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DEVOTED C-SNP CHOICE PLUS 007 UT (PPO C-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for DEVOTED C-SNP CHOICE PLUS 007 UT (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 007 UT (PPO C-SNP) in 2026, please refer to our full plan details page.
DEVOTED C-SNP CHOICE PLUS 007 UT (PPO C-SNP) is a PPO C-SNP plan offered by Devoted Health, Inc. available for enrollment in 2026 to people living in Utah. The overall rating for this plan is not yet available for 2026.
It's important to know that DEVOTED C-SNP CHOICE PLUS 007 UT (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 007 UT (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.
Key Plan Facts
Below are a few key facts and commonly-asked questions about DEVOTED C-SNP CHOICE PLUS 007 UT (PPO 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 CHOICE PLUS 007 UT (PPO C-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $37.60. 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:
Sign up for DEVOTED C-SNP CHOICE PLUS 007 UT (PPO C-SNP)
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Drug Coverage
The DEVOTED C-SNP CHOICE PLUS 007 UT (PPO C-SNP) plan features an annual prescription drug deductible of $615. Under this plan, you will enjoy no copay for Tier 6 Select Care Drugs through standard pharmacies and standard mail order services. For standard tier-one preferred generics, you can expect an $18 copay for a one-month supply, while Tier 2 generics require a $19 copay. For brand-name and specialty prescriptions, costs are determined by coinsurance rather than set copays. Tier 3 preferred brands and Tier 5 specialty drugs require a 25% coinsurance, while Tier 4 non-preferred drugs require a 31% coinsurance through standard pharmacy and mail order channels. This plan offers structured, tier-based drug coverage to help you manage your monthly healthcare expenses.
Additional Benefits
The DEVOTED C-SNP CHOICE PLUS 007 UT (PPO C-SNP) plan offers robust medical coverage, featuring no copays and no coinsurance for primary care visits and covered preventive services. For specialist visits, diagnostic tests, and outpatient services, members will pay no copay alongside coinsurance rates that typically range from 20% to 40%. Inpatient hospital stays require no coinsurance but do carry a flat copay of $2,230 per stay for acute care and $2,080 per stay for psychiatric care. This plan also includes valuable supplemental benefits, such as dental care with no copay or coinsurance up to a $3,000 annual limit and a $400 annual allowance for eyewear. Routine hearing exams incur a 40% coinsurance, while prescription hearing aids require copays between $399 and $699. Additionally, skilled nursing facility care features no copay for the first 20 days, and members receive a $50 quarterly allowance for over-the-counter items with no copay.
Inpatient Hospital See details
DEVOTED C-SNP CHOICE PLUS 007 UT (PPO C-SNP) covers inpatient hospital services with no coinsurance, requiring a $2,230 copay per stay for acute care and a $2,080 copay per stay for psychiatric care. This benefit is partially covered as upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered, and prior authorization is required.
Outpatient Services See details
Outpatient services are covered by DEVOTED C-SNP CHOICE PLUS 007 UT (PPO C-SNP) with no copays, but coinsurance ranges from no coinsurance up to 40% depending on the service. Prior authorization is required for these services, which include outpatient hospital, ambulatory surgical center, substance abuse, and blood services.
Partial Hospitalization See details
Partial hospitalization benefits are covered under the DEVOTED C-SNP CHOICE PLUS 007 UT (PPO C-SNP) plan with no copay and a 20% coinsurance. Prior authorization is required for these services.
Ambulance and Transportation Services See details
DEVOTED C-SNP CHOICE PLUS 007 UT (PPO C-SNP) covers ambulance services with no copay and a coinsurance of no coinsurance to 40% for ground transport and 40% for air transport, with prior authorization required. For transportation benefits, some services are covered but 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 CHOICE PLUS 007 UT (PPO 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 require no copay and a 0% to 20% coinsurance (up to $40 per visit), while worldwide emergency, urgent, and transportation services are fully covered with no copay or coinsurance up to a $25,000 maximum.
Primary Care See details
DEVOTED C-SNP CHOICE PLUS 007 UT (PPO C-SNP) offers primary care physician services with no copay and no coinsurance. Specialist visits, physical and occupational therapy, mental health, and podiatry services are covered with no copay and 30% coinsurance, though chiropractic services are not covered under this plan.
Preventive Services See details
Preventive Services are partially covered by DEVOTED C-SNP CHOICE PLUS 007 UT (PPO C-SNP) with no copay and no coinsurance for covered care such as annual physicals, fitness benefits, and nutritional therapy. Excluded sub-services that are not covered include In-Home Safety Assessments, PERS, post-discharge medication reconciliation, readmission 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 technologies, and counseling.
Hearing Services See details
DEVOTED C-SNP CHOICE PLUS 007 UT (PPO C-SNP) offers hearing exams with no copay, though routine exams require a 40% coinsurance. Prescription hearing aids are partially covered with no coinsurance and copays ranging from $399 to $699, but inner ear, outer ear, over the ear, and OTC hearing aids are not covered.
Vision Services See details
DEVOTED C-SNP CHOICE PLUS 007 UT (PPO C-SNP) partially covers vision services, offering one routine eye exam per year with no copay and 0% to 40% coinsurance, though other eye exam services are not covered. Covered eyewear, including contacts, frames, lenses, and upgrades, has no copay and no coinsurance up to a $400 combined annual maximum.
Dental Services See details
DEVOTED C-SNP CHOICE PLUS 007 UT (PPO C-SNP) partially covers dental services, offering no copay and no coinsurance for most preventive and comprehensive services up to a $3,000 annual maximum, while Medicare-covered dental has no copay and a 30% coinsurance. Implants, orthodontics, maxillofacial prosthetics, other diagnostic, and other preventive dental services are not covered.
Home Infusion bundled Services See details
DEVOTED C-SNP CHOICE PLUS 007 UT (PPO C-SNP) covers home infusion bundled services with no copay, though prior authorization is required. Under this benefit, Medicare Part B chemotherapy, radiation, and other drugs feature no copay and coinsurance ranging from no coinsurance to 20%, while Part B insulin drugs require a $35 copay and range from no coinsurance to 20% coinsurance.
Dialysis Services See details
DEVOTED C-SNP CHOICE PLUS 007 UT (PPO C-SNP) covers Dialysis Services with no copay and a 20% coinsurance, subject to prior authorization.
Medical Equipment See details
DEVOTED C-SNP CHOICE PLUS 007 UT (PPO C-SNP) partially covers medical equipment with no copays, featuring a 20% coinsurance for durable medical equipment and diabetic supplies, and no coinsurance to 20% coinsurance for prosthetics and medical supplies. Prior authorization is required for these services, 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 CHOICE PLUS 007 UT (PPO C-SNP) with no copays, though prior authorization is required for all services. Diagnostic procedures and tests have no coinsurance, while lab services, diagnostic radiological services, and outpatient X-rays incur a 40% coinsurance, and therapeutic radiological services incur a 20% coinsurance.
Home Health Services See details
DEVOTED C-SNP CHOICE PLUS 007 UT (PPO C-SNP) covers home health services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
DEVOTED C-SNP CHOICE PLUS 007 UT (PPO C-SNP) covers some cardiac rehabilitation services with no copay and a 30% coinsurance, subject to prior authorization. However, standard cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and SET for PAD services are not covered under this plan.
Skilled Nursing Facility (SNF) See details
DEVOTED C-SNP CHOICE PLUS 007 UT (PPO C-SNP) covers Skilled Nursing Facility (SNF) care with no coinsurance, offering 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 hospital stay is not required, and additional days beyond the standard 100 days are not covered.
Other Services See details
DEVOTED C-SNP CHOICE PLUS 007 UT (PPO C-SNP) partially covers other services, excluding acupuncture and meal benefits. Covered benefits such as over-the-counter (OTC) items (up to $50 every three months), non-Medicare covered diabetic shoes, and additional preventive services are offered with no copay and no coinsurance.
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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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