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DEVOTED CHOICE 002 CO (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for DEVOTED CHOICE 002 CO (PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on DEVOTED CHOICE 002 CO (PPO) in 2026, please refer to our full plan details page.
DEVOTED CHOICE 002 CO (PPO) is a PPO plan offered by Devoted Health, Inc. available for enrollment in 2025 to people living in Denver Metro. This plan received an overall rating of 4 out of 5 stars in 2026.
It's important to know that DEVOTED CHOICE 002 CO (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 002 CO (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 002 CO (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 $405.00 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 $9550.00 (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 $9550.00 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 002 CO (PPO) Medicare plan features an annual drug deductible of $405. For Tier 1 preferred generic and Tier 2 generic medications, members enjoy no copay for one-month, two-month, and three-month supplies filled at standard pharmacies or through standard mail order. This makes standard generic prescriptions highly affordable and accessible throughout the plan year. For higher-tier medications, costs are based on coinsurance rather than flat copays. Tier 3 preferred brand drugs require a 24% coinsurance, while Tier 4 non-preferred drugs carry a 25% coinsurance for standard pharmacy and mail order fills. Specialty drugs in Tier 5 are covered with a 28% coinsurance for a one-month supply.
Additional Benefits
The DEVOTED CHOICE 002 CO (PPO) plan provides comprehensive medical coverage, featuring no copays and no coinsurance for primary care visits, preventive care, and home health services. Specialist visits require a $35 copay, while inpatient hospital stays have a $295 daily copay for the first six days and no copay for subsequent days. Emergency room visits are covered with a $130 copay, which is waived if you are admitted to the hospital within 24 hours. For supplemental care, this plan offers robust dental benefits up to a $3,000 annual limit with no copay for preventive services, alongside routine vision exams and a $300 yearly allowance for eyewear. Routine hearing exams are available for a $35 copay, with prescription hearing aids covered at copays between $399 and $699. Additionally, diagnostic lab tests, outpatient X-rays, and home infusion services are covered with no copay, though durable medical equipment and dialysis services require coinsurance.
Inpatient Hospital See details
DEVOTED CHOICE 002 CO (PPO) partially covers inpatient hospital services with no coinsurance, requiring a $295 daily copay for days 1 through 6 and no copay for days 7 through 90 for both acute and psychiatric stays. Unlimited additional days are covered for acute care, but additional psychiatric days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
DEVOTED CHOICE 002 CO (PPO) covers outpatient services with no coinsurance, featuring a $0 to $395 copay for outpatient hospital services and a $295 copay per stay for observation services. Outpatient substance abuse sessions have a $35 copay, while ambulatory surgical center and blood services are covered with no copay and no coinsurance.
Partial Hospitalization See details
DEVOTED CHOICE 002 CO (PPO) covers partial hospitalization benefits with a $70 copay and no coinsurance. Prior authorization is required for these services.
Ambulance and Transportation Services See details
DEVOTED CHOICE 002 CO (PPO) covers ground ambulance services with a copay ranging from no copay to $315 and air ambulance services with a 20% coinsurance, with prior authorization required for both. Routine transportation services are not covered under this plan, as rides to plan-approved or health-related locations are unavailable.
Emergency Services See details
DEVOTED CHOICE 002 CO (PPO) covers emergency services with a $130 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services feature no copay to a $45 copay and no coinsurance, while worldwide emergency services are covered up to $25,000 with a $130 copay for emergency or urgent care and a $315 copay and 20% coinsurance for emergency transportation.
Primary Care See details
DEVOTED CHOICE 002 CO (PPO) offers primary care physician services with no copay and no coinsurance, and specialist visits for a $35.00 copay and no coinsurance. Therapy, psychiatric, and telehealth services have copays ranging from $0.00 to $50.00 and no coinsurance, while chiropractic care is partially covered with a $15.00 copay and no coinsurance (other chiropractic services are not covered), and podiatry is not covered.
Preventive Services See details
DEVOTED CHOICE 002 CO (PPO) covers preventive services, including annual physical exams and kidney disease education, with no copay and no coinsurance. Additional preventive benefits are partially covered with no copay, featuring alternative therapies (0% to 50% coinsurance) and therapeutic massage (50% coinsurance), while excluding in-home safety assessments, personal emergency response systems, and medical nutrition therapy.
Hearing Services See details
Hearing services are partially covered under the DEVOTED CHOICE 002 CO (PPO) plan, which offers routine annual hearing exams for a $35 copay and no coinsurance. While prescription hearing aids are covered with no coinsurance and copays between $399 and $699, OTC hearing aids as well as inner ear, outer ear, and over the ear prescription models are not covered.
Vision Services See details
DEVOTED CHOICE 002 CO (PPO) vision services are partially covered, as other eye exam services are not covered. One routine eye exam is covered annually with a $0 to $35 copay and no coinsurance, and eyewear is covered with no copay, no coinsurance, and a $300 yearly limit for contacts, glasses, and upgrades.
Dental Services See details
Dental Services are partially covered by DEVOTED CHOICE 002 CO (PPO) up to a $3,000 yearly maximum for both in- and out-of-network care, excluding maxillofacial prosthetics, implant services, and orthodontics. Medicare-covered dental has a $35 copay and no coinsurance, while covered preventive and diagnostic services have no copay and no coinsurance. Other covered services, such as restorative care and endodontics, feature no copay and 0% to 50% coinsurance.
Home Infusion bundled Services See details
DEVOTED CHOICE 002 CO (PPO) covers home infusion bundled services with no copay, though prior authorization is required. Associated Medicare Part B drugs, including chemotherapy, radiation, and other drugs, require a 0% to 20% coinsurance, while Medicare Part B insulin drugs have a $35 copay and a 0% to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered by DEVOTED CHOICE 002 CO (PPO) with no copay and a 20% coinsurance. Prior authorization is required for these services.
Medical Equipment See details
Medical equipment is covered by DEVOTED CHOICE 002 CO (PPO) with no copays, though prior authorization is required. Durable medical equipment requires a 20% to 35% coinsurance, prosthetics and medical supplies range from no coinsurance to 20% coinsurance, and diabetic equipment is partially covered with no coinsurance to 40% coinsurance on supplies, though diabetic therapeutic shoes and inserts are not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered by DEVOTED CHOICE 002 CO (PPO), with prior authorization required for all services. Diagnostic services feature no coinsurance, offering no copay for lab services and copays from $0 to $95 for procedures, while radiological services require a minimum 20% coinsurance for therapeutic services and no copay for outpatient X-rays.
Home Health Services See details
Home Health Services are covered by DEVOTED CHOICE 002 CO (PPO) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
DEVOTED CHOICE 002 CO (PPO) does not cover Cardiac Rehabilitation Services, including intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) services.
Skilled Nursing Facility (SNF) See details
DEVOTED CHOICE 002 CO (PPO) covers Skilled Nursing Facility (SNF) services with no coinsurance and no prior three-day hospital stay required, though prior authorization is necessary. There is no copay for days 1 through 20, followed by a $218 daily copay for days 21 through 100, with no coverage for additional days beyond the Medicare limit.
Other Services See details
DEVOTED CHOICE 002 CO (PPO) partially covers Other Services, which includes acupuncture with no copay and 50% coinsurance, plus OTC items and additional preventive services with no copay and no coinsurance. Meal benefits are not covered under this plan.
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