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DEVOTED DUAL PLUS 007 PA (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for DEVOTED DUAL PLUS 007 PA (HMO D-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on DEVOTED DUAL PLUS 007 PA (HMO D-SNP) in 2026, please refer to our full plan details page.
DEVOTED DUAL PLUS 007 PA (HMO D-SNP) is a HMO D-SNP plan offered by Devoted Health, Inc. available for enrollment in 2025 to people living in Philadelphia Area. This plan received an overall rating of 4 out of 5 stars in 2026.
It's important to know that DEVOTED DUAL PLUS 007 PA (HMO D-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
DEVOTED DUAL PLUS 007 PA (HMO D-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 DUAL PLUS 007 PA (HMO D-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 DUAL PLUS 007 PA (HMO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $16.90. 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 Maximum Out-Of-Pocket cost of $9250.00 for out-of-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $0.00 for in-network covered services, the plan will pay 100% of in-network covered costs for the rest of the year.
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 DUAL PLUS 007 PA (HMO D-SNP) Medicare plan features an annual drug deductible of $615. For prescription drugs in Tiers 1 through 4, as well as a 1-month supply of Tier 5 specialty drugs, you will pay a 25% coinsurance at standard pharmacies and standard mail order. For Tier 6 select care drugs, the plan offers no copay for 1-month, 2-month, and 3-month supplies at standard pharmacies and standard mail order. This coverage structure helps beneficiaries manage their out-of-pocket medication costs when choosing standard pharmacy or mail order services.
Additional Benefits
The DEVOTED DUAL PLUS 007 PA (HMO D-SNP) plan offers comprehensive coverage that minimizes out-of-pocket costs for essential medical care, featuring no copay and no coinsurance for primary care and routine preventive visits. For inpatient hospital stays, members face a set copay of either $2,230 for acute care or $2,080 for psychiatric care with no coinsurance. Skilled nursing facility care is also highly affordable, requiring no coinsurance and no copay for the first 20 days of a stay. This plan also provides robust supplemental benefits, including up to $2,500 annually for preventive and comprehensive dental care with no copay and no coinsurance. Members can take advantage of a $400 yearly allowance for eyewear with no copay, alongside routine hearing exams and affordable hearing aid coverage. Additionally, many outpatient, home health, and medical equipment services feature no copay, though varying coinsurance rates or prior authorizations may apply.
Inpatient Hospital See details
DEVOTED DUAL PLUS 007 PA (HMO D-SNP) inpatient hospital benefits are partially covered with no coinsurance, requiring prior authorization. Acute stays require a $2,230 copay per stay with unlimited additional days, and psychiatric stays require a $2,080 copay per stay, but upgrades and non-Medicare-covered stays are not covered.
Outpatient Services See details
DEVOTED DUAL PLUS 007 PA (HMO D-SNP) covers outpatient services with no copay, though prior authorization is required for most services. Patients will pay no coinsurance to 40% coinsurance for outpatient hospital and ambulatory surgical center services, and 30% coinsurance for outpatient substance abuse and blood services.
Partial Hospitalization See details
DEVOTED DUAL PLUS 007 PA (HMO D-SNP) covers partial hospitalization services with no copay and a 30% coinsurance. Prior authorization is required to access this benefit.
Ambulance and Transportation Services See details
DEVOTED DUAL PLUS 007 PA (HMO D-SNP) covers ambulance services with no copay, requiring a 0% to 40% coinsurance for ground transport and a 40% coinsurance for air transport, with prior authorization required. Transportation services to plan-approved or other health-related locations are not covered.
Emergency Services See details
Emergency services are covered by DEVOTED DUAL PLUS 007 PA (HMO D-SNP) with a $115 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services require no copay and a 0% to 30% coinsurance (up to a $40 maximum), while worldwide emergency, urgent, and transportation services are covered with no copay and no coinsurance up to a $25,000 lifetime limit.
Primary Care See details
DEVOTED DUAL PLUS 007 PA (HMO D-SNP) primary care benefits feature no copay and no coinsurance for primary care provider visits, while specialists, mental health, psychiatric, opioid treatment, and physical, occupational, and speech therapies have no copay and 30% coinsurance. Telehealth and other healthcare professional services require no copay with 0% to 30% coinsurance, though podiatry and chiropractic services are not covered.
Preventive Services See details
DEVOTED DUAL PLUS 007 PA (HMO D-SNP) preventive services are partially covered with no copay and no coinsurance for annual physical exams, fitness benefits, and alternative therapies. However, several sub-services are not covered under this plan, including personal emergency response systems, in-home support, therapeutic massage, and medical nutrition therapy.
Hearing Services See details
DEVOTED DUAL PLUS 007 PA (HMO D-SNP) partially covers hearing services, providing routine hearing exams with no copay and a 40% coinsurance, and fitting evaluations with no copay or coinsurance. Up to two prescription hearing aids are covered annually with no coinsurance and a copay ranging from $0 to $299, while OTC hearing aids and inner-ear, outer-ear, and over-the-ear prescription models are not covered.
Vision Services See details
Vision Services are partially covered by DEVOTED DUAL PLUS 007 PA (HMO D-SNP), offering one annual routine eye exam with no copay, no deductible, and 0% to 40% coinsurance, while other eye exam services are not covered. Eyewear is also covered with no copay, no deductible, and no coinsurance, up to a $400 yearly maximum for contacts, frames, lenses, and upgrades.
Dental Services See details
DEVOTED DUAL PLUS 007 PA (HMO D-SNP) partially covers dental services, offering up to $2,500 annually for preventive and comprehensive care with no copay and no coinsurance, though Medicare-covered dental services require a 30% coinsurance and no copay. This plan does not cover other diagnostic services, other preventive services, maxillofacial prosthetics, implants, and orthodontics.
Home Infusion bundled Services See details
Home infusion bundled services are covered by DEVOTED DUAL PLUS 007 PA (HMO D-SNP) with no copay, though prior authorization is required. Covered Medicare Part B chemotherapy, radiation, and other drugs have no copay and 0% to 20% coinsurance, while Medicare Part B insulin drugs require a $35 copay and 0% to 20% coinsurance.
Dialysis Services See details
DEVOTED DUAL PLUS 007 PA (HMO D-SNP) covers Dialysis Services with no copay and 20% coinsurance, though prior authorization is required.
Medical Equipment See details
DEVOTED DUAL PLUS 007 PA (HMO D-SNP) covers medical equipment, including durable medical equipment, prosthetics, and diabetic supplies, with no copays and prior authorization required. While there is no copay, a coinsurance of 20% applies to durable medical equipment and diabetic supplies, and coinsurance for prosthetics and medical supplies ranges from no coinsurance up to 20%.
Diagnostic and Radiological Services See details
DEVOTED DUAL PLUS 007 PA (HMO D-SNP) covers diagnostic and radiological services with prior authorization and no copays. Patients pay no coinsurance for diagnostic procedures and tests, but face a 40% coinsurance for lab services, 30% coinsurance for diagnostic radiological and outpatient X-ray services, and 20% coinsurance for therapeutic radiological services.
Home Health Services See details
Home Health Services are covered by DEVOTED DUAL PLUS 007 PA (HMO D-SNP) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are offered by DEVOTED DUAL PLUS 007 PA (HMO D-SNP) with no copay and prior authorization required, meaning some services are covered. However, standard cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for peripheral artery disease (PAD) services are not covered and require a 30% coinsurance.
Skilled Nursing Facility (SNF) See details
DEVOTED DUAL PLUS 007 PA (HMO D-SNP) covers Skilled Nursing Facility (SNF) services with no coinsurance, featuring no copay for days 1 to 20 and a $218 copay for days 21 to 100. Prior authorization is required, a 3-day prior hospital stay is not required, and additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
DEVOTED DUAL PLUS 007 PA (HMO D-SNP) partially covers other services with no copay and no coinsurance, which includes additional non-Medicare preventive services and over-the-counter (OTC) items up to $50 every three months. Acupuncture, meal benefits, and other select services are not covered under this plan.
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