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DEVOTED CHOICE 002 AZ (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for DEVOTED CHOICE 002 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 002 AZ (PPO) in 2026, please refer to our full plan details page.
DEVOTED CHOICE 002 AZ (PPO) is a PPO plan offered by Devoted Health, Inc. available for enrollment in 2025 to people living in Rural Arizona. This plan received an overall rating of 3 out of 5 stars in 2026.
It's important to know that DEVOTED CHOICE 002 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 002 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 002 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 $375.00 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 002 AZ (PPO) Medicare plan features an Enhanced Alternative drug benefit with a $375.00 prescription drug deductible. During the initial coverage phase, you will pay a $5.00 copay for Tier 1 preferred generics, 24% coinsurance for Tier 2 standard generics, 25% coinsurance for Tier 3 preferred brands, and 28% coinsurance for Tier 4 non-preferred drugs at standard pharmacies. Individuals who qualify for the low-income subsidy will also benefit from no cost for their Part D premium. After your yearly out-of-pocket drug costs reach $2,100.00, you enter the catastrophic coverage phase where you will have no copay for covered Medicare Part D prescriptions. While Part D covered drugs cost nothing in this phase, you may still pay a share of the costs for any excluded drugs. Please review the plan's formulary to ensure your specific medications are covered.
Additional Benefits
The DEVOTED CHOICE 002 AZ (PPO) plan offers robust coverage for essential medical services, focusing on fixed copays and no coinsurance for many key benefits. Primary and specialist care visits range from no copay up to $65, while emergency room visits carry a $130 copay that is waived if you are admitted. Inpatient hospital stays require a $335 daily copay for the first week, after which there is no copay for the remainder of a Medicare-covered stay. Supplemental benefits include dental coverage up to a $2,500 annual limit with no copay for comprehensive care, a $200 yearly eyewear allowance, and prescription hearing aids starting at a $399 copay. Members also receive a $40 quarterly allowance for over-the-counter items, no copay for routine preventive services, and no copays for laboratory tests and outpatient X-rays.
Inpatient Hospital See details
Inpatient hospital benefits are partially covered by DEVOTED CHOICE 002 AZ (PPO) with no coinsurance, requiring a $335 daily copay for days 1 to 7 of acute stays (no copay for days 8 to 90) and a $335 daily copay for days 1 to 6 of psychiatric stays (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 002 AZ (PPO) with no coinsurance, featuring a $0 to $435 copay for outpatient hospital services and a $335 copay per stay for observation services. Patients will also pay a $40 copay for outpatient substance abuse sessions, no copay for ambulatory surgical center services, and no deductible for outpatient blood services.
Partial Hospitalization See details
Partial hospitalization benefits are covered by DEVOTED CHOICE 002 AZ (PPO) with a $70 copay and no coinsurance. Prior authorization is required for these services.
Ambulance and Transportation Services See details
Ambulance and transportation services are partially covered by DEVOTED CHOICE 002 AZ (PPO), as transportation services to health-related locations are not covered. Covered ground ambulance services require a copay ranging from no copay to $350 along with coinsurance, while air ambulance services require a 20% coinsurance and a copay.
Emergency Services See details
DEVOTED CHOICE 002 AZ (PPO) 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 have no copay to a $45 copay and no coinsurance, and worldwide emergency services are covered up to a $25,000 maximum benefit with copays up to $350 and up to 20% coinsurance.
Primary Care See details
Primary care benefits are partially covered by DEVOTED CHOICE 002 AZ (PPO), featuring copays ranging from no copay up to $65 and no coinsurance for services like specialist visits, therapy, and telehealth. While most primary care services are covered, podiatry and routine chiropractic care are not covered.
Preventive Services See details
Preventive Services are partially covered by DEVOTED CHOICE 002 AZ (PPO), which offers Medicare-covered zero-dollar preventive services with no copay or coinsurance. While annual physicals, fitness benefits, and health education are covered, several other services are not covered, including in-home safety assessments, personal emergency response systems, therapeutic massage, and counseling.
Hearing Services See details
DEVOTED CHOICE 002 AZ (PPO) offers partially covered hearing services, which include annual routine hearing exams for a $40 copay and fitting evaluations with no copay, both with no coinsurance. Up to two annual prescription hearing aids (all types) are covered with a $399 to $699 copay and no coinsurance, while OTC, inner ear, outer ear, and over the ear hearing aids are not covered.
Vision Services See details
DEVOTED CHOICE 002 AZ (PPO) covers vision services, including annual routine eye exams with copays ranging from no copay to $40 and no coinsurance. The plan also features a $200 annual allowance for eyewear, including contacts, frames, lenses, and upgrades, with no copay, no deductible, and no coinsurance.
Dental Services See details
DEVOTED CHOICE 002 AZ (PPO) partially covers dental services up to a $2,500 annual maximum, excluding maxillofacial prosthetics, implant services, and orthodontics. Medicare-covered dental services require a $40 copay and no coinsurance, while covered comprehensive services like restorative care and endodontics have no copay and 0% to 50% coinsurance.
Home Infusion bundled Services See details
DEVOTED CHOICE 002 AZ (PPO) partially covers home infusion bundled services with prior authorization, as Part D home infusion drugs are not covered. Covered Medicare Part B drugs, including chemotherapy, require no copay and a coinsurance ranging from no coinsurance to 20%, while Part B insulin drugs carry a $35 copay and a coinsurance ranging from no coinsurance to 20%.
Dialysis Services See details
DEVOTED CHOICE 002 AZ (PPO) covers Dialysis Services with a 20% coinsurance and no copay. Prior authorization is required to receive these covered services.
Medical Equipment See details
DEVOTED CHOICE 002 AZ (PPO) covers medical equipment with no copays, though coinsurance ranges from 20% to 50% for durable medical equipment, and from no coinsurance up to 20% for prosthetics and medical supplies. Diabetic equipment is partially covered with no copay and up to 50% coinsurance for diabetic supplies, but diabetic therapeutic shoes and inserts are not covered.
Diagnostic and Radiological Services See details
DEVOTED CHOICE 002 AZ (PPO) covers diagnostic and radiological services, with prior authorization required. Lab services and outpatient X-rays have no copay, while diagnostic procedures cost between $0 and $95, diagnostic radiological services carry a copay of up to $300, and therapeutic radiological services require a 20% coinsurance.
Home Health Services See details
Home Health Services are covered under the DEVOTED CHOICE 002 AZ (PPO) plan, requiring prior authorization, though specific copay and coinsurance details are not specified.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the DEVOTED CHOICE 002 AZ (PPO) plan, as none of the sub-services—including cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation—are covered.
Skilled Nursing Facility (SNF) See details
DEVOTED CHOICE 002 AZ (PPO) partially covers Skilled Nursing Facility (SNF) services, which require prior authorization and feature no copay for days 1 through 20, a $218 daily copay for days 21 through 100, and no coinsurance. Additional days beyond the Medicare-covered limit are not covered.
Other Services See details
DEVOTED CHOICE 002 AZ (PPO) partially covers other services, which includes a $40 allowance every three months for over-the-counter items and coverage for additional preventive services. Acupuncture, meal benefits, and dual-eligible SNP services are not covered under this plan.
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