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Devoted CHOICE Arizona (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Devoted CHOICE Arizona (PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Devoted CHOICE Arizona (PPO) in 2025, please refer to our full plan details page.
Devoted CHOICE Arizona (PPO) is a PPO plan offered by Devoted Health, Inc. available for enrollment in 2025 to people living in Maricopa and Pinal Counties. This plan received an overall rating of 3 out of 5 stars in 2025.
It's important to know that Devoted CHOICE Arizona (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 Arizona (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 Arizona (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 Arizona (PPO) plan has an enhanced alternative drug benefit. The plan has a deductible of $590. After the deductible is met, you will pay a copay or coinsurance depending on the drug tier and pharmacy you use. For preferred generic drugs, you will pay a $10 copay at standard and mail order pharmacies. For standard generic, preferred brand, and non-preferred drugs, you will pay 25% coinsurance at standard and mail order pharmacies. Once your total drug costs reach $2000, you enter the catastrophic coverage phase and pay nothing for covered drugs.
Additional Benefits
The Devoted CHOICE Arizona (PPO) plan offers a variety of health benefits with varying cost-sharing. Inpatient hospital stays have a copay, while outpatient services have copays that vary by service. Emergency and primary care services also have copays, and preventive services are covered. Additional benefits include hearing, vision, and dental services. Hearing exams have a copay, and the plan covers hearing aids. Vision services include eye exams and eyewear coverage. Dental services offer coverage for Medicare dental services and other dental procedures, including orthodontics.
Inpatient Hospital See details
Inpatient Hospital coverage includes both Inpatient Hospital-Acute and Inpatient Hospital Psychiatric services. For Inpatient Hospital-Acute, you will pay a $335 copay for days 1-7, and no copay for days 8-90. For Inpatient Hospital Psychiatric, you will pay a $335 copay for days 1-6, and no copay for days 7-90. Additional days for Inpatient Hospital-Acute are covered, while Non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute, as well as additional days and non-Medicare-covered stays for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services are covered by the Devoted CHOICE Arizona (PPO) plan, including all outpatient hospital services, observation services, ambulatory surgical center services, outpatient substance abuse services, and outpatient blood services. Outpatient hospital services have a copay between $0 and $435, observation services have a $335 copay, and ambulatory surgical center services have no copay. Individual and group sessions for outpatient substance abuse have a copay of $40. Outpatient blood services include a waived three-pint deductible.
Partial Hospitalization See details
Partial Hospitalization is covered under the Devoted CHOICE Arizona (PPO) plan, and requires prior authorization. The copay for this benefit is $70.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Devoted CHOICE Arizona (PPO) plan, with prior authorization required for all ambulance services. Ground ambulance services have a copay between $0 and $350, while air ambulance services have a 20% coinsurance. 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 under the Devoted CHOICE Arizona (PPO) plan. Emergency Services have a $125 copay, while Urgently Needed Services have a copay between $0 and $45. Worldwide Emergency Transportation has a 20% coinsurance and a $350 copay, while Worldwide Emergency Coverage and Worldwide Urgent Coverage each have a $125 copay.
Primary Care See details
Primary Care benefits include coverage for Primary Care Physician Services, Chiropractic Services, Occupational Therapy Services, Physician Specialist Services, Mental Health Specialty Services, Other Health Care Professional, Psychiatric Services, Physical Therapy and Speech-Language Pathology Services, Additional Telehealth Benefits, and Opioid Treatment Program Services. Chiropractic Services have a $20 copay, Occupational Therapy Services have a copay between $0 and $45, Physician Specialist Services have a copay between $0 and $40, individual and group Mental Health and Psychiatric Sessions have a $40 copay, Other Health Care Professional services have a copay between $0 and $40, Physical Therapy and Speech-Language Pathology Services have a copay between $0 and $65, Additional Telehealth Benefits have a copay between $0 and $40, and Opioid Treatment Program Services have a $40 copay. Routine Chiropractic Care and Podiatry Services are not covered.
Preventive Services See details
The Devoted CHOICE Arizona (PPO) plan covers preventive services, including Medicare-covered services and annual physical exams. Additional services like Health Education, Personal Emergency Response System (PERS), 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 are also covered. However, 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 includes hearing exams with a $30 copay, routine hearing exams (1 per year), and fitting/evaluation for hearing aids. Prescription hearing aids (all types) are covered with a copay between $199 and $499 for up to 2 per year, while prescription hearing aids for inner ear, outer ear, and over the ear are not covered, and OTC hearing aids are not covered.
Vision Services See details
Vision services include eye exams with a $30 copay. Eyewear is covered with a combined maximum benefit of $1000 every year for both in-network and out-of-network services. Contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades are also covered.
Dental Services See details
Dental Services includes coverage for Medicare Dental Services with a $40 copay, and other dental services like oral exams, x-rays, and fluoride treatments, with no copay. Orthodontic Services have a maximum benefit of $1000 per year. 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. Medicare Part B Insulin Drugs have a $35 copay and 20% coinsurance, while Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have between 0% and 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered by the Devoted CHOICE Arizona (PPO) plan, with a coinsurance of 20%.
Medical Equipment See details
Medical equipment, including durable medical equipment (DME), prosthetics, and medical supplies are covered. For DME, there is a coinsurance between 0% and 20%, and for medical supplies, there is a 20% coinsurance. Diabetic equipment is covered, but diabetic supplies and diabetic therapeutic shoes/inserts are not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including Diagnostic Procedures/Tests with a copay between $0 and $95, Lab Services with no copay, Diagnostic Radiological Services with a copay up to $300, Therapeutic Radiological Services with a coinsurance up to 20%, and Outpatient X-Ray Services with no copay. All services require prior authorization.
Home Health Services See details
Home Health Services are covered by the Devoted CHOICE Arizona (PPO) plan with no copay or coinsurance, but authorization is required. However, additional hours of care and personal care services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by the Devoted CHOICE Arizona (PPO) plan, but none of the sub-services are covered. The plan does not specify any cost sharing details.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Devoted CHOICE Arizona (PPO) plan, but require prior authorization. For days 1-20, there is no copay, and for days 21-100, the copay is $214. Additional days beyond Medicare-covered and non-Medicare-covered stays for SNF are not covered.
Other Services See details
Other Services are not covered by the Devoted CHOICE Arizona (PPO) plan, including acupuncture, over-the-counter items, meal benefits, and other services.
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