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Devoted CHOICE Georgia (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Devoted CHOICE Georgia (PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Devoted CHOICE Georgia (PPO) in 2025, please refer to our full plan details page.
Devoted CHOICE Georgia (PPO) is a PPO plan offered by Devoted Health, Inc. available for enrollment in 2025 to people living in Greater Atlanta. The overall rating for this plan is not yet available for 2025.
It's important to know that Devoted CHOICE Georgia (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 Georgia (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 Georgia (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 $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 combined Maximum Out-Of-Pocket cost of $8950.00 (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 $8950.00 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 Georgia (PPO) plan has an enhanced alternative drug benefit. The plan has a deductible of $590.00. In the initial coverage phase, after you meet your deductible, you will pay either a $0 copay or 25% coinsurance depending on the drug tier and pharmacy. Once your total drug costs reach $2000.00, you enter the catastrophic coverage phase where you pay nothing for covered drugs.
Additional Benefits
The Devoted CHOICE Georgia (PPO) plan offers a variety of benefits, including inpatient hospital stays with a $350 copay for the first few days, and no copay after, as well as outpatient services with varying copays. The plan also covers emergency services, primary care with no copay for many services, hearing and vision services with copays, and dental services with a $1,000 annual maximum. This plan provides coverage for home health services with no copay, and skilled nursing facility stays with no copay for the first 20 days. It also includes coverage for ambulance services, preventive services, diagnostic and radiological services, and home infusion bundled services. However, certain services like routine chiropractic care, podiatry services, and other services are not covered.
Inpatient Hospital See details
Inpatient Hospital benefits, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, are covered. For Inpatient Hospital-Acute, you will pay a $350 copay for days 1-7, and no copay for days 8-90. For Inpatient Hospital Psychiatric, you will pay a $350 copay for days 1-6, and no copay for days 7-90. Additional Days for Inpatient Hospital-Acute are covered, but Non-Medicare-covered Stay and Upgrades for Inpatient Hospital-Acute, and Additional Days and Non-Medicare-covered Stay for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services include outpatient hospital services with a copay between $0 and $450, observation services with a $350 copay, ambulatory surgical center services with no copay, individual and group outpatient substance abuse sessions with a $30 copay, and outpatient blood services.
Partial Hospitalization See details
Partial Hospitalization is covered by the Devoted CHOICE Georgia (PPO) plan, but requires prior authorization. The copay for this benefit is $70.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, with prior authorization required for all ambulance services. Ground ambulance services have a copay between $0 and $290, while air ambulance services have a 20% coinsurance. Transportation services to plan-approved or any health-related locations are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered under the Devoted CHOICE Georgia (PPO) plan. Emergency Services have a $125 copay, and Urgently Needed Services have a copay between $0-$45. Worldwide Emergency Transportation has a $290 copay and a 20% coinsurance, while Worldwide Emergency Coverage and Worldwide Urgent Coverage have a $125 copay.
Primary Care See details
Devoted CHOICE Georgia (PPO) covers primary care physician services with no copay, chiropractic services with a $20 copay, occupational therapy services with a $30-$45 copay, physician specialist services with a $30 copay, and mental health specialty services with a $30 copay. The plan also covers other health care professional services with a $0-$30 copay, psychiatric services with a $30 copay, physical therapy and speech-language pathology services with a $30-$50 copay, additional telehealth benefits with a $0-$30 copay, and opioid treatment program services with a $30 copay. However, routine chiropractic care and podiatry services are not covered.
Preventive Services See details
The Devoted CHOICE Georgia (PPO) plan covers preventive services including health education, weight management programs, alternative therapies, nutritional/dietary benefits, fitness benefits, home and bathroom safety devices and modifications, kidney disease education services, glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKG following Welcome Visit. In-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge in-home medication reconciliation, readmission 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 includes coverage for hearing exams with a $30 copay, and prescription hearing aids with a copay between $399 and $699, but does not cover inner ear, outer ear, or over-the-ear prescription hearing aids, or OTC hearing aids. Routine hearing exams are covered for one visit every year, and fitting/evaluation for hearing aids is unlimited.
Vision Services See details
Vision Services includes coverage for eye exams with a $30 copay, eyewear with a combined maximum benefit of $1000 every year, and contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades with no copay or coinsurance. Routine eye exams are covered once per year.
Dental Services See details
Devoted CHOICE Georgia (PPO) covers Medicare Dental Services with a $30 copay, and other dental services, including oral exams, dental x-rays, and more, with a $1,000 annual maximum benefit. Maxillofacial Prosthetics, Implant Services, and Orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, with prior authorization required. For Medicare Part B Insulin Drugs, there is a $35 copay with 20% coinsurance. Other Medicare Part B Drugs have a coinsurance between 0% and 20%, while Medicare Part B Chemotherapy/Radiation Drugs have a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by the Devoted CHOICE Georgia (PPO) plan, with a coinsurance between 20% and 20%.
Medical Equipment See details
Medical equipment is covered by the Devoted CHOICE Georgia (PPO) plan, including Durable Medical Equipment (DME) with a coinsurance between 0% and 20%, and no copay, but Durable Medical Equipment for use outside the home is not covered. Prosthetic Devices have a coinsurance between 0% and 20%, and Medical Supplies have a 20% coinsurance, while Diabetic Supplies and Diabetic Therapeutic Shoes/Inserts are not covered.
Diagnostic and Radiological Services See details
The Devoted CHOICE Georgia (PPO) plan covers diagnostic and radiological services. Diagnostic Procedures/Tests have a copay between $0 and $95, while Lab Services have no copay. Diagnostic Radiological Services have a copay up to $300, and Therapeutic Radiological Services have a coinsurance of at least 20%. Outpatient X-Ray Services have no copay.
Home Health Services See details
Home Health Services are covered by the Devoted CHOICE Georgia (PPO) plan with no copay and no coinsurance, but additional hours of care and personal care services are not covered. Prior authorization is required for this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but the plan does not cover any of the sub-services, including 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. There is a copay for Cardiac and Pulmonary Rehabilitation Services, but the specific amount is not listed.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by Devoted CHOICE Georgia (PPO), but require prior authorization. For days 1-20, there is no copay, and for days 21-100, the copay is $214.
Other Services See details
Other Services are not covered, including acupuncture, over-the-counter (OTC) 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.
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