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Devoted CHOICE Ohio (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Devoted CHOICE Ohio (PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Devoted CHOICE Ohio (PPO) in 2025, please refer to our full plan details page.
Devoted CHOICE Ohio (PPO) is a PPO plan offered by Devoted Health, Inc. available for enrollment in 2025 to people living in Ohio. This plan received an overall rating of 4.5 out of 5 stars in 2025.
It's important to know that Devoted CHOICE Ohio (PPO) 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 CHOICE Ohio (PPO).
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 CHOICE Ohio (PPO), 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 combined Maximum Out-Of-Pocket cost of $5300.00 (in-network or out-of-network combined). You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $5300.00 for covered services, the plan will pay 100% of covered costs for the rest of the year.
The plan may have separate out-pocket-maximums for in-network and out-of-network services. See our full plan details page for more information.
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 CHOICE Ohio (PPO) plan has an "Enhanced Alternative" drug benefit. The plan has a deductible of $590.00. After you meet the deductible, you will pay a copay or coinsurance for your prescriptions. For preferred generic drugs, you will pay a $5.00 copay at a standard or mail-order pharmacy. For standard generic, preferred brand, and non-preferred drugs, you will pay 25% coinsurance. After your total yearly drug costs reach $2000.00, you will enter the catastrophic coverage phase where you pay nothing for covered drugs.
Additional Benefits
The Devoted CHOICE Ohio (PPO) plan offers a wide range of benefits with varying cost-sharing. Inpatient hospital stays have a copay, with no copay after the first five days. Outpatient services have copays that vary by service, and some services, like ambulance and specialist visits, require prior authorization. The plan covers preventive, hearing, vision, and dental services, each with its own cost structure, including copays and coinsurance. Additionally, the plan covers home health services with no copay, and offers benefits for medical equipment and diagnostic services.
Inpatient Hospital See details
Inpatient Hospital benefits, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, are covered. For Inpatient Hospital-Acute, you will pay a $380 copay for days 1-5, and no copay for days 6-90; for Inpatient Hospital Psychiatric, you will pay a $380 copay for days 1-5, and no copay for days 6-90. Additional days for Inpatient Hospital-Acute are covered, while Non-Medicare-covered stays and Upgrades for Inpatient Hospital-Acute are not covered. Additional days and Non-Medicare-covered stays for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services, including all outpatient hospital services and outpatient substance abuse services, are covered. Outpatient Hospital Services have a copay of $0-$480, Observation Services have a copay of $380, Ambulatory Surgical Center (ASC) Services have no copay, and both individual and group outpatient substance abuse sessions have a copay of $40.00. Outpatient Blood Services are also covered.
Partial Hospitalization See details
Partial Hospitalization is covered by the Devoted CHOICE Ohio (PPO) plan, with a $70 copay. Prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Devoted CHOICE Ohio (PPO) plan, with prior authorization required for all ambulance services. Ground ambulance services have a copay between $0 and $290, and air ambulance services have a 20% coinsurance; however, transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, including Urgently Needed Services, are covered by the Devoted CHOICE Ohio (PPO) plan. Emergency Services have a $125 copay, while Urgently Needed Services have a copay between $0-$45. Worldwide Emergency Coverage and Worldwide Urgent Coverage have a $125 copay, and Worldwide Emergency Transportation has a $290 copay and 20% coinsurance.
Primary Care See details
Primary Care Physician Services, Occupational Therapy Services, Physician Specialist Services, Mental Health Specialty Services, Other Health Care Professional, Psychiatric Services, Physical Therapy and Speech-Language Pathology Services, Additional Telehealth Benefits, and Opioid Treatment Program Services are covered. Chiropractic Services have a $20 copay for routine care, and Occupational Therapy Services have a copay between $40 and $45. Physician Specialist Services and Additional Telehealth Benefits have a copay between $0 and $40. Mental Health and Psychiatric Services, including individual and group sessions, and Opioid Treatment Program Services have a $40 copay. Physical Therapy and Speech-Language Pathology Services have a copay between $40 and $50. Routine Chiropractic Care is not covered, and Podiatry Services are not covered.
Preventive Services See details
Preventive services, including Medicare-covered services and annual physical exams, are covered by the Devoted CHOICE Ohio (PPO) plan. Additional preventive services are covered, but in-home safety assessments, medical nutrition therapy, 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, and counseling services are not covered.
Hearing Services See details
Hearing Services include routine hearing exams with a $35 copay, fitting/evaluation for hearing aids, and prescription hearing aids, with a copay between $0 and $299 for all types. Prescription hearing aids for the inner ear, outer ear, and over the ear are not covered, nor are OTC hearing aids.
Vision Services See details
The Devoted CHOICE Ohio (PPO) plan covers vision services, including eye exams with a $35 copay, and eyewear with a combined maximum benefit of $1000 every year for both in-network and out-of-network services. Contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades are also covered.
Dental Services See details
The Devoted CHOICE Ohio (PPO) plan covers Medicare Dental Services with a $40 copay, as well as other dental services, up to a maximum of $1000 per year. The plan covers 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. However, Maxillofacial Prosthetics, Implant Services, and Orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs, Medicare Part B Chemotherapy/Radiation Drugs, and Other Medicare Part B Drugs, but prior authorization is required. For Medicare Part B Insulin Drugs, you will pay a $35 copay and 20% coinsurance. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, you may pay between 0% and 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered under the Devoted CHOICE Ohio (PPO) plan. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment is covered, including 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. 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 are covered. Diagnostic Procedures/Tests have a minimum copay of $0 and a maximum copay of $95, while Lab Services have no copay. Diagnostic Radiological Services have a maximum copay of $300, and Therapeutic Radiological Services have a minimum coinsurance of 20%. Outpatient X-Ray Services have no copay.
Home Health Services See details
Home Health Services are covered by the Devoted CHOICE Ohio (PPO) plan with no copay and no coinsurance. Additional hours of care and personal care services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by the Devoted CHOICE Ohio (PPO) plan, but none of the sub-services are covered. There is a copay for some Cardiac and Pulmonary Rehabilitation Services, but the specific amount is not listed.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Devoted CHOICE Ohio (PPO) 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, including acupuncture, over-the-counter items, and meal benefits, are not covered. Other services such as Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, private duty nursing services, and case management are also not covered.
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