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DEVOTED CHOICE MA ONLY 006 TX (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for DEVOTED CHOICE MA ONLY 006 TX (PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on DEVOTED CHOICE MA ONLY 006 TX (PPO) in 2026, please refer to our full plan details page.
DEVOTED CHOICE MA ONLY 006 TX (PPO) is a PPO plan offered by Devoted Health, Inc. available for enrollment in 2025 to people living in Austin. This plan received an overall rating of 3.5 out of 5 stars in 2026.
It's important to know that DEVOTED CHOICE MA ONLY 006 TX (PPO) is a Medicare Advantage (MA) Plan without drug coverage. That means that this plan covers medical services but doesn't cover prescription drugs. If you are looking for a plan with prescription drug coverage, please search for other MA and PDP plans offered in your area.
Key Plan Facts
Below are a few key facts and commonly-asked questions about DEVOTED CHOICE MA ONLY 006 TX (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 MA ONLY 006 TX (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. Additionally, this plan comes with a Part B Premium reduction of $158.00. You must continue to pay paying your reduced Part B Premium.
Deductibles
This plan does not have a health deductible. Your insurance coverage on covered health services will start immediately.
Drugs are not covered by this plan, so a prescription drug deductible is not applicable.
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
Prescription drugs are not covered by DEVOTED CHOICE MA ONLY 006 TX (PPO).
Additional Benefits
The DEVOTED CHOICE MA ONLY 006 TX (PPO) plan offers comprehensive medical coverage with no copay for primary care visits, preventive services, and home health care. For specialized care, members pay a $45 copay for specialist visits, while inpatient hospital stays require a $425 daily copay for the first four days and no copay for days five through ninety. Emergency room visits carry a $115 copay, which is waived if you are admitted, and urgently needed care ranges from no copay to a $40 copay. Supplemental benefits include dental coverage up to a $1,000 annual limit with no copay for preventive care and up to 50% coinsurance for restorative services. Vision care features a $400 annual eyewear allowance and routine exams with a copay up to $45, while hearing benefits cover routine exams for a $45 copay and prescription hearing aids with copays starting at $599. Skilled nursing facility stays require no copay for the first 20 days, and diagnostic lab work and outpatient X-rays are also covered with no copay.
Inpatient Hospital See details
DEVOTED CHOICE MA ONLY 006 TX (PPO) covers inpatient hospital services with no coinsurance, requiring a copay of $425 per day for days 1 to 4 and no copay for days 5 to 90 per stay. This benefit is partially covered, as upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
DEVOTED CHOICE MA ONLY 006 TX (PPO) covers outpatient services with no coinsurance, offering ambulatory surgical center and blood services with no copay. Outpatient hospital services carry a copay of $0 to $525, while observation services cost a $425 copay per stay and outpatient substance abuse sessions have a $45 copay.
Partial Hospitalization See details
Partial hospitalization is covered by DEVOTED CHOICE MA ONLY 006 TX (PPO) with a $70.00 copay and no coinsurance. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered by DEVOTED CHOICE MA ONLY 006 TX (PPO), featuring ground ambulance services with prior authorization and a copay ranging from no copay to $350 (with no coinsurance). Air ambulance services require prior authorization and have a 20% coinsurance with no copay, and while some transportation services are covered, trips to plan-approved or any health-related locations are not covered.
Emergency Services See details
DEVOTED CHOICE MA ONLY 006 TX (PPO) covers emergency services with a $115 copay and no coinsurance, with the copay waived if you are admitted to the hospital within 24 hours. Urgently needed services range from no copay to a $40 copay with no coinsurance, while worldwide emergency services are covered up to $25,000 with copays up to $350 and 20% coinsurance for emergency transportation.
Primary Care See details
Primary care physician services are covered by DEVOTED CHOICE MA ONLY 006 TX (PPO) with no copay and no coinsurance, while specialist visits require a $45 copay and no coinsurance. Other covered benefits include occupational therapy ($35 copay) and physical/speech therapy ($45 to $50 copay) with no coinsurance. Some chiropractic services are covered, but routine and other chiropractic services are not covered, and podiatry services are not covered.
Preventive Services See details
Preventive services are covered by DEVOTED CHOICE MA ONLY 006 TX (PPO) with no copay and no coinsurance, including annual physical exams, kidney disease education, and select supplemental wellness programs. This benefit is partially covered, as specific services like in-home safety assessments, personal emergency response systems, therapeutic massage, and medical nutrition therapy are not covered.
Hearing Services See details
Hearing services are partially covered by DEVOTED CHOICE MA ONLY 006 TX (PPO), excluding OTC hearing aids and inner ear, outer ear, or over the ear prescription hearing aids. Covered benefits include one routine hearing exam per year for a $45 copay and no coinsurance, alongside up to two prescription hearing aids per year with a copay ranging from $599 to $899 and no coinsurance.
Vision Services See details
Vision services are partially covered by DEVOTED CHOICE MA ONLY 006 TX (PPO), offering one annual routine eye exam with a $0 to $45 copay and no coinsurance, while other eye exam services are not covered. Eyewear is covered with no copay or coinsurance up to a $400 combined annual maximum for contacts, eyeglasses, frames, and upgrades.
Dental Services See details
DEVOTED CHOICE MA ONLY 006 TX (PPO) offers partially covered dental services with a $1,000 annual maximum benefit, featuring no copay and no coinsurance for preventive care, diagnostics, periodontics, and oral surgery. Restorative care, endodontics, and prosthodontics are covered with no copay and 0% to 50% coinsurance, while Medicare-covered dental services require a $45 copay with no coinsurance. Maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
DEVOTED CHOICE MA ONLY 006 TX (PPO) covers home infusion bundled services with no copay, though prior authorization and step therapy are required. Associated Medicare Part B chemotherapy, radiation, and other drugs require no copay with coinsurance ranging from no coinsurance up to 20%, while Part B insulin drugs carry a $35 copay and up to 20% coinsurance.
Dialysis Services See details
DEVOTED CHOICE MA ONLY 006 TX (PPO) covers dialysis services with no copay and a 20% coinsurance. Prior authorization is required to receive these covered services.
Medical Equipment See details
DEVOTED CHOICE MA ONLY 006 TX (PPO) medical equipment benefits are partially covered with no copays, though prior authorization is required for these services. Durable medical equipment requires a 15% coinsurance, prosthetics and medical supplies range from no coinsurance to 20% coinsurance, and diabetic supplies range from no coinsurance to 15% coinsurance, while diabetic therapeutic shoes and inserts are not covered.
Diagnostic and Radiological Services See details
DEVOTED CHOICE MA ONLY 006 TX (PPO) covers diagnostic services with no coinsurance, featuring no copay for lab services and copays ranging from $0 to $95 for diagnostic procedures. Covered radiological services require prior authorization, offering no copay for outpatient X-rays, copays starting at $0 for diagnostic radiology, and a 20% coinsurance for therapeutic radiology.
Home Health Services See details
Home Health Services are covered by DEVOTED CHOICE MA ONLY 006 TX (PPO) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are offered by DEVOTED CHOICE MA ONLY 006 TX (PPO) with no coinsurance and require prior authorization, though some services are covered while standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) services are not covered.
Skilled Nursing Facility (SNF) See details
DEVOTED CHOICE MA ONLY 006 TX (PPO) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring prior authorization but no prior three-day inpatient hospital stay. There is no copay for days 1 through 20, followed by a $218 daily copay for days 21 through 100, though additional days beyond the Medicare-covered limit are not covered.
Other Services See details
DEVOTED CHOICE MA ONLY 006 TX (PPO) other services are partially covered, offering additional preventive services not covered by Medicare with no copay and no coinsurance. Acupuncture, over-the-counter (OTC) items, and meal benefits are not covered under this plan.
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