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DEVOTED CORE 009 MO (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for DEVOTED CORE 009 MO (HMO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on DEVOTED CORE 009 MO (HMO) in 2026, please refer to our full plan details page.
DEVOTED CORE 009 MO (HMO) is a HMO plan offered by Devoted Health, Inc. available for enrollment in 2026 to people living in Southern Missouri. The overall rating for this plan is not yet available for 2026.
It's important to know that DEVOTED CORE 009 MO (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 009 MO (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 009 MO (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 $305.00 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 $3200.00 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 009 MO (HMO) prescription drug plan features an annual drug deductible of $305. Under this plan, you will enjoy no copay for Tier 1 preferred generic and Tier 2 generic medications filled at standard pharmacies or through standard mail order. This cost-sharing structure applies to one-month, two-month, and three-month supplies of these generic drugs. For higher-tier medications, your costs are based on a coinsurance percentage rather than a flat copay. Tier 3 preferred brand drugs require a 19% coinsurance, while Tier 4 non-preferred drugs carry a 25% coinsurance. Specialty drugs in Tier 5 have a 28% coinsurance for a one-month supply at standard pharmacies and mail order.
Additional Benefits
The DEVOTED CORE 009 MO (HMO) plan offers robust coverage for essential medical services, featuring no copays for primary care visits, home health care, and preventive services. For specialist visits, patients will pay a $30 copay, while inpatient hospital stays require a $275 daily copay for the first six days followed by no copay for days seven through 90. Outpatient hospital services range from no copay up to a $375 copay, and emergency room visits require a $150 copay. This plan also provides valuable supplemental benefits, including up to $3,000 annually for dental care with no copays on preventive services, and a $300 annual allowance for eyewear with no copay. Routine hearing exams carry a $30 copay, while covered prescription hearing aids require a copay between $399 and $699. Additionally, members benefit from a $100 quarterly over-the-counter allowance and no copays for the first 20 days of skilled nursing facility stays.
Inpatient Hospital See details
DEVOTED CORE 009 MO (HMO) inpatient hospital benefits are partially covered with no coinsurance, requiring a $275 daily copay for days 1 through 6 and no copay for days 7 through 90. Prior authorization is required, and while unlimited additional acute days are covered, upgrades, psychiatric additional days, and non-Medicare-covered stays are not covered.
Outpatient Services See details
DEVOTED CORE 009 MO (HMO) covers outpatient services with no coinsurance, featuring a $0 to $375 copay for outpatient hospital services and a $275 copay per stay for observation services. Ambulatory surgical center and outpatient blood services require no copay and no coinsurance, while outpatient substance abuse sessions carry a $30 copay.
Partial Hospitalization See details
Partial hospitalization is covered under the DEVOTED CORE 009 MO (HMO) plan with a $60 copay and no coinsurance, though prior authorization is required.
Ambulance and Transportation Services See details
DEVOTED CORE 009 MO (HMO) covers ambulance services with prior authorization, featuring a copay ranging from no copay to $315 for ground services and a 20% coinsurance for air services. Routine transportation services to health-related locations are not covered by this plan.
Emergency Services See details
DEVOTED CORE 009 MO (HMO) covers emergency services with a $150 copay and no coinsurance, which is waived if admitted within 24 hours, and urgently needed services with no copay up to a $45 copay and no coinsurance. Worldwide emergency and urgent care are also covered up to a $25,000 limit with a $150 copay and no coinsurance, while worldwide emergency transportation requires a $315 copay and 20% coinsurance.
Primary Care See details
DEVOTED CORE 009 MO (HMO) provides primary care physician services with no copay and no coinsurance, and specialist visits for a $30 copay and no coinsurance. Other covered benefits like physical, occupational, and mental health therapies require copays ranging from $30 to $50 with no coinsurance, while podiatry and chiropractic services are not covered.
Preventive Services See details
DEVOTED CORE 009 MO (HMO) preventive services are partially covered with no copay and no coinsurance for covered benefits like annual physical exams, fitness programs, and kidney disease education. However, sub-services including in-home safety assessments, PERS, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, wigs, therapeutic massage, adult day health, home-based palliative care, in-home support, caregiver support, additional smoking cessation, enhanced disease management, telemonitoring, remote access, and counseling are not covered.
Hearing Services See details
Hearing services are partially covered by DEVOTED CORE 009 MO (HMO), offering routine hearing exams for a $30 copay and no coinsurance, with no deductible. Covered prescription hearing aids require a copay of $399 to $699 and no coinsurance, while OTC hearing aids and 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 CORE 009 MO (HMO), offering one routine eye exam per year with a $0 to $30 copay and no coinsurance, while other eye exam services are not covered. Eyewear is covered with no copay, no coinsurance, and a $300 annual maximum allowance for contacts, eyeglasses, frames, and upgrades.
Dental Services See details
DEVOTED CORE 009 MO (HMO) offers partially covered dental services with a $3,000 yearly maximum, featuring no copay and no coinsurance for preventive care, diagnostic services, periodontics, and oral surgery. Medicare-covered dental has a $30 copay and no coinsurance, while restorative, endodontic, and prosthodontic services have no copay and 0% to 50% coinsurance; however, implants, orthodontics, and maxillofacial prosthetics are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by DEVOTED CORE 009 MO (HMO) with no copay, though prior authorization is required. Medicare Part B chemotherapy, radiation, and other drugs have no copay and a coinsurance ranging from no coinsurance to 20%, while Part B insulin has a $35 copay and a coinsurance ranging from no coinsurance to 20%.
Dialysis Services See details
Dialysis Services are covered by the DEVOTED CORE 009 MO (HMO) plan with no copay and a 20% coinsurance. Prior authorization is required for these services.
Medical Equipment See details
DEVOTED CORE 009 MO (HMO) partially covers medical equipment with no copays, though prior authorization is required for these services. Durable medical equipment requires 20% to 50% coinsurance, diabetic supplies require no coinsurance to 50% coinsurance, and prosthetics and medical supplies require no coinsurance to 20% coinsurance, while diabetic therapeutic shoes and inserts are not covered.
Diagnostic and Radiological Services See details
DEVOTED CORE 009 MO (HMO) covers diagnostic and radiological services with prior authorization required. There is no copay for lab services and outpatient X-rays, a copay of $0 to $95 for diagnostic procedures and tests, and a 20% coinsurance for therapeutic radiological services.
Home Health Services See details
Home Health Services are covered by DEVOTED CORE 009 MO (HMO) with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
DEVOTED CORE 009 MO (HMO) provides some covered cardiac rehabilitation services with no coinsurance and a $30 copay, though standard cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered. Prior authorization is required for covered services.
Skilled Nursing Facility (SNF) See details
DEVOTED CORE 009 MO (HMO) covers Skilled Nursing Facility (SNF) services 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, and while a 3-day prior hospital stay is not required, additional days beyond the standard 100 days are not covered.
Other Services See details
DEVOTED CORE 009 MO (HMO) partially covers other services, offering over-the-counter (OTC) items and additional preventive services with no copay and no coinsurance. While the OTC benefit provides up to $100 every three months, other services such as acupuncture and meal benefits are not covered.
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