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DEVOTED C-SNP CHOICE PREMIUM 018 GA (PPO C-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for DEVOTED C-SNP CHOICE PREMIUM 018 GA (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 PREMIUM 018 GA (PPO C-SNP) in 2026, please refer to our full plan details page.
DEVOTED C-SNP CHOICE PREMIUM 018 GA (PPO C-SNP) is a PPO C-SNP plan offered by Devoted Health, Inc. available for enrollment in 2026 to people living in Greater Georgia. The overall rating for this plan is not yet available for 2026.
It's important to know that DEVOTED C-SNP CHOICE PREMIUM 018 GA (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 PREMIUM 018 GA (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 PREMIUM 018 GA (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 PREMIUM 018 GA (PPO C-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $25.40. 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 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:
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Drug Coverage
The DEVOTED C-SNP CHOICE PREMIUM 018 GA (PPO C-SNP) plan features an annual drug deductible of $615. For Select Care Drugs (Tier 6), members enjoy no copay for 1-month, 2-month, or 3-month supplies at standard pharmacies and standard mail order. For other generics, standard copays start at $18 for a 1-month supply of Tier 1 Preferred Generics and go up to $57 for a 3-month supply of Tier 2 Generic drugs. Higher-tier medications under this plan are covered via coinsurance rather than flat copays. Standard pharmacy and standard mail order fills require a 21% coinsurance for Tier 3 Preferred Brand drugs and a 33% coinsurance for Tier 4 Non-Preferred drugs. Tier 5 Specialty Tier drugs require a 25% coinsurance for a 1-month supply.
Additional Benefits
The DEVOTED C-SNP CHOICE PREMIUM 018 GA (PPO C-SNP) plan offers robust medical coverage featuring no copay for primary care visits and routine preventive services. For inpatient hospital stays, members pay a daily copay for the first few days and no copay for subsequent days, while emergency room visits carry a flat copay that is waived if admitted. Most outpatient services, diagnostic lab work, and home health services are also available with no copay or low copayments and no coinsurance. This plan also includes key supplemental benefits, such as preventive dental care and routine vision exams with no copay, alongside annual allowances for eyewear and quarterly allowances for over-the-counter items. Prescription hearing aids and comprehensive dental services are partially covered with affordable copays, though some services like transportation, cardiac rehabilitation, and acupuncture are not covered. Overall, the plan helps manage healthcare costs by eliminating coinsurance on most standard medical services.
Inpatient Hospital See details
DEVOTED C-SNP CHOICE PREMIUM 018 GA (PPO C-SNP) covers inpatient hospital services with no coinsurance, requiring a $430 daily copay for days 1 to 5 for acute stays (with no copay for days 6 and beyond) and a $430 daily copay for days 1 to 4 for psychiatric stays (with no copay for days 5 to 90). This benefit is partially covered because upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Outpatient services under the DEVOTED C-SNP CHOICE PREMIUM 018 GA (PPO C-SNP) are covered with no coinsurance, featuring no copay for ambulatory surgical center and blood services. Outpatient substance abuse sessions require a $40 copay, while outpatient hospital and observation services carry copays ranging from $0 to $530.
Partial Hospitalization See details
DEVOTED C-SNP CHOICE PREMIUM 018 GA (PPO C-SNP) covers partial hospitalization services with a $70.00 copay and no coinsurance. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Ambulance services under DEVOTED C-SNP CHOICE PREMIUM 018 GA (PPO C-SNP) require prior authorization, offering ground ambulance coverage with a copay ranging from no copay to $315 (coinsurance applies) and air ambulance coverage with a 20% coinsurance (copay applies). Transportation services to plan-approved or other health-related locations are not covered under this plan.
Emergency Services See details
DEVOTED C-SNP CHOICE PREMIUM 018 GA (PPO C-SNP) covers emergency services with a $115 copay and no coinsurance (waived if admitted within 24 hours), and urgently needed services with no copay to a $40 copay and no coinsurance. Worldwide emergency and urgent services are covered up to a $25,000 limit with a $115 copay and no coinsurance, except for worldwide emergency transportation which requires a $315 copay and 20% coinsurance.
Primary Care See details
DEVOTED C-SNP CHOICE PREMIUM 018 GA (PPO C-SNP) covers primary care physician services with no copay and no coinsurance, while specialist visits, occupational therapy, and mental health services require copays ranging from $35 to $40 and no coinsurance. Physical therapy and speech-language pathology services feature a $40 to $50 copay and no coinsurance, telehealth ranges from no copay to a $40 copay with no coinsurance, and chiropractic services are not covered.
Preventive Services See details
DEVOTED C-SNP CHOICE PREMIUM 018 GA (PPO C-SNP) 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 and no coinsurance, though services such as in-home safety assessments, personal emergency response systems (PERS), and therapeutic massage are not covered.
Hearing Services See details
DEVOTED C-SNP CHOICE PREMIUM 018 GA (PPO C-SNP) covers routine hearing exams with a $40 copay and no coinsurance, while prescription hearing aids are partially covered with a copay ranging from $399 to $699 and no coinsurance. Inner ear, outer ear, over the ear, and OTC hearing aids are not covered by this plan.
Vision Services See details
Vision services are partially covered by DEVOTED C-SNP CHOICE PREMIUM 018 GA (PPO C-SNP) because other eye exam services are not covered. Covered eye exams carry a $0 to $40 copay and no coinsurance, while eyewear is covered with no copay and no coinsurance up to a $300 annual maximum.
Dental Services See details
Dental services under the DEVOTED C-SNP CHOICE PREMIUM 018 GA (PPO C-SNP) plan are partially covered, featuring a $40 copay and no coinsurance for Medicare-covered dental, and no copay or coinsurance for most preventive and comprehensive services up to a $2,000 yearly maximum. Excluded services that are not covered include other diagnostic and preventive dental services, maxillofacial prosthetics, implants, and orthodontics.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by DEVOTED C-SNP CHOICE PREMIUM 018 GA (PPO C-SNP) with no copay, although prior authorization is required. Associated Medicare Part B chemotherapy, radiation, and other drugs feature a coinsurance ranging from no coinsurance to 20%, while Part B insulin drugs require a $35 copay and a coinsurance ranging from no coinsurance to 20%.
Dialysis Services See details
Dialysis Services are covered under the DEVOTED C-SNP CHOICE PREMIUM 018 GA (PPO C-SNP) plan with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
DEVOTED C-SNP CHOICE PREMIUM 018 GA (PPO C-SNP) covers medical equipment with no copays, requiring prior authorization for all services. Durable medical equipment carries a 20% coinsurance, while covered prosthetics, medical supplies, and diabetic supplies range from no coinsurance to 20% coinsurance. Diabetic therapeutic shoes and inserts are not covered under this plan.
Diagnostic and Radiological Services See details
DEVOTED C-SNP CHOICE PREMIUM 018 GA (PPO C-SNP) covers diagnostic services with no coinsurance, offering no copay for lab work and copays ranging from $0 to $95 for procedures. Radiological services are also covered with prior authorization, featuring coinsurance and no copay for X-rays, copays starting at $0 for diagnostic radiology, and a copay plus a minimum 20% coinsurance for therapeutic radiology.
Home Health Services See details
Home Health Services are covered by DEVOTED C-SNP CHOICE PREMIUM 018 GA (PPO C-SNP) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the DEVOTED C-SNP CHOICE PREMIUM 018 GA (PPO C-SNP) plan, meaning there is no copay or coinsurance since none of the specific rehabilitation sub-services are covered in practice.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is covered by DEVOTED C-SNP CHOICE PREMIUM 018 GA (PPO 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, a 3-day inpatient hospital stay is not required prior to admission, and additional days beyond the standard 100-day limit are not covered.
Other Services See details
DEVOTED C-SNP CHOICE PREMIUM 018 GA (PPO C-SNP) provides partially covered other services with no copay and no coinsurance for over-the-counter items, non-Medicare covered diabetic shoes, and additional preventive services. The over-the-counter benefit has a fifty-dollar maximum limit every three months, while acupuncture and meal benefits are not covered.
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