A non-government entity
DEVOTED C-SNP PREMIUM 074 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 074 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 074 FL (HMO C-SNP) in 2026, please refer to our full plan details page.
DEVOTED C-SNP PREMIUM 074 FL (HMO C-SNP) is a HMO C-SNP plan offered by Devoted Health, Inc. available for enrollment in 2026 to people living in Osceola, Seminole, and Orange 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 074 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 074 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 074 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 074 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:
Sign up for DEVOTED C-SNP PREMIUM 074 FL (HMO C-SNP)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
Drug Coverage
The DEVOTED C-SNP PREMIUM 074 FL (HMO C-SNP) Medicare plan features an annual prescription drug deductible of $615. Under this plan, you will pay no copay for Tier 6 select care drugs filled through standard pharmacies or standard mail order. For Tier 1 preferred generics, the cost is an $18 copay for a 1-month supply, while Tier 2 generics carry a $20 copay per month. For higher-tier medications, the plan utilizes coinsurance rather than flat copays. Tier 3 preferred brand drugs require a 23% coinsurance, and Tier 4 non-preferred drugs carry a 26% coinsurance for standard pharmacy and mail order fills. Specialty drugs in Tier 5 are limited to a 1-month supply and require a 25% coinsurance.
Additional Benefits
The DEVOTED C-SNP PREMIUM 074 FL (HMO C-SNP) plan offers strong healthcare coverage with no copay for primary care visits, preventive services, and home health care. For specialist visits and mental health services, members pay a low $10 copay, while inpatient hospital stays require a $175 copay for the first five days and no copay for days six through 90. Emergency room visits carry a $150 copay, which is waived if you are admitted to the hospital within 24 hours. This plan also features robust supplemental benefits, including no copay for preventive and comprehensive dental services up to a $2,000 yearly limit, and no copay for routine eyewear up to a $300 annual maximum. Routine hearing exams require a $10 copay, with prescription hearing aids costing between a $399 and $699 copay. While many diagnostic and home services feature no copay, specialized needs like durable medical equipment and dialysis require a 20% to 30% coinsurance.
Inpatient Hospital See details
DEVOTED C-SNP PREMIUM 074 FL (HMO C-SNP) inpatient hospital services are partially covered with no coinsurance, requiring a $175 copay for days 1 through 5 and no copay for days 6 through 90. Unlimited additional days for acute care are covered, but additional psychiatric days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
DEVOTED C-SNP PREMIUM 074 FL (HMO C-SNP) covers outpatient services with no coinsurance, featuring no copay for ambulatory surgical center and blood services. Outpatient hospital services carry a copay of up to $175, while outpatient substance abuse sessions require a $10 copay.
Partial Hospitalization See details
Partial hospitalization services are covered by DEVOTED C-SNP PREMIUM 074 FL (HMO C-SNP) with a $55.00 copay and no coinsurance. Prior authorization is required to receive this benefit.
Ambulance and Transportation Services See details
DEVOTED C-SNP PREMIUM 074 FL (HMO C-SNP) covers ground ambulance services with a copay ranging from no copay to $275 and no coinsurance, while air ambulance services require a 20% coinsurance and no copay. Prior authorization is required for all ambulance services, and transportation services to plan-approved or health-related locations are not covered.
Emergency Services See details
DEVOTED C-SNP PREMIUM 074 FL (HMO C-SNP) covers emergency services with a $150 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services are covered with a copay ranging from no copay to $45 and no coinsurance, while worldwide emergency services are covered up to a $25,000 maximum and include a $150 copay (no coinsurance) for care and a $275 copay with 20% coinsurance for transportation.
Primary Care See details
DEVOTED C-SNP PREMIUM 074 FL (HMO C-SNP) offers primary care physician services with no copay and no coinsurance, while specialist, mental health, and podiatry visits require a $10 copay and no coinsurance. Physical, occupational, and speech therapy services carry a $10 to $50 copay and no coinsurance, though chiropractic benefits are only partially covered since routine and other chiropractic services are not covered.
Preventive Services See details
Preventive services are partially covered by DEVOTED C-SNP PREMIUM 074 FL (HMO C-SNP) with no copay and no coinsurance for covered benefits like annual physical exams, fitness benefits, and kidney disease education. Non-covered sub-services under this plan include in-home safety assessments, personal emergency response systems, therapeutic massage, and home-based palliative care.
Hearing Services See details
Hearing services are covered by DEVOTED C-SNP PREMIUM 074 FL (HMO C-SNP), including one annual routine hearing exam for a $10 copay and no coinsurance, with no deductible. Prescription hearing aids are partially covered with no coinsurance and a copay ranging from $399 to $699 for up to two aids per year, though 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 074 FL (HMO C-SNP), as other eye exam services are not covered. Covered benefits include one routine eye exam per year with a $0 to $10 copay and no coinsurance, as well as eyewear with no copay, no coinsurance, and a $300 annual maximum limit.
Dental Services See details
Dental services are partially covered by DEVOTED C-SNP PREMIUM 074 FL (HMO C-SNP) up to a $2,000 annual maximum, featuring a $10 copay and no coinsurance for Medicare-covered dental, and no copay and no coinsurance for covered preventive and comprehensive services. Sub-services that are not covered include other diagnostic dental, other preventive dental, maxillofacial prosthetics, implants, and orthodontics.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by DEVOTED C-SNP PREMIUM 074 FL (HMO C-SNP) with no copay, though prior authorization is required. Associated Medicare Part B drugs, including chemotherapy and other drugs, require a coinsurance ranging from no coinsurance up to 20%, while Part B insulin has a $35 copay and up to 20% coinsurance.
Dialysis Services See details
DEVOTED C-SNP PREMIUM 074 FL (HMO C-SNP) covers dialysis services with no copay and a 20% coinsurance. Prior authorization is required to receive this benefit.
Medical Equipment See details
Medical equipment benefits under DEVOTED C-SNP PREMIUM 074 FL (HMO C-SNP) are covered with no copays, though prior authorization is required and coinsurance applies to most items. Durable medical equipment has a 20% to 30% coinsurance, prosthetics and medical supplies range from 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
DEVOTED C-SNP PREMIUM 074 FL (HMO C-SNP) covers diagnostic and radiological services, with prior authorization required. Diagnostic lab services have no copay and no coinsurance, while diagnostic procedures and tests range from a $0 to $95 copay with no coinsurance. Outpatient X-rays have no copay but require coinsurance, diagnostic radiological services have a copay starting at $0, and therapeutic radiological services require a 20% coinsurance.
Home Health Services See details
Home Health Services are fully covered under the DEVOTED C-SNP PREMIUM 074 FL (HMO C-SNP) plan with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by DEVOTED C-SNP PREMIUM 074 FL (HMO C-SNP) with no coinsurance, though prior authorization is required. Some services are covered, but Cardiac Rehabilitation, Intensive Cardiac Rehabilitation, Pulmonary Rehabilitation, and Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) services are not covered and require a 10 dollar copay.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is covered by DEVOTED C-SNP PREMIUM 074 FL (HMO C-SNP) with no coinsurance, requiring prior authorization but no prior 3-day hospital stay. There is no copay for days 1 through 20, a $218 daily copay for days 21 through 100, and additional days beyond the Medicare-covered limit are not covered.
Other Services See details
DEVOTED C-SNP PREMIUM 074 FL (HMO C-SNP) partially covers other services, offering no copay and no coinsurance for over-the-counter items up to $50 every three months, non-Medicare covered diabetic shoes, and additional preventive services. Acupuncture, meal benefits, and dual-eligible highly integrated services are not covered.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
*/SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
MedicareAdvantageRX.com is owned and operated by Dog Media Solutions LLC.
This is a promotional communication.
Every year, Medicare evaluates plans based on a 5-star rating system.
Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
* 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.
Enrollment in Medicare/Medicare Advantage may be limited to certain times of the year unless you qualify for a Special Enrollment Period
We do not offer every plan available in your area. Currently, we represent 18 organizations, which offer 52,101 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
We represent Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan's contract renewal.
Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.
Please contact Medicare.gov ,1-800-MEDICARE , or your local State Health Insurance Program (SHIP) to get information on all of your options.
Medicare has neither approved nor endorsed any information on this site.
Speak with a licensed insurance agent: 1-877-649-2073 / TTY 711 | 8am - 11pm ET | 7 days a week
© 2023 Dog Media Solutions LLC. All rights reserved