A non-government entity
DEVOTED CHOICE 001 AZ (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for DEVOTED CHOICE 001 AZ (PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on DEVOTED CHOICE 001 AZ (PPO) in 2026, please refer to our full plan details page.
DEVOTED CHOICE 001 AZ (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 2026.
It's important to know that DEVOTED CHOICE 001 AZ (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 001 AZ (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 001 AZ (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 $595.00 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:
Sign up for DEVOTED CHOICE 001 AZ (PPO)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
Drug Coverage
The DEVOTED CHOICE 001 AZ (PPO) Medicare plan features an annual prescription drug deductible of $595.00. During the initial coverage phase, you will enjoy no copay for Tier 1 preferred generic drugs filled at standard pharmacies or through standard mail. For other tiers, you will pay a 24% coinsurance for Tier 2 standard generic drugs and a 25% coinsurance for Tier 3 preferred brand and Tier 4 non-preferred drugs. These cost-sharing rates apply until your yearly out-of-pocket drug costs reach $2,100.00. Once you reach this milestone, you enter the catastrophic coverage phase and will pay nothing for Medicare Part D covered drugs.
Additional Benefits
The DEVOTED CHOICE 001 AZ (PPO) plan offers balanced coverage for essential medical needs with predictable cost-sharing and no coinsurance for many core services. Inpatient hospital stays require a $335 daily copay for the first several days followed by no copay, while primary care and specialist visits range from no copay up to a $65 copay. Emergency care is available with a $130 copay, and ambulatory surgical center services are provided with no copay. For supplemental care, the plan features a $1,500 annual dental benefit with no copay for preventive services and a $150 annual eyewear allowance with no copay or deductible. Routine hearing exams require a $40 copay, and skilled nursing facility stays have no copay for the first 20 days. Additionally, members receive a $30 quarterly allowance for over-the-counter items, though some benefits like cardiac rehabilitation and transportation are not covered.
Inpatient Hospital See details
Inpatient Hospital benefits are partially covered under DEVOTED CHOICE 001 AZ (PPO), requiring no coinsurance for covered stays. Acute hospitalizations require a $335 copay for days 1 to 7 and no copay for days 8 to 90, while psychiatric stays require a $335 copay for days 1 to 6 and no copay for days 7 to 90. Upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Outpatient services are covered by DEVOTED CHOICE 001 AZ (PPO) with no coinsurance, although prior authorization is required for most treatments. Patients will pay no copay for ambulatory surgical center services, a $0 to $435 copay for outpatient hospital services, $335 per stay for observation services, and a $40 copay for outpatient substance abuse sessions.
Partial Hospitalization See details
DEVOTED CHOICE 001 AZ (PPO) covers partial hospitalization benefits with a $70.00 copay and no coinsurance. Prior authorization is required for these covered services.
Ambulance and Transportation Services See details
Ambulance and transportation services are partially covered by DEVOTED CHOICE 001 AZ (PPO), as transportation services to health-related locations are not covered. Ground ambulance services feature a copay ranging from no copay to $350 plus coinsurance, while air ambulance services require a 20% coinsurance plus a copay.
Emergency Services See details
Emergency services under DEVOTED CHOICE 001 AZ (PPO) are covered with a $130 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services require no copay to a $45 copay and no coinsurance, while worldwide emergency care is covered up to $25,000 with copays up to $350 and up to 20% coinsurance.
Primary Care See details
Primary Care benefits are partially covered by DEVOTED CHOICE 001 AZ (PPO) with no coinsurance, though podiatry and routine chiropractic care are not covered. Covered services require copayments ranging from no copay up to $65, including a $40 copay for specialist visits and mental health sessions.
Preventive Services See details
DEVOTED CHOICE 001 AZ (PPO) partially covers preventive services, featuring no copay and no coinsurance for Medicare-covered zero-dollar preventive services and annual physical exams. The plan does not cover sub-services such as in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, chemotherapy-related wigs, therapeutic massage, adult day health, palliative care, in-home support, caregiver support, additional smoking cessation counseling, disease management, telemonitoring, remote access technologies, and counseling services.
Hearing Services See details
DEVOTED CHOICE 001 AZ (PPO) partially covers hearing services, featuring a $40 copay and no coinsurance for routine exams, and a $399 to $699 copay with no coinsurance for up to two annual prescription hearing aids. OTC hearing aids and prescription hearing aids for the inner ear, outer ear, and over the ear are not covered.
Vision Services See details
DEVOTED CHOICE 001 AZ (PPO) covers vision services, including one routine eye exam every year with a copay ranging from no copay to $40 and no coinsurance. Additionally, the plan provides a $150 combined annual maximum benefit for eyewear, including contacts and eyeglasses, with no deductible, no copay, and no coinsurance.
Dental Services See details
Dental services are partially covered by DEVOTED CHOICE 001 AZ (PPO), offering up to a $1,500 annual maximum benefit for combined in-network and out-of-network care. Medicare-covered dental services require a $40 copay and no coinsurance, preventive services have no copays or coinsurance, and other comprehensive services range from no coinsurance to 50% coinsurance; however, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
DEVOTED CHOICE 001 AZ (PPO) covers home infusion bundled services, requiring prior authorization and step therapy for certain treatments. Medicare Part B insulin drugs require a $35 copay and no coinsurance to 20% coinsurance, while chemotherapy, radiation, and other Part B drugs feature no copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
DEVOTED CHOICE 001 AZ (PPO) covers Dialysis Services with a 20% coinsurance and no copay, though prior authorization is required.
Medical Equipment See details
DEVOTED CHOICE 001 AZ (PPO) partially covers medical equipment with no copays, though prior authorization is required. Durable medical equipment requires 20% to 50% coinsurance, prosthetic devices and medical supplies carry up to 20% coinsurance, and diabetic supplies carry up to 50% coinsurance, while diabetic therapeutic shoes and inserts are not covered.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by DEVOTED CHOICE 001 AZ (PPO) with prior authorization required. Lab services and outpatient X-rays feature no copay and no coinsurance, diagnostic procedures require a $0 to $95 copay with no coinsurance, diagnostic radiology costs a $0 to $300 copay with no coinsurance, and therapeutic radiology has a 20% coinsurance with no copay.
Home Health Services See details
Home Health Services are covered under the DEVOTED CHOICE 001 AZ (PPO) plan, though prior authorization is required to receive these services. Specific copay and coinsurance cost-sharing details are not specified for this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the DEVOTED CHOICE 001 AZ (PPO) plan, as none of the sub-services—including intensive cardiac, pulmonary, and SET for PAD rehabilitation—are covered in practice.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are partially covered by DEVOTED CHOICE 001 AZ (PPO), as additional days beyond the Medicare-covered limit are not covered. Covered stays require prior authorization and feature no copay or coinsurance for days 1 through 20, followed by a $218 daily copay and no coinsurance for days 21 through 100.
Other Services See details
Other Services are partially covered by DEVOTED CHOICE 001 AZ (PPO), featuring a $30 quarterly allowance for over-the-counter (OTC) items and coverage for additional preventive services with no copay or coinsurance. Acupuncture, meal benefits, and Dual Eligible SNPs are not covered under this plan.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
*/SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
MedicareAdvantageRX.com is owned and operated by Dog Media Solutions LLC.
This is a promotional communication.
Every year, Medicare evaluates plans based on a 5-star rating system.
Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
Enrollment in Medicare/Medicare Advantage may be limited to certain times of the year unless you qualify for a Special Enrollment Period
We do not offer every plan available in your area. Currently, we represent 18 organizations, which offer 52,101 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
We represent Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan's contract renewal.
Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.
Please contact Medicare.gov ,1-800-MEDICARE , or your local State Health Insurance Program (SHIP) to get information on all of your options.
Medicare has neither approved nor endorsed any information on this site.
Speak with a licensed insurance agent: 1-877-649-2073 / TTY 711 | 8am - 11pm ET | 7 days a week
© 2023 Dog Media Solutions LLC. All rights reserved