Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for DEVOTED C-SNP PLUS 090 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 PLUS 090 FL (HMO C-SNP) in 2026, please refer to our full plan details page.
DEVOTED C-SNP PLUS 090 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 PLUS 090 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 PLUS 090 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 PLUS 090 FL (HMO C-SNP).
The cost of a Medicare Advantage Plan is made up of four main parts.
For DEVOTED C-SNP PLUS 090 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 $9250.00 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 PLUS 090 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 at standard pharmacies and through standard mail order services. For Tier 1 Preferred Generic drugs, standard copays start at $18 for a one-month supply, while Tier 2 Generic drugs carry a standard copay starting at $19. For higher-tier medications, the plan transitions from flat copays to coinsurance percentages at standard pharmacies and mail order. Tier 3 Preferred Brand drugs and Tier 5 Specialty drugs require a 25% coinsurance, while Tier 4 Non-Preferred drugs require a 31% coinsurance. These straightforward cost-sharing tiers help you easily estimate your monthly prescription expenses with this Devoted health plan.
The DEVOTED C-SNP PLUS 090 FL (HMO C-SNP) plan offers comprehensive medical coverage with no copays for primary care visits, preventive services, outpatient care, and home health services. For inpatient hospital stays, members pay no coinsurance but are responsible for a copay of $2,230 per acute care stay or $2,080 per psychiatric stay. Emergency room visits carry a $115 copay, which is waived if you are admitted, while specialist visits and outpatient diagnostic tests feature no copays but may require coinsurance up to 30% and 50% respectively. This plan also includes key supplemental benefits to reduce out-of-pocket costs, such as dental and vision care with no deductibles and no copays, including a $3,500 annual limit for dental and a $300 allowance for eyewear. Prescription hearing aids require no coinsurance and a copay ranging from $399 to $699, while skilled nursing facility stays feature no copay for the first 20 days followed by a $218 daily copay up to day 100. Additionally, durable medical equipment and diabetic supplies are covered with no copay and a 20% coinsurance.
DEVOTED C-SNP PLUS 090 FL (HMO C-SNP) covers inpatient hospital services with no coinsurance, requiring a $2,230 copay per stay for acute care and a $2,080 copay per stay for psychiatric care. This benefit is partially covered, as upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
DEVOTED C-SNP PLUS 090 FL (HMO C-SNP) covers outpatient services with no copays, though prior authorization is required for most benefits. Outpatient hospital and ambulatory surgical center services range from no coinsurance to 50% coinsurance, while outpatient substance abuse and blood services carry a 30% coinsurance with no deductible.
Partial hospitalization services are covered by DEVOTED C-SNP PLUS 090 FL (HMO C-SNP) with no copay and a 20% coinsurance. Prior authorization is required for this benefit.
DEVOTED C-SNP PLUS 090 FL (HMO C-SNP) covers ambulance services with no copay, requiring no coinsurance to 50% coinsurance for ground transport and 50% coinsurance for air transport. Routine transportation services to plan-approved or health-related locations are not covered.
DEVOTED C-SNP PLUS 090 FL (HMO C-SNP) covers emergency services with a $115 copay and no coinsurance, with the copay waived if you are admitted to the hospital within 24 hours. Urgently needed services require no copay and a 0% to 20% coinsurance (up to a $40 maximum), while worldwide emergency, urgent, and transportation services are covered with no copay and no coinsurance up to a $25,000 maximum limit.
DEVOTED C-SNP PLUS 090 FL (HMO C-SNP) offers primary care physician services with no copay and no coinsurance, while most specialist, therapy, and telehealth services feature no copay and up to 30% coinsurance. For chiropractic services, some services are covered but routine chiropractic care and other chiropractic services are not covered.
Preventive services are covered by DEVOTED C-SNP PLUS 090 FL (HMO C-SNP) with no copay and no coinsurance, including annual physical exams, kidney disease education, and diabetes self-management training. Additional preventive benefits are partially covered with no copay and no coinsurance, but do not cover in-home safety assessments, PERS, medication reconciliation, readmission prevention, chemotherapy wigs, therapeutic massage, adult day health, palliative care, in-home support, caregiver support, additional smoking cessation, enhanced disease management, telemonitoring, remote access technologies, or counseling services.
DEVOTED C-SNP PLUS 090 FL (HMO C-SNP) hearing services are partially covered, featuring hearing exams with no copay, though routine exams carry a 50% coinsurance. Prescription hearing aids are covered with no coinsurance and a copay of $399 to $699, but OTC hearing aids and inner ear, outer ear, and over-the-ear prescription hearing aids are not covered.
DEVOTED C-SNP PLUS 090 FL (HMO C-SNP) partially covers vision services with no deductibles, offering eye exams with no copay and 0% to 50% coinsurance, though other eye exam services are not covered. Eyewear is covered with no copay, no coinsurance, and a $300 annual maximum allowance for contacts, eyeglasses, and upgrades.
DEVOTED C-SNP PLUS 090 FL (HMO C-SNP) offers partially covered dental services with no copay and a 30% coinsurance for Medicare-covered dental, and no copay and no coinsurance for other covered preventive and comprehensive dental services up to a $3,500 annual limit. Sub-services that are not covered under this plan include other diagnostic dental services, other preventive dental services, maxillofacial prosthetics, implant services, and orthodontics.
DEVOTED C-SNP PLUS 090 FL (HMO C-SNP) covers home infusion bundled services with no copay, though prior authorization and step therapy are required. Medicare Part B insulin drugs require a $35 copay and 0% to 20% coinsurance, while chemotherapy, radiation, and other Part B drugs have no copay and 0% to 20% coinsurance.
Dialysis Services are covered under the DEVOTED C-SNP PLUS 090 FL (HMO C-SNP) plan with no copay and a 20% coinsurance, though prior authorization is required.
DEVOTED C-SNP PLUS 090 FL (HMO C-SNP) covers medical equipment with no copay, although prior authorization is required. Durable medical equipment and diabetic supplies are subject to a 20% coinsurance, while prosthetics and medical supplies range from no coinsurance to 20% coinsurance, and diabetic therapeutic shoes and inserts are not covered.
DEVOTED C-SNP PLUS 090 FL (HMO C-SNP) covers diagnostic and radiological services with no copays, although prior authorization is required. Diagnostic procedures and tests have no coinsurance, while therapeutic radiological services have a 20% coinsurance, and lab services, diagnostic radiological services, and outpatient X-rays carry a 50% coinsurance.
Home Health Services are covered by DEVOTED C-SNP PLUS 090 FL (HMO C-SNP) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services are covered by DEVOTED C-SNP PLUS 090 FL (HMO C-SNP) with no copay and prior authorization, though only some services are covered. Cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and SET for PAD services are not covered and require a 30% coinsurance.
DEVOTED C-SNP PLUS 090 FL (HMO C-SNP) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring prior authorization but no prior three-day hospital stay. There is no copay for days 1 through 20, a daily copay of $218 for days 21 through 100, and additional days beyond the standard Medicare-covered limit are not covered.
Other services under the DEVOTED C-SNP PLUS 090 FL (HMO C-SNP) plan are partially covered with no copay and no coinsurance for over-the-counter items up to $50 every three months, diabetic shoes, and additional preventive services. Acupuncture and meal benefits are not covered.
SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
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