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DEVOTED C-SNP PLUS 009 OR (HMO C-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for DEVOTED C-SNP PLUS 009 OR (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 PLUS 009 OR (HMO C-SNP) in 2026, please refer to our full plan details page.
DEVOTED C-SNP PLUS 009 OR (HMO C-SNP) is a HMO C-SNP plan offered by Devoted Health, Inc. available for enrollment in 2026 to people living in Oregon. This plan received an overall rating of 3.5 out of 5 stars in 2026.
It's important to know that DEVOTED C-SNP PLUS 009 OR (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 PLUS 009 OR (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 PLUS 009 OR (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 PLUS 009 OR (HMO C-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $10.50. 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 $9250.00 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 PLUS 009 OR (HMO C-SNP) prescription drug plan features an annual drug deductible of $615. For Tier 6 Select Care Drugs, you will pay no copay for 1-month, 2-month, or 3-month supplies filled at standard pharmacies or through standard mail order. Tier 1 Preferred Generic drugs require an $18 copay for a 1-month supply, while Tier 2 Generic drugs have a $19 copay for a 1-month supply. For higher-tier medications, the plan charges coinsurance instead of a flat copayment. Tier 3 Preferred Brand drugs and Tier 5 Specialty drugs require a 25% coinsurance, whereas Tier 4 Non-Preferred drugs carry a 31% coinsurance. These coinsurance rates apply to standard pharmacy and standard mail order options.
Additional Benefits
The DEVOTED C-SNP PLUS 009 OR (HMO C-SNP) plan offers comprehensive medical coverage with no copay for primary care visits, while specialist visits require no copay but carry a 30% coinsurance. Inpatient hospital stays require a copay of $2,230 per acute stay and $2,080 per psychiatric stay with no coinsurance, whereas outpatient services feature no copay and coinsurance ranging up to 40%. Emergency room visits have a $115 copay, which is waived if you are admitted within 24 hours, and urgently needed care is available with no copay and low coinsurance. For routine care, this plan provides robust dental, vision, and hearing benefits, including a $3,000 yearly maximum for dental services with no copay or coinsurance. Vision services feature no copay for routine exams and up to a $300 annual allowance for eyewear with no copay, while hearing exams have no copay and prescription hearing aids require copays between $399 and $699. Additionally, members benefit from no copay or coinsurance for home health services and receive a $50 quarterly allowance for over-the-counter items.
Inpatient Hospital See details
DEVOTED C-SNP PLUS 009 OR (HMO C-SNP) offers partially covered inpatient hospital services with no coinsurance, requiring a $2,230 copay per acute stay and a $2,080 copay per psychiatric stay. Prior authorization is required, and non-Medicare-covered stays, upgrades, and additional psychiatric days are not covered.
Outpatient Services See details
DEVOTED C-SNP PLUS 009 OR (HMO C-SNP) covers outpatient services with no copay, though prior authorization is required for most care. Outpatient hospital and ambulatory surgical center services range from no coinsurance to 40% coinsurance, while outpatient substance abuse and blood services require 30% coinsurance with no deductible.
Partial Hospitalization See details
Partial hospitalization is covered by DEVOTED C-SNP PLUS 009 OR (HMO C-SNP) with no copay and a 20% coinsurance. Prior authorization is required for these services.
Ambulance and Transportation Services See details
DEVOTED C-SNP PLUS 009 OR (HMO C-SNP) covers ambulance services with no copay, requiring no coinsurance to 40% coinsurance for ground services and 40% coinsurance for air services, with prior authorization required. While some transportation services are covered, transportation to plan-approved health-related locations and any health-related locations is not covered.
Emergency Services See details
Emergency services are covered by DEVOTED C-SNP PLUS 009 OR (HMO C-SNP) with a $115 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services feature no copay and a 0% to 20% coinsurance up to $40, while worldwide emergency, urgent, and transportation services are covered with no copay or coinsurance up to a maximum benefit of $25,000.
Primary Care See details
DEVOTED C-SNP PLUS 009 OR (HMO C-SNP) covers primary care physician services with no copay and no coinsurance, while most specialist, therapy, and mental health services feature no copay and 30% coinsurance. Chiropractic benefits are partially covered, offering up to 12 routine visits per year for a $15 copay and no coinsurance, while other chiropractic services are not covered.
Preventive Services See details
Preventive services are covered by DEVOTED C-SNP PLUS 009 OR (HMO C-SNP) with no copay and no coinsurance, though some additional benefits are only partially covered. Covered options include annual physical exams, fitness programs, and therapeutic massage, while excluded services include in-home safety assessments, personal emergency response systems, and home-based palliative care.
Hearing Services See details
DEVOTED C-SNP PLUS 009 OR (HMO C-SNP) covers hearing exams with no copay, though routine exams require prior authorization and a 40% coinsurance. Prescription hearing aids are partially covered with no coinsurance and copays ranging from $399 to $699 for up to two aids per year, but OTC hearing aids and inner ear, outer ear, and over-the-ear prescription models are not covered.
Vision Services See details
DEVOTED C-SNP PLUS 009 OR (HMO C-SNP) partially covers vision services, offering one routine eye exam per year with no copay and 0% to 40% coinsurance, while other eye exam services are not covered. Eyewear is covered with no copay, no coinsurance, and no deductible, up to a $300 annual maximum for contacts, eyeglasses, frames, lenses, and upgrades.
Dental Services See details
Dental services are partially covered by DEVOTED C-SNP PLUS 009 OR (HMO C-SNP) with a $3,000 yearly maximum for preventive and comprehensive services featuring no copay and no coinsurance, while Medicare-covered dental services have no copay and a 30% coinsurance. Covered options include exams, cleanings, and extractions, but other diagnostic dental, other preventive dental, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by DEVOTED C-SNP PLUS 009 OR (HMO C-SNP) with no copay, though prior authorization and step therapy may be required. Under this benefit, Medicare Part B insulin drugs require a $35 copay and no coinsurance to 20% coinsurance, while chemotherapy, radiation, and other Part B drugs have no coinsurance to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered by DEVOTED C-SNP PLUS 009 OR (HMO C-SNP) with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
DEVOTED C-SNP PLUS 009 OR (HMO C-SNP) covers medical equipment with no copays, though prior authorization is required for these services. Durable medical equipment and diabetic supplies require a 20% coinsurance, prosthetics and medical supplies range from no coinsurance to 20% coinsurance, and diabetic therapeutic shoes or inserts are not covered.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered under the DEVOTED C-SNP PLUS 009 OR (HMO C-SNP) with prior authorization and no copays. Covered diagnostic procedures and tests have no coinsurance, while there is a 40% coinsurance for lab services, 20% coinsurance for therapeutic radiological services, and 35% coinsurance for both diagnostic radiological services and outpatient X-rays.
Home Health Services See details
Home health services are covered by DEVOTED C-SNP PLUS 009 OR (HMO C-SNP) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
DEVOTED C-SNP PLUS 009 OR (HMO C-SNP) offers some covered cardiac rehabilitation services with no copay, though prior authorization is required. However, standard cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) are not covered and carry a 30% coinsurance.
Skilled Nursing Facility (SNF) See details
DEVOTED C-SNP PLUS 009 OR (HMO C-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 prior 3-day inpatient hospital stay is not needed, and additional days beyond the standard 100 days are not covered.
Other Services See details
DEVOTED C-SNP PLUS 009 OR (HMO C-SNP) provides partial coverage for other services with no copay and no coinsurance, which includes unlimited acupuncture, non-Medicare covered diabetic shoes, additional preventive services, and a $50 quarterly allowance for over-the-counter items. Meal benefits are not covered under this plan.
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1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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