. While most services are covered (some requiring prior authorization), implant services, orthodontics, maxillofacial prosthetics, other diagnostic dental, and other preventive dental services are not covered.
DEVOTED C-SNP PREMIUM 068 FL (HMO C-SNP) covers home infusion bundled services with no copay, although prior authorization is required. Medicare Part B chemotherapy, insulin, and other drugs are covered with coinsurance ranging from no coinsurance up to 20%, with insulin drugs also requiring a $35 copay.
Dialysis Services are covered by DEVOTED C-SNP PREMIUM 068 FL (HMO C-SNP) with no copay and a 20% coinsurance. Prior authorization is required to receive these services.
DEVOTED C-SNP PREMIUM 068 FL (HMO C-SNP) partially covers medical equipment with no copays, but coinsurance ranges from no coinsurance up to 50% and prior authorization is required. Covered items include durable medical equipment, prosthetics, and diabetic supplies, but diabetic therapeutic shoes and inserts are not covered.
DEVOTED C-SNP PREMIUM 068 FL (HMO C-SNP) covers diagnostic services with no coinsurance, offering no copay for lab services and copays from $0 to $95 for diagnostic procedures. Covered radiological services include outpatient X-rays with no copay, diagnostic radiology with copays starting at $0, and therapeutic radiology with a 20% minimum coinsurance.
Home health services are covered by DEVOTED C-SNP PREMIUM 068 FL (HMO C-SNP) with no copay and no coinsurance. Prior authorization is required to receive these services.
DEVOTED C-SNP PREMIUM 068 FL (HMO C-SNP) covers some cardiac rehabilitation services with no coinsurance, though prior authorization is required. However, standard cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered and require a $5 copay.
Skilled Nursing Facility (SNF) services are covered by DEVOTED C-SNP PREMIUM 068 FL (HMO C-SNP) with no coinsurance, featuring no copay for days 1 to 20 and a $218 daily copay for days 21 to 100. Prior authorization is required, a prior 3-day inpatient hospital stay is not required for admission, and additional days beyond the standard 100 days are not covered.
Other services are partially covered by DEVOTED C-SNP PREMIUM 068 FL (HMO C-SNP) with no copay and no coinsurance, which includes diabetic shoes, additional preventive services, and up to $50 every three months for over-the-counter items. Acupuncture and meal benefits are not covered under this plan.
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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