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DEVOTED C-SNP PREMIUM 018 OH (HMO C-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for DEVOTED C-SNP PREMIUM 018 OH (HMO C-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on DEVOTED C-SNP PREMIUM 018 OH (HMO C-SNP) in 2026, please refer to our full plan details page.
DEVOTED C-SNP PREMIUM 018 OH (HMO C-SNP) is a HMO C-SNP plan offered by Devoted Health, Inc. available for enrollment in 2026 to people living in Western Ohio. This plan received an overall rating of 4 out of 5 stars in 2026.
It's important to know that DEVOTED C-SNP PREMIUM 018 OH (HMO C-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
DEVOTED C-SNP PREMIUM 018 OH (HMO C-SNP)is a Special Needs Type (SNP) plan. This means you can only enroll in this plan if you meet specific criteria. See our full plan details page for more information.
Key Plan Facts
Below are a few key facts and commonly-asked questions about DEVOTED C-SNP PREMIUM 018 OH (HMO C-SNP).
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 C-SNP PREMIUM 018 OH (HMO C-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $31.40. 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 $615.00 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 $5200.00 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 C-SNP PREMIUM 018 OH (HMO C-SNP) plan features an annual drug deductible of $615. Under this plan, Tier 6 select care drugs are available with no copay for one-month, two-month, or three-month supplies through standard pharmacies and standard mail order. Tier 1 preferred generic drugs require an $18 copay for a one-month supply, while Tier 2 generic drugs carry a $20 copay for a one-month supply. For brand-name and specialty medications, cost-sharing is based on coinsurance through standard pharmacies and mail order. Tier 3 preferred brand drugs require a 23% coinsurance, and Tier 4 non-preferred drugs carry a 26% coinsurance. Tier 5 specialty medications require a 25% coinsurance for a one-month supply.
Additional Benefits
The DEVOTED C-SNP PREMIUM 018 OH (HMO C-SNP) plan offers robust coverage with no copay and no coinsurance for primary care visits, preventive services, and home health care. For specialized medical needs, the plan features predictable costs, such as a $475 daily copay for the first few days of inpatient hospital stays and a $130 copay for emergency room visits. Outpatient services and specialist visits are also highly accessible, with copays ranging from no copay up to $575 depending on the specific service. This plan also includes valuable supplemental benefits, featuring no copay for routine eyewear up to a $300 annual limit and no copay for preventive dental care up to a $2,000 yearly maximum. Hearing services are covered with a $40 copay for routine exams and fixed copays for prescription hearing aids, all with no coinsurance. Additionally, members benefit from no copays on medical equipment, though durable medical equipment carries a 20% to 50% coinsurance.
Inpatient Hospital See details
DEVOTED C-SNP PREMIUM 018 OH (HMO C-SNP) covers inpatient hospital services with no coinsurance, though upgrades and non-Medicare-covered stays are not covered. Acute stays require a $475 daily copay for days 1-5 and no copay for days 6 and beyond, while psychiatric stays require a $475 daily copay for days 1-4 and no copay for days 5-90.
Outpatient Services See details
DEVOTED C-SNP PREMIUM 018 OH (HMO C-SNP) outpatient services are covered with no coinsurance, featuring no copay for ambulatory surgical center and blood services. Outpatient hospital services require a copay of $0 to $575, observation services have a $475 copay per stay, and outpatient substance abuse sessions carry a $40 copay.
Partial Hospitalization See details
DEVOTED C-SNP PREMIUM 018 OH (HMO C-SNP) covers partial hospitalization services with a $70.00 copay and no coinsurance. Prior authorization is required to receive this benefit.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered under DEVOTED C-SNP PREMIUM 018 OH (HMO C-SNP), with ground ambulance services requiring no copay to a $315 copay and no coinsurance, and air ambulance services requiring a 20% coinsurance and no copay. Although some transportation services are covered, plan-approved and health-related transportation services are not covered in practice.
Emergency Services See details
DEVOTED C-SNP PREMIUM 018 OH (HMO C-SNP) covers emergency services with a $130 copay and no coinsurance, which is waived if admitted to the hospital within 24 hours, and urgently needed services with no copay to a $45 copay and no coinsurance. Worldwide emergency services are covered up to a $25,000 limit, with a $130 copay and no coinsurance for emergency and urgent care, and a $315 copay with 20% coinsurance for emergency transportation.
Primary Care See details
DEVOTED C-SNP PREMIUM 018 OH (HMO C-SNP) offers primary care physician services with no copay and no coinsurance, while other covered services like specialists, therapy, and telehealth require copays ranging from $0 to $50 with no coinsurance. For chiropractic services, some services are covered but routine chiropractic care and other chiropractic services are not covered.
Preventive Services See details
Preventive services are partially covered by DEVOTED C-SNP PREMIUM 018 OH (HMO C-SNP) with no copay and no coinsurance for covered services such as annual physicals, fitness benefits, and nutritional therapy. Sub-services that are not covered under this plan include in-home safety assessments, personal emergency response systems (PERS), post-discharge medication reconciliation, re-admission prevention, chemotherapy 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.
Hearing Services See details
Hearing services are partially covered by DEVOTED C-SNP PREMIUM 018 OH (HMO C-SNP), offering routine hearing exams for a $40 copay and no coinsurance, and up to two prescription hearing aids per year with a $399 to $699 copay and no coinsurance. Over-the-counter (OTC) hearing aids, along with inner ear, outer ear, and over the ear prescription hearing aids, are not covered.
Vision Services See details
Vision services are covered by DEVOTED C-SNP PREMIUM 018 OH (HMO C-SNP), offering one routine eye exam per year with a $0 to $40 copay and no coinsurance, though other eye exam services are not covered. Eyewear, including contacts, lenses, frames, and upgrades, is covered with no copay, no coinsurance, and no deductible up to a $300 annual maximum.
Dental Services See details
DEVOTED C-SNP PREMIUM 018 OH (HMO C-SNP) offers partially covered dental services with a $40 copay and no coinsurance for Medicare-covered dental, and no copay or coinsurance for other covered services up to a $2,000 annual maximum. Sub-services such as other diagnostic and preventive dental, maxillofacial prosthetics, implants, and orthodontics are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by DEVOTED C-SNP PREMIUM 018 OH (HMO C-SNP) with no copay and no coinsurance, though prior authorization is required. Associated Medicare Part B chemotherapy, radiation, and other Part B drugs feature no copay and coinsurance ranging from no coinsurance to 20%. Covered Part B insulin drugs require a $35 copay and coinsurance ranging from no coinsurance to 20%.
Dialysis Services See details
DEVOTED C-SNP PREMIUM 018 OH (HMO C-SNP) covers Dialysis Services with no copay and a 20% coinsurance. Prior authorization is required for these services.
Medical Equipment See details
DEVOTED C-SNP PREMIUM 018 OH (HMO C-SNP) covers medical equipment with no copays, though prior authorization is required. Durable medical equipment requires 20% to 50% coinsurance, prosthetics and medical supplies range from no coinsurance to 20% coinsurance, and diabetic equipment is partially covered with diabetic supplies ranging from no coinsurance to 50% coinsurance while diabetic therapeutic shoes and inserts are not covered.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by DEVOTED C-SNP PREMIUM 018 OH (HMO C-SNP), with prior authorization required. Lab services and diagnostic radiological services feature no copay and no coinsurance, while diagnostic tests range from a $0 to $95 copay with no coinsurance, outpatient X-rays have no copay but require coinsurance, and therapeutic services have a 20% coinsurance.
Home Health Services See details
DEVOTED C-SNP PREMIUM 018 OH (HMO C-SNP) covers home health services with no copay and no coinsurance. Prior authorization is required to receive these services.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by DEVOTED C-SNP PREMIUM 018 OH (HMO C-SNP) with no coinsurance, though prior authorization is required. While some services are covered, cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled nursing facility (SNF) services are covered by DEVOTED C-SNP PREMIUM 018 OH (HMO C-SNP) with no coinsurance, featuring no copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required, a prior three-day hospital stay is not required, and additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Other services are partially covered by DEVOTED C-SNP PREMIUM 018 OH (HMO C-SNP), offering no copay and no coinsurance for over-the-counter items (up to $50 every three months), diabetic shoes, and additional preventive services. Acupuncture and meal benefits are not covered under this plan.
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