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Devoted CORE Ohio (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Devoted CORE Ohio (HMO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Devoted CORE Ohio (HMO) in 2025, please refer to our full plan details page.
Devoted CORE Ohio (HMO) is a HMO plan offered by Devoted Health, Inc. available for enrollment in 2025 to people living in Northern Ohio. This plan received an overall rating of 4.5 out of 5 stars in 2025.
It's important to know that Devoted CORE Ohio (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 Ohio (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 Ohio (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 $4900.00 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 Ohio (HMO) plan has a $590 deductible for prescription drugs. During the initial coverage phase, after you meet your deductible, you will pay a copay or coinsurance depending on the drug tier and pharmacy. For preferred generics, you will pay a $5 copay at standard or mail order pharmacies. For standard generics, preferred brands, and non-preferred drugs, you will pay 25% coinsurance. Once your total drug costs reach $2000, you enter the catastrophic coverage phase and pay nothing for covered drugs.
Additional Benefits
The Devoted CORE Ohio (HMO) plan offers a range of benefits, including coverage for inpatient and outpatient services, with varying copays depending on the specific service. Emergency, hearing, vision, and dental services are also covered, with copays for exams and other services. The plan also includes coverage for home health, medical equipment, and diagnostic services. This plan includes a $325 copay for inpatient hospital stays for the first six days, and no copay for days 7-90. Prescription hearing aids are covered with a copay between $0 and $299. Vision services include eye exams with a $35 copay, and dental services include oral exams for a $35 copay.
Inpatient Hospital See details
Inpatient Hospital services, including acute and psychiatric care, are covered. For the first 6 days, there is a $325 copay, and then no copay for days 7-90.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services with a copay between $0 and $425, observation services with a $325 copay, and ambulatory surgical center services with no copay. Outpatient substance abuse individual and group sessions have a copay of $35, and outpatient blood services are covered.
Partial Hospitalization See details
Partial Hospitalization is covered by the Devoted CORE Ohio (HMO) plan with a $55 copay, and prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered. Ground ambulance services have a copay of $0 - $300, while air ambulance services have a 20% coinsurance. Transportation services to health-related locations are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by the Devoted CORE Ohio (HMO) plan. Emergency Services have a $125 copay, while Urgently Needed Services have a copay between $0 and $45; Worldwide Emergency Coverage and Worldwide Urgent Coverage have a $125 copay, and Worldwide Emergency Transportation has a $300 copay and 20% coinsurance.
Primary Care See details
Primary Care Physician Services, Chiropractic 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 under the Devoted CORE Ohio (HMO) plan. Chiropractic Services has a $20 copay. Occupational Therapy Services, Individual and Group Sessions for Mental Health Specialty Services, Individual and Group Sessions for Psychiatric Services, and Opioid Treatment Program Services have a copay between $35 and $45. Physician Specialist Services and Additional Telehealth Benefits have a copay between $0 and $35. Physical Therapy and Speech-Language Pathology Services have a copay between $35 and $50. Routine Chiropractic Care and Podiatry Services are not covered.
Preventive Services See details
The Devoted CORE Ohio (HMO) plan covers preventive services, including annual physical exams, with no copay. Additional preventive services include Health Education, Personal Emergency Response System (PERS), 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. However, In-Home Safety Assessment, 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, and Counseling Services are not covered.
Hearing Services See details
Hearing Services include routine hearing exams with a $35 copay, and fitting/evaluation for hearing aids. Prescription hearing aids (all types) are covered with a copay between $0 and $299, while inner ear, outer ear, and over the ear prescription hearing aids are not covered. OTC hearing aids are not covered.
Vision Services See details
Vision services include eye exams with a $35 copay, as well as coverage for eyewear. Eyewear includes contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames and upgrades. There is a combined maximum benefit of $1000 for all eyewear every year.
Dental Services See details
Dental Services include coverage for oral exams with a $35 copay, 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. Orthodontic Services are covered under Diagnostic and Preventive Dental (16b). Maxillofacial prosthetics, implant services, and orthodontics are not covered. There is a $1000 maximum plan benefit coverage amount every year.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, with prior authorization required. For Medicare Part B Insulin Drugs, there is a $35 copay and 20% coinsurance. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, there is between 0% and 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered by the Devoted CORE Ohio (HMO) plan. You will pay a coinsurance of 20% for these services.
Medical Equipment See details
Medical Equipment benefits are covered under the Devoted CORE Ohio (HMO) plan. Durable Medical Equipment (DME) has a coinsurance between 0% and 50%, and Prosthetic Devices have a coinsurance between 0% and 20%, while Medical Supplies have a 20% coinsurance; there is no copay for these services. 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, including all diagnostic services, diagnostic procedures/tests, lab services, all radiological services, diagnostic radiological services, therapeutic radiological services, and outpatient X-ray services. Diagnostic procedures/tests have a copay between $0 and $100, while lab services have no copay. Diagnostic radiological services have a copay of up to $200, and therapeutic radiological services have a coinsurance of at least 20%. Outpatient X-ray services have no copay.
Home Health Services See details
Home Health Services are covered by the Devoted CORE Ohio (HMO) plan with no copay and no coinsurance, but prior authorization is required. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the Devoted CORE Ohio (HMO) plan. Specifically, Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, and Additional Cardiac Rehabilitation Services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Devoted CORE Ohio (HMO) plan, but require prior authorization. There is no copay for days 1-20, and a $214 copay for days 21-100; days beyond Medicare-covered and non-Medicare-covered stays are not covered.
Other Services See details
The Devoted CORE Ohio (HMO) plan does not cover 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, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, and Self-Directed Personal Assistance Services. Other Services and Other 2 include preventive services with no copay.
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