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Devoted CORE Missouri (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Devoted CORE Missouri (HMO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Devoted CORE Missouri (HMO) in 2025, please refer to our full plan details page.
Devoted CORE Missouri (HMO) is a HMO plan offered by Devoted Health, Inc. available for enrollment in 2025 to people living in Greater St. Louis. The overall rating for this plan is not yet available for 2025.
It's important to know that Devoted CORE Missouri (HMO) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Key Plan Facts
Below are a few key facts and commonly-asked questions about Devoted CORE Missouri (HMO).
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 CORE Missouri (HMO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $0.00. 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 $590.00 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 $3600.00 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 CORE Missouri (HMO) plan has an enhanced alternative drug benefit. The plan has a deductible of $590.00. After the deductible is met, you will pay either a 25% coinsurance or no copay depending on the drug tier and pharmacy used. During the initial coverage phase, you pay these costs until your total drug costs reach $2000.00. After reaching this amount, you enter the catastrophic coverage phase where you pay nothing for covered drugs.
Additional Benefits
The Devoted CORE Missouri (HMO) plan offers a range of benefits with varying costs. Inpatient hospital stays have a $245 copay for days 1-8, with no copay for the remainder of the stay. Outpatient services have copays ranging from $0 to $345, while emergency services have a $140 copay. The plan also covers primary care, specialist visits, and mental health services with a $20-$25 copay. Preventive services are covered, and hearing and vision services include exams and eyewear, with a $1,000 maximum for vision. Dental services have a $25 copay, with a $1,000 maximum benefit.
Inpatient Hospital See details
Inpatient Hospital benefits, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, are covered, but require prior authorization. For Inpatient Hospital-Acute, you pay a $245 copay for days 1-8, and no copay for days 9-90. For Inpatient Hospital Psychiatric, you also pay a $245 copay for days 1-8, and no copay for days 9-90.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services, with a copay ranging from $0 to $345, and observation services with a $245 copay. Ambulatory Surgical Center (ASC) services have no copay, and outpatient substance abuse services have a copay of $25 for both individual and group sessions. Outpatient blood services are also covered.
Partial Hospitalization See details
Partial Hospitalization is covered by the Devoted CORE Missouri (HMO) plan, with a $60 copay. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Devoted CORE Missouri (HMO) plan. Ground ambulance services have a copay between $0-$290, while air ambulance services have a 20% coinsurance; transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by the Devoted CORE Missouri (HMO) plan. Emergency Services have a $140 copay, while Urgently Needed Services have a copay between $0 and $45. Worldwide Emergency Transportation has a $290 copay and 20% coinsurance, and Worldwide Emergency Coverage and Worldwide Urgent Coverage each have a $140 copay.
Primary Care See details
The Devoted CORE Missouri (HMO) plan covers primary care physician services, chiropractic services with a $20 copay, occupational therapy services with a $25-$50 copay, physician specialist services with a $25 copay, mental health specialty services with a $25 copay, other health care professional services with a $0-$25 copay, psychiatric services with a $25 copay, physical therapy and speech-language pathology services with a $25-$50 copay, additional telehealth benefits with a $0-$25 copay, and opioid treatment program services with a $25 copay. Routine chiropractic care and podiatry services are not covered.
Preventive Services See details
Preventive Services, including Medicare-covered services, annual physical exams, and additional preventive services, are covered. Health Education, Weight Management Programs, Alternative Therapies, Nutritional/Dietary Benefit, Fitness Benefit, Home and Bathroom Safety Devices and Modifications, Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit are covered, while In-Home Safety Assessment, Personal Emergency Response System (PERS), Medical Nutrition Therapy (MNT), Post discharge In-Home Medication Reconciliation, Re-admission Prevention, Wigs for Hair Loss Related to Chemotherapy, Therapeutic Massage, Adult Day Health Services, Home-Based Palliative Care, In-Home Support Services, Support for Caregivers of Enrollees, Additional Sessions of Smoking and Tobacco Cessation Counseling, Enhanced Disease Management, Telemonitoring Services, Remote Access Technologies (including Web/Phone-based technologies and Nursing Hotline), and Counseling Services are not covered.
Hearing Services See details
Hearing services include routine hearing exams with a $25 copay, and are limited to one visit per year. Prescription hearing aids are covered with a copay between $399 and $699 for all types, limited to two per year, but inner ear, outer ear, and over the ear hearing aids are not covered.
Vision Services See details
Vision Services include coverage for eye exams with a $25 copay, routine eye exams (1 per year), and eyewear, including contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades. There is a combined maximum benefit of $1,000 per year for all eyewear.
Dental Services See details
Devoted CORE Missouri (HMO) covers Medicare Dental Services with a $25 copay, and other dental services including oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatment, other preventive dental services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), and oral and maxillofacial surgery, but does not cover maxillofacial prosthetics, implant services, or orthodontics. The plan has a $1,000 maximum benefit for other dental services each year.
Home Infusion bundled Services See details
Home Infusion bundled Services, including Medicare Part B Insulin Drugs, Medicare Part B Chemotherapy/Radiation Drugs, and Other Medicare Part B Drugs, are covered with prior authorization. For Medicare Part B Insulin Drugs, there is a $35 copay and a coinsurance between 20% and 20%. Other services have a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by the Devoted CORE Missouri (HMO) plan with a coinsurance between 20% and 20%.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with a coinsurance between 0% and 30%, Prosthetic Devices with a coinsurance between 0% and 20%, and Medical Supplies with a 20% coinsurance; however, Durable Medical Equipment for use outside the home, Diabetic Supplies, and Diabetic Therapeutic Shoes/Inserts are not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services include coverage for all diagnostic services and all radiological services. Diagnostic Procedures/Tests have a copay between $0 and $95, while Lab Services have no copay, and Outpatient X-Ray Services have no copay. Diagnostic Radiological Services have a copay of at most $250, and Therapeutic Radiological Services have a coinsurance of at least 20%.
Home Health Services See details
Home Health Services are covered by the Devoted CORE Missouri (HMO) plan with no copay and no coinsurance, but additional hours of care and personal care services are not covered. This benefit requires authorization.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by the Devoted CORE Missouri (HMO) plan, but the specific services of Cardiac Rehabilitation, Intensive Cardiac Rehabilitation, Pulmonary Rehabilitation, and SET for PAD are not covered. There is a copay for these services, but the exact amount is not specified.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Devoted CORE Missouri (HMO) plan, but require prior authorization. For days 1-20, there is no copay, and for days 21-100, the copay is $214.
Other Services See details
Other Services are not covered, including acupuncture, over-the-counter items, meal benefits, Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, and several other services. Some Other Services, such as $0 Preventive Services, are covered with no copay.
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