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Devoted DUAL PLUS North Carolina (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Devoted DUAL PLUS North Carolina (HMO D-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Devoted DUAL PLUS North Carolina (HMO D-SNP) in 2025, please refer to our full plan details page.
Devoted DUAL PLUS North Carolina (HMO D-SNP) is a HMO D-SNP plan offered by Devoted Health, Inc. available for enrollment in 2025 to people living in North Carolina. This plan received an overall rating of 4.5 out of 5 stars in 2025.
It's important to know that Devoted DUAL PLUS North Carolina (HMO D-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
Devoted DUAL PLUS North Carolina (HMO D-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 DUAL PLUS North Carolina (HMO D-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 DUAL PLUS North Carolina (HMO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $40.10. 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 $590.00 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 $9350.00 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 DUAL PLUS North Carolina (HMO D-SNP) plan has a $590 deductible for prescription drugs. If you qualify for the low-income subsidy, you will pay $40.10 for your Part D premium. After your deductible is met, you will pay costs for drugs in each tier until your total drug costs reach $2000. Once your yearly out-of-pocket drug costs reach $2000, you pay nothing for Medicare Part D covered drugs.
Additional Benefits
The Devoted DUAL PLUS North Carolina (HMO D-SNP) plan offers a range of benefits. This plan covers inpatient hospital stays with a $1700 copay per admission and covers outpatient services with coinsurance between 20% and 40%. Emergency services have a $110 copay, and ambulance services are covered with no copay, but coinsurance applies. This plan includes coverage for primary care, hearing, vision, dental, and home health services. Hearing exams have coinsurance of at most 35%, and prescription hearing aids are covered with a copay between $399 and $699. Vision services include eye exams with a 35% coinsurance and eyewear benefits up to $500 annually. Dental services are covered with a maximum plan benefit of $500 per year. Home health services are covered with no copay or coinsurance.
Inpatient Hospital See details
Inpatient Hospital benefits, including Acute and Psychiatric, are covered by the Devoted DUAL PLUS North Carolina (HMO D-SNP) plan, with a copay of $1700 per admission or stay for Medicare-covered stays; however, additional days and non-Medicare-covered stays for psychiatric services are not covered. Additional days and upgrades for Inpatient Hospital-Acute are covered, but non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute are not covered.
Outpatient Services See details
Outpatient Services, including all outpatient hospital services, are covered by this plan. Outpatient Hospital Services and Observation Services have a coinsurance of 35% - 40%, and 35% respectively. Ambulatory Surgical Center (ASC) Services and Outpatient Substance Abuse Services have a coinsurance between 35% and 40%, and 35% respectively. Outpatient Blood Services are covered with a 20% coinsurance.
Partial Hospitalization See details
Partial Hospitalization is covered by the Devoted DUAL PLUS North Carolina (HMO D-SNP) plan, but requires prior authorization. You will pay 30% coinsurance for this benefit.
Ambulance and Transportation Services See details
The Devoted DUAL PLUS North Carolina (HMO D-SNP) plan covers ambulance services with no copay, but coinsurance applies for Medicare-covered ground ambulance services (0-35%) and air ambulance services (35%). Transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered. Emergency Services have a $110 copay, and no coinsurance. Urgently Needed Services have a 30% coinsurance. Worldwide Emergency Services have no copay and no coinsurance.
Primary Care See details
Primary Care Physician Services, Chiropractic Services, Occupational Therapy Services, Physician Specialist Services, Podiatry Services, Physical Therapy and Speech-Language Pathology Services, Additional Telehealth Benefits, and Opioid Treatment Program Services are covered. Mental Health Specialty Services and Psychiatric Services are covered, but Individual and Group Sessions are not covered.
Preventive Services See details
Preventive Services include coverage for services such as Health Education, Personal Emergency Response System, Weight Management Programs, Alternative Therapies, Nutritional/Dietary Benefit, Fitness Benefit, Home and Bathroom Safety Devices and Modifications, Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit. In-Home Safety Assessment, Medical Nutrition Therapy, Post discharge In-Home Medication Reconciliation, Re-admission Prevention, Wigs for Hair Loss Related to Chemotherapy, Therapeutic Massage, Adult Day Health Services, Home-Based Palliative Care, In-Home Support Services, Support for Caregivers of Enrollees, Additional Sessions of Smoking and Tobacco Cessation Counseling, Enhanced Disease Management, Telemonitoring Services, Remote Access Technologies, and Counseling Services are not covered.
Hearing Services See details
Hearing Services include routine hearing exams with a coinsurance of at most 35% and fitting/evaluation for hearing aids. Prescription hearing aids (all types) are covered with a copay between $399 and $699, but inner ear, outer ear, and over the ear prescription hearing aids are not covered, and OTC hearing aids are not covered.
Vision Services See details
Vision services include coverage for eye exams with a 35% coinsurance, and routine eye exams once per year. Eyewear benefits are covered up to a combined maximum of $500 every year, and includes coverage for contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades.
Dental Services See details
The Devoted DUAL PLUS North Carolina (HMO D-SNP) plan covers a variety of dental services, including oral exams, dental x-rays, and other diagnostic services, with a maximum plan benefit of $500 per year. The plan also covers other preventive, restorative, and general dental services, but does not cover maxillofacial prosthetics, implant services, or orthodontics.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, requiring prior authorization. For Medicare Part B Insulin Drugs, there is a $35 copay and a coinsurance between 20% and 20%. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, there is a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by the Devoted DUAL PLUS North Carolina (HMO D-SNP) plan, with a coinsurance between 20% and 20%.
Medical Equipment See details
Medical Equipment is covered, including Durable Medical Equipment (DME) with no copay and a coinsurance between 0% and 18%, though Durable Medical Equipment for use outside the home is not covered. Prosthetics/Medical Supplies - Non-Medicare benefit has no copay and coinsurance applies for Medicare-covered Prosthetic Devices and Medical Supplies. Diabetic Equipment is also covered, with a 20% coinsurance for Diabetic Supplies, while Diabetic Therapeutic Shoes/Inserts are not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered under the Devoted DUAL PLUS North Carolina (HMO D-SNP) plan. Diagnostic Procedures/Tests and Lab Services have a coinsurance of at most 35%, while Diagnostic Radiological Services have a minimum coinsurance of 35%, Therapeutic Radiological Services have a coinsurance of at most 20% (minimum 20%), and Outpatient X-Ray Services have a coinsurance of at most 30% (minimum 30%).
Home Health Services See details
Home Health Services are covered by the Devoted DUAL PLUS North Carolina (HMO D-SNP) plan with no copay and no coinsurance, but prior authorization is required. Additional hours of care and personal care services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the Devoted DUAL PLUS North Carolina (HMO D-SNP) plan. Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, and Additional Cardiac Rehabilitation Services are all not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Devoted DUAL PLUS North Carolina (HMO D-SNP) plan, but prior authorization is required. There is no copay for days 1-20 and days 61-100, but there is a $214 copay for days 21-60. Additional days beyond Medicare-covered for SNF and Non-Medicare-covered stays for SNF are not covered.
Other Services See details
Other Services are not covered, including acupuncture, over-the-counter items, meal benefits, Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, and Self-Directed Personal Assistance Services. However, Other 2 benefits are covered.
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