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DEVOTED CHOICE 001 KS (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for DEVOTED CHOICE 001 KS (PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on DEVOTED CHOICE 001 KS (PPO) in 2026, please refer to our full plan details page.
DEVOTED CHOICE 001 KS (PPO) is a PPO plan offered by Devoted Health, Inc. available for enrollment in 2026 to people living in Kansas City Metro/Eastern Kansas. The overall rating for this plan is not yet available for 2026.
It's important to know that DEVOTED CHOICE 001 KS (PPO) 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 CHOICE 001 KS (PPO).
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 CHOICE 001 KS (PPO), 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 $375.00 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 $5600.00 (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 $5600.00 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 CHOICE 001 KS (PPO) Medicare plan features a yearly prescription drug deductible of $375. For both Tier 1 preferred generic and Tier 2 generic medications, you will pay no copay for one-month, two-month, or three-month supplies filled at standard pharmacies or through standard mail order. This coverage helps minimize your out-of-pocket costs for common everyday prescriptions. For higher-tier medications, your costs are shared through coinsurance rather than flat copays. Tier 3 preferred brands require a 19% coinsurance, while Tier 4 non-preferred drugs carry a 25% coinsurance for standard pharmacy and mail-order fills. Specialty drugs in Tier 5 require a 28% coinsurance, which is limited to a one-month supply.
Additional Benefits
The DEVOTED CHOICE 001 KS (PPO) Medicare plan provides robust coverage with predictable costs, featuring no copays and no coinsurance for primary care visits, preventive services, and home health care. Members benefit from generous additional perks, including a $3,500 annual dental allowance with no copay for preventive cleanings, and a $400 yearly limit for eyewear. Routine hearing exams have a low $30 copay, while specialist visits and diagnostic tests range from no copay to $95. For major medical needs, inpatient hospital stays require a $330 daily copay for days 1 through 6 and no copay for days 7 through 90. Emergency room visits have a $150 copay, which is waived if you are admitted, and skilled nursing care has no copay for the first 20 days. Durable medical equipment is covered with no copays and 20% to 30% coinsurance, and members receive a $100 quarterly allowance for over-the-counter items.
Inpatient Hospital See details
DEVOTED CHOICE 001 KS (PPO) covers inpatient acute and psychiatric hospital stays with no coinsurance, requiring a $330 daily copay for days 1 to 6 and no copay for days 7 to 90. Unlimited additional days are covered for acute care, but upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
DEVOTED CHOICE 001 KS (PPO) covers outpatient services with no coinsurance, though prior authorization is required. You will pay no copay for ambulatory surgical center and outpatient blood services, a $30 copay for outpatient substance abuse sessions, a $330 copay per stay for observation services, and a copay ranging from no copay to $430 for outpatient hospital services.
Partial Hospitalization See details
Partial hospitalization is covered by DEVOTED CHOICE 001 KS (PPO) with a $130.00 copay and no coinsurance. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
DEVOTED CHOICE 001 KS (PPO) covers ambulance services with prior authorization, requiring no copay to a $340 copay (with no coinsurance) for ground transport and a 20% coinsurance (with no copay) for air transport. Some transportation services are covered, but transportation to plan-approved or any health-related locations is not covered.
Emergency Services See details
DEVOTED CHOICE 001 KS (PPO) covers emergency services with a $150 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services range from no copay to a $45 copay with no coinsurance, and worldwide emergency services are covered up to $25,000 with copays up to $340 and a 20% coinsurance for emergency transportation.
Primary Care See details
DEVOTED CHOICE 001 KS (PPO) covers primary care physician services with no copay and no coinsurance, while specialist, therapy, and mental health services feature copays ranging from $0 to $50 and no coinsurance. Podiatry is not covered, and while some chiropractic services are covered, routine chiropractic care and other chiropractic services are not covered.
Preventive Services See details
Preventive services are partially covered under DEVOTED CHOICE 001 KS (PPO) with no copay and no coinsurance for covered care, such as annual physical exams and fitness programs. However, excluded sub-services that are not covered include in-home safety assessments, PERS, medical nutrition therapy, post-discharge medication reconciliation, readmission prevention, wigs, therapeutic massage, adult day health, palliative care, in-home support, caregiver support, additional smoking cessation, enhanced disease management, telemonitoring, remote access technologies, and counseling.
Hearing Services See details
Hearing services are covered by DEVOTED CHOICE 001 KS (PPO), featuring a $30 copay and no coinsurance for one annual routine exam, alongside unlimited fitting evaluations. Prescription hearing aids are partially covered with no coinsurance and a $399 to $699 copay for up to two devices per year, excluding inner ear, outer ear, over the ear, and OTC hearing aids.
Vision Services See details
DEVOTED CHOICE 001 KS (PPO) covers vision services with no deductibles, including one annual routine eye exam with a $0 to $30 copay and no coinsurance, though other eye exam services are not covered. Eyewear is covered with no copay or coinsurance up to a $400 annual maximum allowance for contacts, lenses, frames, and upgrades.
Dental Services See details
DEVOTED CHOICE 001 KS (PPO) partially covers dental services up to a $3,500 annual limit, offering preventive care, cleanings, and oral exams with no copay and no coinsurance. Restorative and endodontic services have no copay and 0% to 50% coinsurance, though orthodontics, implant services, and maxillofacial prosthetics are not covered.
Home Infusion bundled Services See details
DEVOTED CHOICE 001 KS (PPO) covers Home Infusion bundled Services with no copay and no coinsurance, subject to prior authorization. Under this benefit, Medicare Part B chemotherapy and other drugs require no copay and a coinsurance ranging from no coinsurance to 20%, while covered Part B insulin has a $35 copay and a coinsurance ranging from no coinsurance to 20%.
Dialysis Services See details
Dialysis Services are covered by DEVOTED CHOICE 001 KS (PPO) with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
Medical equipment is covered by DEVOTED CHOICE 001 KS (PPO) with no copays, featuring a 20% to 30% coinsurance for durable medical equipment and up to 20% coinsurance for prosthetics and medical supplies. Diabetic equipment is partially covered with no coinsurance to 30% coinsurance for diabetic supplies, but diabetic therapeutic shoes and inserts are not covered.
Diagnostic and Radiological Services See details
DEVOTED CHOICE 001 KS (PPO) covers diagnostic and radiological services, requiring prior authorization for both. Diagnostic procedures and tests carry a copay ranging from $0 to $95 with no coinsurance, while lab services, outpatient X-rays, and diagnostic radiological services have no copay, and therapeutic radiological services require a 20% coinsurance.
Home Health Services See details
DEVOTED CHOICE 001 KS (PPO) covers home health services with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services under DEVOTED CHOICE 001 KS (PPO) require prior authorization and have no coinsurance. Although some services are covered, standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) rehabilitation services are not covered and require a $30 copay.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by DEVOTED CHOICE 001 KS (PPO) with no coinsurance, featuring no copay for days 1 through 20 and a $218 copay for days 21 through 100. Prior authorization is required, prior hospital stays of under three days are permitted, and additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Other services are partially covered by DEVOTED CHOICE 001 KS (PPO), offering over-the-counter (OTC) items with a $100 quarterly limit and additional preventive services with no copay and no coinsurance. Acupuncture, meal benefits, and dual-eligible SNP services are not covered under this plan.
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