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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 Central 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 $590.00 deductible for prescription drugs. After the deductible is met, you'll pay a copay or coinsurance depending on the drug tier and pharmacy. For example, in the initial coverage phase, you'll pay a $5.00 copay for preferred generic drugs at a standard or mail-order pharmacy. Standard generic, preferred brand, and non-preferred drugs have a 25% coinsurance. Once your total drug costs reach $2,000.00, you enter the catastrophic coverage phase, where you pay nothing for covered drugs.
Additional Benefits
The Devoted CORE Ohio (HMO) plan offers a range of benefits with varying cost-sharing. Inpatient hospital stays have a copay, while outpatient services have copays that vary depending on the service. The plan also includes coverage for ambulance, emergency, and vision services, with copays and coinsurance applying to certain services. This plan provides coverage for primary care, preventive services, hearing, and dental services. Hearing exams have a copay, and prescription hearing aids are covered with a copay. Dental services include a $35 copay for Medicare dental services and a $1,000 annual maximum for dental services.
Inpatient Hospital See details
Inpatient Hospital benefits, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, are covered, but require prior authorization. For days 1-6, there is a $350 copay, and for days 7-90 there is no copay. Additional days for Inpatient Hospital-Acute are covered, but non-Medicare covered stays and upgrades for Inpatient Hospital-Acute and additional days and non-Medicare-covered stays for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services, observation services, ambulatory surgical center (ASC) services, outpatient substance abuse services, and outpatient blood services. Outpatient hospital services have a copay between $0 and $450, observation services have a $350 copay, and ASC services have no copay. Individual and group sessions for outpatient substance abuse have a copay of $35, and outpatient blood services have a waived three-pint deductible.
Partial Hospitalization See details
Partial Hospitalization is covered with a $70 copay. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, with prior authorization required for all ambulance services. Ground ambulance services have a copay ranging from $0 to $280, 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. Emergency Services has a $125 copay, Urgently Needed Services has a copay between $0 and $45, and Worldwide Emergency Transportation has a $280 copay and 20% coinsurance, while Worldwide Emergency Coverage and Worldwide Urgent Coverage have a $125 copay.
Primary Care See details
The Devoted CORE Ohio (HMO) plan covers primary care physician services, chiropractic services, occupational therapy, physician specialist services, mental health specialty services, other health care professionals, psychiatric services, physical therapy and speech-language pathology services, additional telehealth benefits, and opioid treatment program services. Chiropractic services have a $20 copay, while individual and group mental health and psychiatric sessions have a $35 copay; other services have varying copays. Routine chiropractic care and podiatry services are not covered.
Preventive Services See details
The Devoted CORE Ohio (HMO) plan covers preventive services, including Medicare-covered services, annual physical exams, and additional preventive services. Additional preventive services include health education, personal emergency response systems, weight management programs, alternative therapies, nutritional/dietary benefits, fitness benefits, 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 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 exams are covered by the Devoted CORE Ohio (HMO) plan with a $20 copay, and routine hearing exams are limited to one visit per year. Prescription hearing aids are covered with a copay between $399 and $699 for all types, but inner ear, outer ear, and over-the-ear prescription hearing aids are not covered.
Vision Services See details
The Devoted CORE Ohio (HMO) plan covers vision services, including eye exams with a $20 copay, and eyewear with a combined maximum benefit of $1000 per year. Contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades are also covered.
Dental Services See details
The Devoted CORE Ohio (HMO) plan covers Medicare Dental Services with a $35 copay, and covers 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. Orthodontic services are covered under Diagnostic and Preventive Dental, and there is a $1,000 annual maximum for dental services. Maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by the Devoted CORE Ohio (HMO) plan, and require prior authorization. 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 a 0-20% coinsurance.
Dialysis Services See details
Dialysis Services are covered by the Devoted CORE Ohio (HMO) plan, with a coinsurance between 20% and 20%.
Medical Equipment See details
Medical Equipment coverage includes Durable Medical Equipment (DME) with a coinsurance between 0% and 35%, and Prosthetics/Medical Supplies with no copay and coinsurance for Medicare-covered items. Diabetic Equipment is covered, though 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, diagnostic procedures/tests, and lab services, with a copay of up to $95 for diagnostic procedures/tests and no copay for lab services. Radiological services are also covered, with copays for diagnostic and therapeutic radiological services, as well as a coinsurance of at least 20% for therapeutic radiological services. 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. 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. For days 1-20, there is no copay, but for days 21-100, the copay is $214.00 per day; additional days beyond Medicare-covered SNF stays and non-Medicare-covered SNF stays are not covered.
Other Services See details
Other Services are not covered by the Devoted CORE Ohio (HMO) plan, 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, 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. However, Other 2 benefits are covered, including $0 preventive services.
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