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DEVOTED DUAL CHOICE FULL 003 OK (PPO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for DEVOTED DUAL CHOICE FULL 003 OK (PPO D-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on DEVOTED DUAL CHOICE FULL 003 OK (PPO D-SNP) in 2026, please refer to our full plan details page.
DEVOTED DUAL CHOICE FULL 003 OK (PPO D-SNP) is a PPO D-SNP plan offered by Devoted Health, Inc. available for enrollment in 2026 to people living in Oklahoma. The overall rating for this plan is not yet available for 2026.
It's important to know that DEVOTED DUAL CHOICE FULL 003 OK (PPO D-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
DEVOTED DUAL CHOICE FULL 003 OK (PPO D-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 DUAL CHOICE FULL 003 OK (PPO D-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 DUAL CHOICE FULL 003 OK (PPO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $28.20. 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 has a $990.00 health deductible. This means, every calendar year, you pay this amount towards covered services before your insurance coverage kicks in.
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 combined Maximum Out-Of-Pocket cost of $13900.00 (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 $13900.00 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 DUAL CHOICE FULL 003 OK (PPO D-SNP) Medicare plan features an annual drug deductible of $615. For prescription drugs filled at standard pharmacies or through standard mail order, you will pay a 25% coinsurance for Tier 1 preferred generics, Tier 2 generics, Tier 3 preferred brands, Tier 4 non-preferred drugs, and 1-month supplies of Tier 5 specialty drugs. This clear cost-sharing structure helps you easily plan for your medication expenses throughout the year. For Tier 6 select care drugs, the plan offers no copay for 1-month, 2-month, and 3-month supplies at standard pharmacies and standard mail order. This coverage structure ensures affordable access to essential maintenance medications under this Dual Special Needs Plan.
Additional Benefits
The DEVOTED DUAL CHOICE FULL 003 OK (PPO D-SNP) offers comprehensive coverage for essential medical services, featuring no copays and no coinsurance for primary care doctor visits and annual preventive exams. For hospital care, inpatient acute stays require a $2,230 copay per stay, while outpatient services feature no copays with coinsurance ranging up to 50%. Emergency room visits are covered with a $115 copay, which is waived if you are admitted to the hospital within 24 hours. This plan also includes supplemental benefits such as preventive and comprehensive dental care with no copay up to a $3,000 annual limit, alongside a $400 yearly eyewear allowance with no copay. Routine hearing exams and prescription hearing aids are covered with varying cost-sharing, and members receive a $50 quarterly allowance for over-the-counter items. Additionally, home health services are covered with no copay and no coinsurance, though cardiac rehabilitation and medical transportation are not covered.
Inpatient Hospital See details
DEVOTED DUAL CHOICE FULL 003 OK (PPO D-SNP) covers inpatient hospital services, though upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered. Covered acute stays require a $2,230 copay per stay and no coinsurance, while covered psychiatric stays require a $2,080 copay per stay and no coinsurance, with prior authorization required for both.
Outpatient Services See details
DEVOTED DUAL CHOICE FULL 003 OK (PPO D-SNP) covers outpatient services with no copays, though prior authorization is required for most treatments. Covered outpatient hospital and ambulatory surgical center services range from no coinsurance to 50% coinsurance (50% for observation), while outpatient substance abuse and outpatient blood services require 30% coinsurance.
Partial Hospitalization See details
DEVOTED DUAL CHOICE FULL 003 OK (PPO D-SNP) covers partial hospitalization services with no copay and a 30% coinsurance. Prior authorization is required to receive this benefit.
Ambulance and Transportation Services See details
DEVOTED DUAL CHOICE FULL 003 OK (PPO D-SNP) covers ambulance services with no copay, requiring no coinsurance to 50% coinsurance for ground ambulance and 50% coinsurance for air ambulance. Under the transportation benefit, some services are covered, but transportation to plan-approved health-related locations and any health-related locations is not covered.
Emergency Services See details
DEVOTED DUAL CHOICE FULL 003 OK (PPO D-SNP) covers emergency services with a $115 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services are covered with no copay and a 0% to 30% coinsurance up to a $40 maximum, while worldwide emergency, urgent, and transportation services are covered up to a $25,000 limit with no copay and no coinsurance.
Primary Care See details
DEVOTED DUAL CHOICE FULL 003 OK (PPO D-SNP) offers primary care physician services with no copay and no coinsurance, while covered specialist visits, physical therapy, telehealth, and mental health services require no copay and up to 30% coinsurance. Podiatry and chiropractic services are not covered under this plan.
Preventive Services See details
Preventive services are covered by DEVOTED DUAL CHOICE FULL 003 OK (PPO D-SNP) with no copay and no coinsurance for annual physical exams, kidney disease education, and other screenings. Additional preventive services are partially covered with no copay and no coinsurance, excluding in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, wigs for chemotherapy-related hair loss, therapeutic massage, adult day health, home-based palliative care, in-home support, caregiver support, additional smoking cessation counseling, enhanced disease management, telemonitoring, remote access technologies, and counseling services.
Hearing Services See details
DEVOTED DUAL CHOICE FULL 003 OK (PPO D-SNP) covers hearing exams with no copay and 50% coinsurance for routine exams, alongside unlimited fitting evaluations. Prescription hearing aids are partially covered with no coinsurance and a copay of $399 to $699 for up to two aids per year, though inner ear, outer ear, over the ear, and OTC hearing aids are not covered.
Vision Services See details
DEVOTED DUAL CHOICE FULL 003 OK (PPO D-SNP) offers partially covered vision services, which include one routine eye exam per year with no copay and 0% to 50% coinsurance, though other eye exam services are not covered. Eyewear is covered with no copay and no coinsurance, providing up to a $400 combined annual maximum for contacts, eyeglasses, frames, lenses, and upgrades.
Dental Services See details
DEVOTED DUAL CHOICE FULL 003 OK (PPO D-SNP) partially covers dental services, offering Medicare-covered dental with no copay and 30% coinsurance, and other covered preventive and comprehensive services with no copay, no coinsurance, and a $3,000 annual limit. Services not covered under this plan include other diagnostic services, other preventive services, maxillofacial prosthetics, implant services, and orthodontics.
Home Infusion bundled Services See details
Home infusion bundled services are covered by DEVOTED DUAL CHOICE FULL 003 OK (PPO D-SNP) with no copay, though prior authorization is required. Medicare Part B chemotherapy, radiation, and other drugs carry no coinsurance to 20% coinsurance, while Medicare Part B insulin requires a $35 copay and no coinsurance to 20% coinsurance that counts toward the deductible.
Dialysis Services See details
Dialysis Services are covered under the DEVOTED DUAL CHOICE FULL 003 OK (PPO D-SNP) plan with no copay and a 20% coinsurance. Prior authorization is required for these services.
Medical Equipment See details
DEVOTED DUAL CHOICE FULL 003 OK (PPO D-SNP) covers medical equipment, prosthetics, and diabetic supplies with no copays, though prior authorization is required. Durable medical equipment and diabetic supplies carry a 20% coinsurance, while coinsurance for prosthetics and medical supplies ranges from 0% to 20%.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by DEVOTED DUAL CHOICE FULL 003 OK (PPO D-SNP) with no copays, though prior authorization is required. Diagnostic procedures and tests have no coinsurance, while lab services require a 50% coinsurance, therapeutic radiological services require a 20% coinsurance, and both diagnostic radiological and outpatient X-ray services require a 30% coinsurance.
Home Health Services See details
Home health services are covered under the DEVOTED DUAL CHOICE FULL 003 OK (PPO D-SNP) plan with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
DEVOTED DUAL CHOICE FULL 003 OK (PPO D-SNP) does not cover Cardiac Rehabilitation Services, as none of the individual sub-services are covered by the plan. This includes cardiac, pulmonary, and supervised exercise therapy (SET) for peripheral artery disease (PAD) services, which are all excluded from coverage.
Skilled Nursing Facility (SNF) See details
DEVOTED DUAL CHOICE FULL 003 OK (PPO D-SNP) covers Skilled Nursing Facility (SNF) services 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 3-day inpatient hospital stay is not required prior to admission, and additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Other services are partially covered by DEVOTED DUAL CHOICE FULL 003 OK (PPO D-SNP), offering over-the-counter (OTC) items with a $50 quarterly limit and additional preventive services with no copay and no coinsurance. Acupuncture, meal benefits, and highly integrated services for dual-eligible SNPs are not covered.
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