Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for DEVOTED C-SNP CHOICE PLUS 008 OK (PPO 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 CHOICE PLUS 008 OK (PPO C-SNP) in 2026, please refer to our full plan details page.
DEVOTED C-SNP CHOICE PLUS 008 OK (PPO C-SNP) is a PPO C-SNP plan offered by Devoted Health, Inc. available for enrollment in 2026 to people living in Tulsa. The overall rating for this plan is not yet available for 2026.
It's important to know that DEVOTED C-SNP CHOICE PLUS 008 OK (PPO 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 CHOICE PLUS 008 OK (PPO 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.
Below are a few key facts and commonly-asked questions about DEVOTED C-SNP CHOICE PLUS 008 OK (PPO C-SNP).
The cost of a Medicare Advantage Plan is made up of four main parts.
For DEVOTED C-SNP CHOICE PLUS 008 OK (PPO C-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.
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
The DEVOTED C-SNP CHOICE PLUS 008 OK (PPO C-SNP) plan features an annual drug deductible of $615. For prescription coverage, Tier 6 Select Care Drugs are highly affordable with no copay for 1-month, 2-month, or 3-month supplies at standard pharmacies and standard mail order. Tier 1 Preferred Generic drugs have an $18 copay for a 1-month supply, and Tier 2 Generic drugs carry a $19 copay for a 1-month supply through standard services. For brand-name and specialty medications, the plan utilizes coinsurance rather than flat copays. Tier 3 Preferred Brand drugs and Tier 5 Specialty medications require a 25% coinsurance, while Tier 4 Non-Preferred drugs require a 31% coinsurance through standard pharmacies and standard mail order. These cost-sharing details help you estimate your out-of-pocket expenses for this Medicare Advantage plan.
The DEVOTED C-SNP CHOICE PLUS 008 OK (PPO C-SNP) plan offers comprehensive medical coverage with no copay and no coinsurance for primary care visits, preventive care, and home health services. For inpatient hospital services, members pay a flat copay per stay, such as $2,230 for acute care, with no coinsurance. Emergency room visits require a $115 copay, while outpatient services, specialist visits, and diagnostic tests feature no copay but may require coinsurance up to 50 percent. Supplemental benefits include dental care with no copay or coinsurance up to a $3,000 annual limit, alongside a $400 yearly allowance for eyewear with no copay or coinsurance. Prescription hearing aids are covered with copays ranging from $399 to $699, and skilled nursing facility care is available with no copay for the first 20 days before a $218 daily copay applies. Members also receive an over-the-counter benefit of $50 every three months with no copay or coinsurance.
DEVOTED C-SNP CHOICE PLUS 008 OK (PPO C-SNP) partially covers inpatient hospital services, requiring a $2,230 copay and no coinsurance per stay for acute care, and a $2,080 copay and no coinsurance per psychiatric stay. Non-Medicare-covered stays, hospital upgrades, and additional psychiatric days are not covered under this benefit.
Outpatient services under DEVOTED C-SNP CHOICE PLUS 008 OK (PPO C-SNP) are covered with no copays, though coinsurance and prior authorization are required for most benefits. Outpatient hospital and ambulatory surgical center services feature no copay and range from no coinsurance to 50% coinsurance, while outpatient substance abuse and blood services require no copay and 30% coinsurance.
Partial hospitalization is covered by DEVOTED C-SNP CHOICE PLUS 008 OK (PPO C-SNP) with no copay and a 20% coinsurance. Prior authorization is required for these services.
Ambulance services are covered by DEVOTED C-SNP CHOICE PLUS 008 OK (PPO C-SNP) with no copay, requiring a 0% to 50% coinsurance for ground transport and a 50% coinsurance for air transport. While some transportation services are covered, transportation to plan-approved or any health-related locations is not covered.
DEVOTED C-SNP CHOICE PLUS 008 OK (PPO C-SNP) covers emergency services with a $115 copay and no coinsurance, with the copay waived if admitted to the hospital within 24 hours. Urgently needed services require no copay and a 0% to 20% coinsurance (maximum $40 per visit), while worldwide emergency, urgent, and transportation services are covered up to $25,000 with no copay and no coinsurance.
DEVOTED C-SNP CHOICE PLUS 008 OK (PPO C-SNP) offers primary care physician services with no copay and no coinsurance. Most other services, including specialist visits, mental health, and physical therapy, feature no copay and a 30% coinsurance, though some chiropractic services are covered but routine and other chiropractic services are not.
Preventive services are partially covered by DEVOTED C-SNP CHOICE PLUS 008 OK (PPO C-SNP) with no copay and no coinsurance for covered benefits like annual physical exams, fitness benefits, and kidney disease education. However, several sub-services are not covered under this benefit, such as in-home safety assessments, personal emergency response systems, therapeutic massage, and caregiver support.
DEVOTED C-SNP CHOICE PLUS 008 OK (PPO C-SNP) provides partially covered hearing services with no copay for exams, though routine annual exams require a 50% coinsurance. Prescription hearing aids are covered with no coinsurance and copays ranging from $399 to $699 for up to two aids per year, but over-the-counter (OTC) options and inner-ear, outer-ear, or over-the-ear prescription models are not covered.
Vision services under DEVOTED C-SNP CHOICE PLUS 008 OK (PPO C-SNP) include partially covered eye exams with no copay and 0% to 50% coinsurance for one routine yearly exam, while other eye exam services are not covered. Eyewear is covered with no copay, no coinsurance, and a $400 combined annual maximum limit for contacts, lenses, frames, and upgrades.
DEVOTED C-SNP CHOICE PLUS 008 OK (PPO C-SNP) offers dental services with no copay and no coinsurance for preventive and most comprehensive care up to a $3,000 yearly limit, while Medicare-covered dental services require a 30% coinsurance and no copay. This benefit is partially covered, excluding implants, orthodontics, maxillofacial prosthetics, other diagnostic dental, and other preventive dental services.
DEVOTED C-SNP CHOICE PLUS 008 OK (PPO C-SNP) covers home infusion bundled services with no copay, though prior authorization is required. Covered Medicare Part B chemotherapy, radiation, and other drugs incur a coinsurance ranging from no coinsurance up to 20%, while Part B insulin has a $35 copay that counts toward the plan-level deductible and up to 20% coinsurance.
Dialysis services are covered by DEVOTED C-SNP CHOICE PLUS 008 OK (PPO C-SNP) with no copay and a 20% coinsurance, and prior authorization is required.
DEVOTED C-SNP CHOICE PLUS 008 OK (PPO C-SNP) partially covers medical equipment with no copays and coinsurance ranging from 0% to 20%, depending on the service. Covered items include durable medical equipment, prosthetics, and diabetic supplies, though diabetic therapeutic shoes and inserts are not covered.
DEVOTED C-SNP CHOICE PLUS 008 OK (PPO C-SNP) covers diagnostic and radiological services with prior authorization required and no copays. Diagnostic procedures and tests have no coinsurance, while therapeutic radiology has a 20% coinsurance, and lab services, diagnostic radiology, and outpatient X-rays require a 50% coinsurance.
Home Health Services are covered under the DEVOTED C-SNP CHOICE PLUS 008 OK (PPO C-SNP) plan with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services are covered under the DEVOTED C-SNP CHOICE PLUS 008 OK (PPO C-SNP) plan with no copay and require prior authorization, though some services are covered while standard cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered and require a 30% coinsurance.
DEVOTED C-SNP CHOICE PLUS 008 OK (PPO C-SNP) covers Skilled Nursing Facility (SNF) care 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 necessary, and additional days beyond the standard Medicare benefit are not covered.
DEVOTED C-SNP CHOICE PLUS 008 OK (PPO C-SNP) partially covers Other Services, offering over-the-counter (OTC) items up to $50 every three months, non-Medicare diabetic shoes, and additional preventive services with no copay and no coinsurance. Acupuncture and meal benefits are not covered.
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* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
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