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DEVOTED C-SNP PREMIUM 018 NC (HMO C-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for DEVOTED C-SNP PREMIUM 018 NC (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 PREMIUM 018 NC (HMO C-SNP) in 2026, please refer to our full plan details page.
DEVOTED C-SNP PREMIUM 018 NC (HMO C-SNP) is a HMO C-SNP plan offered by Devoted Health, Inc. available for enrollment in 2026 to people living in Western North Carolina. This plan received an overall rating of 5 out of 5 stars in 2026.
It's important to know that DEVOTED C-SNP PREMIUM 018 NC (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 PREMIUM 018 NC (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 PREMIUM 018 NC (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 PREMIUM 018 NC (HMO C-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $36.20. 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 $5600.00 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 PREMIUM 018 NC (HMO C-SNP) prescription drug plan has an annual drug deductible of $615. For Tier 6 select care drugs, members enjoy no copay for 1-month, 2-month, or 3-month supplies at standard pharmacies and standard mail order. Tier 1 preferred generics require an $18 copay for a 1-month supply, while Tier 2 generics have a $20 copay for a 1-month supply. For brand-name and specialized medications, standard costs are based on coinsurance rather than flat copays. Tier 3 preferred brands require a 23% coinsurance, and Tier 4 non-preferred drugs carry a 26% coinsurance through standard pharmacies and standard mail order. Tier 5 specialty drugs are covered with a 25% coinsurance for a 1-month supply.
Additional Benefits
The DEVOTED C-SNP PREMIUM 018 NC (HMO C-SNP) plan offers robust healthcare coverage featuring no copay and no coinsurance for primary care visits, with specialist copays capped at $50. Inpatient hospital stays require a $475 daily copay for the first few days with no coinsurance, while outpatient services range from no copay up to a $575 copay. Emergency room visits carry a $130 copay that is waived if admitted, and urgent care services require a copay of up to $45. This plan also includes valuable supplemental benefits, such as dental coverage with no copay up to a $2,000 annual limit and vision eyewear with no copay up to $300 annually. Hearing aids are covered with copays between $399 and $699, and members receive a $50 quarterly allowance for over-the-counter items with no copay. Skilled nursing facility care has no copay for the first 20 days, followed by a $218 daily copay up to day 100.
Inpatient Hospital See details
DEVOTED C-SNP PREMIUM 018 NC (HMO C-SNP) covers inpatient hospital services with no coinsurance, requiring a daily copay of $475 for days 1 through 5 of acute stays (no copay for days 6 to 90) and days 1 through 4 of psychiatric stays (no copay for days 5 to 90). Prior authorization is required, and some services such as upgrades and non-Medicare-covered stays are not covered.
Outpatient Services See details
DEVOTED C-SNP PREMIUM 018 NC (HMO C-SNP) covers outpatient services with no coinsurance, featuring a $0 to $575 copay for hospital visits and a $475 copay per stay for observation services. Ambulatory surgical center and blood services have no copay, while outpatient substance abuse individual and group sessions carry a $30 copay.
Partial Hospitalization See details
DEVOTED C-SNP PREMIUM 018 NC (HMO C-SNP) covers partial hospitalization services with a $60.00 copay and no coinsurance. Prior authorization is required to access this benefit.
Ambulance and Transportation Services See details
DEVOTED C-SNP PREMIUM 018 NC (HMO C-SNP) covers ambulance services with prior authorization, offering ground ambulance services with a copay ranging from no copay to $325 and no coinsurance, and air ambulance services with a 20% coinsurance and no copay. Transportation services to health-related locations are not covered under this plan.
Emergency Services See details
DEVOTED C-SNP PREMIUM 018 NC (HMO C-SNP) 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 are covered with no coinsurance and a copay ranging from no copay to $45. Worldwide emergency and urgent care are covered up to a $25,000 limit with a $130 copay and no coinsurance, while worldwide emergency transportation requires a $325 copay and 20% coinsurance.
Primary Care See details
Primary care and specialist benefits are covered by DEVOTED C-SNP PREMIUM 018 NC (HMO C-SNP) with no copay and no coinsurance for primary care physician visits, and copays ranging up to $50 with no coinsurance for specialists, therapy, and mental health services. Chiropractic services are only partially covered, with routine chiropractic care and other chiropractic services not covered under the plan.
Preventive Services See details
DEVOTED C-SNP PREMIUM 018 NC (HMO C-SNP) offers partially covered preventive services with no copay and no coinsurance, including annual physical exams, fitness benefits, and nutritional counseling. Excluded from coverage are in-home safety assessments, personal emergency response systems, post-discharge medication reconciliation, readmission prevention, chemotherapy-related 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
Hearing services are partially covered by DEVOTED C-SNP PREMIUM 018 NC (HMO C-SNP), offering routine exams and unlimited fitting evaluations for a $30 copay and no coinsurance. Up to two prescription hearing aids per year are covered with no coinsurance and copays ranging from $399 to $699, but OTC hearing aids and inner ear, outer ear, and over the ear prescription aids are not covered.
Vision Services See details
Vision services are partially covered by DEVOTED C-SNP PREMIUM 018 NC (HMO C-SNP) since other eye exam services are not covered. Covered benefits include one routine eye exam per year with a $0 to $30 copay, no coinsurance, and no deductible, as well as eyewear with no copay, no coinsurance, and no deductible up to a $300 annual maximum.
Dental Services See details
DEVOTED C-SNP PREMIUM 018 NC (HMO C-SNP) partially covers dental services, offering Medicare-covered dental with a $30 copay and no coinsurance, and other covered preventive and comprehensive services with no copay and no coinsurance up to a $2,000 annual maximum. Covered options include exams, cleanings, x-rays, fluoride, fillings, root canals, periodontics, dentures, and oral surgery, while other diagnostic, other preventive, maxillofacial prosthetics, implants, and orthodontics are not covered.
Home Infusion bundled Services See details
DEVOTED C-SNP PREMIUM 018 NC (HMO C-SNP) covers home infusion bundled services with no copay, though prior authorization is required. Associated Medicare Part B drugs, including chemotherapy, radiation, and insulin, carry a coinsurance ranging from 0% to 20%, with insulin also requiring a $35 copay.
Dialysis Services See details
Dialysis Services are covered under the DEVOTED C-SNP PREMIUM 018 NC (HMO C-SNP) plan with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
DEVOTED C-SNP PREMIUM 018 NC (HMO C-SNP) covers medical equipment with no copay, though prior authorization is required for these services. Durable medical equipment requires a 20% to 50% coinsurance, while prosthetics, medical supplies, and diabetic supplies range from no coinsurance to up to 20% or 50% coinsurance. Diabetic therapeutic shoes and inserts are not covered under this plan.
Diagnostic and Radiological Services See details
DEVOTED C-SNP PREMIUM 018 NC (HMO C-SNP) covers diagnostic and radiological services, with prior authorization required for these benefits. Diagnostic tests and procedures carry a copay of $0 to $95 with no coinsurance, while lab services, outpatient X-rays, and diagnostic radiological services feature no copay. Therapeutic radiological services require a 20% coinsurance.
Home Health Services See details
DEVOTED C-SNP PREMIUM 018 NC (HMO C-SNP) covers Home Health Services with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by DEVOTED C-SNP PREMIUM 018 NC (HMO C-SNP) with no coinsurance, though prior authorization is required. While some services are covered, sub-services such as Cardiac, Intensive Cardiac, Pulmonary, and Supervised Exercise Therapy (SET) for Peripheral Artery Disease (PAD) rehabilitation are not covered and have copays ranging from $25 to $30.
Skilled Nursing Facility (SNF) See details
Skilled nursing facility (SNF) care is covered by DEVOTED C-SNP PREMIUM 018 NC (HMO C-SNP) 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, though a 3-day prior inpatient hospital stay is not, and additional days beyond the standard 100-day limit are not covered.
Other Services See details
DEVOTED C-SNP PREMIUM 018 NC (HMO C-SNP) partially covers other services with no copay and no coinsurance, including diabetic shoes, additional preventive services, and over-the-counter items up to $50 every three months. Acupuncture and meal benefits are not covered.
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1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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