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DEVOTED C-SNP PREMIUM 071 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 071 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 071 FL (HMO C-SNP) in 2026, please refer to our full plan details page.

DEVOTED C-SNP PREMIUM 071 FL (HMO C-SNP) is a HMO C-SNP plan offered by Devoted Health, Inc. available for enrollment in 2026 to people living in Clay, Duval, Nassau, and St. Johns Counties. This plan received an overall rating of 5 out of 5 stars in 2026.

It's important to know that DEVOTED C-SNP PREMIUM 071 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 071 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.

Overview IconKey Plan Facts

Below are a few key facts and commonly-asked questions about DEVOTED C-SNP PREMIUM 071 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 071 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 $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:

Regular visits to your primary care doctor are covered and will have a copay of and coinsurance of 0% (no coinsurance).

Specialist Visits:

Visits to specialists are covered and will have a copay of and coinsurance of 0% (no coinsurance). Specialist visits may require a referral from your primary care doctor or prior authorization.

Emergency Room:

Trips to the Emergency Room are covered, and will have a copay of and coinsurance of 0% (no coinsurance). Coverage may vary for in-network and out-of-network hospitals.

Urgent Care:

Trips to Urgent Care arecovered and will have a copay of and coinsurance of 0% (no coinsurance). Coverage may vary for in-network and out-of-network hospitals.

Sign up for DEVOTED C-SNP PREMIUM 071 FL (HMO C-SNP)

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Drug Coverage IconDrug Coverage

The DEVOTED C-SNP PREMIUM 071 FL (HMO C-SNP) Medicare plan has an annual prescription drug deductible of $615. Under this plan, Tier 6 select care drugs are available with no copay for one, two, or three-month supplies at standard pharmacies and through standard mail order. 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 using standard filling methods. For brand-name and specialty medications, costs are determined by coinsurance. Tier 3 preferred brand drugs carry a 23% coinsurance, and Tier 4 non-preferred drugs require a 26% coinsurance for standard one, two, and three-month supplies. Tier 5 specialty drugs require a 25% coinsurance for a one-month supply at standard pharmacies or via standard mail order.

Additional Benefits IconAdditional Benefits

The DEVOTED C-SNP PREMIUM 071 FL (HMO C-SNP) plan offers robust coverage for core medical needs, featuring no copay and no coinsurance for primary care visits and preventive services. For inpatient hospital stays, members pay a daily copay of $175 for the first five days and no copay for days six through ninety, with no coinsurance required. Emergency room visits carry a $130 copay, which is waived if you are admitted to the hospital within 24 hours. This plan also includes valuable supplemental benefits, such as dental coverage with no copay or coinsurance up to a $2,000 annual limit. Vision care features routine exams with up to a $15 copay and up to $300 annually for eyewear with no copay, while hearing exams require a $15 copay and prescription hearing aids carry copays between $399 and $699. Additionally, members receive a $50 allowance every three months for over-the-counter items with no copay.

Inpatient Hospital See details

DEVOTED C-SNP PREMIUM 071 FL (HMO C-SNP) covers inpatient acute and psychiatric hospital stays with no coinsurance and a copay of $175 per day for days 1 through 5, and no copay for days 6 through 90. Prior authorization is required, and while additional acute care days are unlimited, additional psychiatric days, upgrades, and non-Medicare-covered stays are not covered.

Outpatient Services See details

DEVOTED C-SNP PREMIUM 071 FL (HMO C-SNP) covers outpatient services with no coinsurance, featuring a $0 to $175 copay for outpatient hospital services and a $175 copay per stay for observation services. Outpatient substance abuse sessions require a $15 copay, while ambulatory surgical center and outpatient blood services are covered with no copay.

Partial Hospitalization See details

DEVOTED C-SNP PREMIUM 071 FL (HMO C-SNP) covers partial hospitalization services with a $55.00 copay and no coinsurance. Prior authorization is required for this covered benefit.

Ambulance and Transportation Services See details

Ambulance and transportation services are partially covered by DEVOTED C-SNP PREMIUM 071 FL (HMO C-SNP), as transportation to plan-approved or any health-related locations is not covered. Prior-authorized ground ambulance services require no copay to a $250 copay plus coinsurance, while air ambulance services carry a 20% coinsurance and a copay.

Emergency Services See details

DEVOTED C-SNP PREMIUM 071 FL (HMO C-SNP) covers emergency services with a $130 copay and no coinsurance, which is waived if 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 copays up to $250 and a 20% coinsurance for transportation.

Primary Care See details

DEVOTED C-SNP PREMIUM 071 FL (HMO C-SNP) covers primary care physician services with no copay and no coinsurance, while specialist, therapy, and mental health services require copays ranging from $15 to $50 and no coinsurance. Telehealth and podiatry services are covered with copays up to $45 and no coinsurance, though chiropractic services are not covered in practice as routine and other chiropractic care are excluded.

Preventive Services See details

Preventive Services are partially covered by DEVOTED C-SNP PREMIUM 071 FL (HMO C-SNP) with no copay and no coinsurance for covered services like annual physicals, fitness benefits, and nutritional training. However, the plan does not cover In-Home Safety Assessments, Personal Emergency Response Systems (PERS), post-discharge medication reconciliation, readmission prevention, wigs for chemotherapy hair loss, therapeutic massage, adult day health, home-based palliative care, in-home support, caregiver support, additional smoking cessation counseling, enhanced disease management, telemonitoring, remote access technologies, and counseling.

Hearing Services See details

Hearing services are partially covered by DEVOTED C-SNP PREMIUM 071 FL (HMO C-SNP), offering routine exams for a $15 copay with no coinsurance and up to two prescription hearing aids per year for a $399 to $699 copay with no coinsurance. Over-the-counter (OTC) hearing aids, as well as inner ear, outer ear, and over the ear prescription hearing aids, are not covered.

Vision Services See details

Vision Services are partially covered by DEVOTED C-SNP PREMIUM 071 FL (HMO C-SNP), offering one routine eye exam per year with a $0 to $15 copay, no coinsurance, and no deductible (prior authorization required), though other eye exam services are not covered. Eyewear is covered with no copay, no coinsurance, and no deductible, providing up to a $300 annual maximum for contact lenses, eyeglasses, frames, lenses, and upgrades.

Dental Services See details

Dental services are partially covered by DEVOTED C-SNP PREMIUM 071 FL (HMO C-SNP), featuring a $15 copay and no coinsurance for Medicare-covered dental, and a $2,000 annual limit with no copay and no coinsurance for other covered services. Sub-services that are not covered include other diagnostic, other preventive, maxillofacial prosthetics, implant services, and orthodontics.

Home Infusion bundled Services See details

Home infusion bundled services are covered by DEVOTED C-SNP PREMIUM 071 FL (HMO C-SNP) with no copay and no coinsurance, though prior authorization is required. Associated Medicare Part B chemotherapy and other drugs carry no copay and a 0% to 20% coinsurance, while Part B insulin requires a $35 copay and 0% to 20% coinsurance.

Dialysis Services See details

DEVOTED C-SNP PREMIUM 071 FL (HMO C-SNP) covers dialysis services with no copay and a 20% coinsurance, though prior authorization is required.

Medical Equipment See details

DEVOTED C-SNP PREMIUM 071 FL (HMO C-SNP) covers medical equipment with no copays, featuring coinsurance of 20% to 30% for durable medical equipment, no coinsurance to 20% for prosthetics and medical supplies, and no coinsurance to 30% for diabetic supplies. Diabetic equipment is partially covered under this plan, as diabetic therapeutic shoes and inserts are not covered, and prior authorization is required for these benefits.

Diagnostic and Radiological Services See details

DEVOTED C-SNP PREMIUM 071 FL (HMO C-SNP) covers diagnostic and radiological services with prior authorization required. Diagnostic tests and procedures have no coinsurance and a copay ranging from $0 to $95, lab services and outpatient X-rays feature no copay, and therapeutic radiological services require a minimum 20% coinsurance along with a copay.

Home Health Services See details

Home health services are covered by DEVOTED C-SNP PREMIUM 071 FL (HMO C-SNP) with no copay and no coinsurance. Prior authorization is required to receive these services.

Cardiac Rehabilitation Services See details

Cardiac Rehabilitation Services are covered by DEVOTED C-SNP PREMIUM 071 FL (HMO C-SNP) with no coinsurance and prior authorization required. While some services are covered, cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and SET for PAD services are not covered and require a $15 copay.

Skilled Nursing Facility (SNF) See details

Skilled Nursing Facility (SNF) care is partially covered by DEVOTED C-SNP PREMIUM 071 FL (HMO C-SNP) with no coinsurance, requiring no copay for days 1 to 20 and a $218 daily copay for days 21 to 100. Prior authorization is required, a prior three-day hospital stay is not needed, and additional days beyond the standard Medicare limit are not covered.

Other Services See details

DEVOTED C-SNP PREMIUM 071 FL (HMO C-SNP) partially covers other services, offering no copay and no coinsurance for over-the-counter (OTC) items up to $50 every three months, diabetic shoes, and additional preventive services. Acupuncture, meal benefits, and dual eligible SNP services are not covered.

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