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Devoted DUAL PLUS Pennsylvania (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Devoted DUAL PLUS Pennsylvania (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 Pennsylvania (HMO D-SNP) in 2025, please refer to our full plan details page.
Devoted DUAL PLUS Pennsylvania (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 2025.
It's important to know that Devoted DUAL PLUS Pennsylvania (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 Pennsylvania (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 Pennsylvania (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 Pennsylvania (HMO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $31.00. 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 Maximum Out-Of-Pocket cost of $9350.00 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 Pennsylvania (HMO D-SNP) plan has a $590 deductible for prescription drugs. After meeting the deductible, your cost-sharing will vary depending on the specific drug and pharmacy. If you qualify for the low-income subsidy (LIS), your Part D premium will be $31.00. Once your total drug costs reach $2000.00, you enter the catastrophic coverage phase where you will pay nothing for covered drugs.
Additional Benefits
The Devoted DUAL PLUS Pennsylvania (HMO D-SNP) plan offers a range of benefits, including inpatient and outpatient hospital services, with varying cost-sharing like coinsurance. Emergency and urgently needed services have copays or coinsurance, while primary care, preventive services, and home health services have no copay. Additional benefits include coverage for hearing, vision, and dental services, with specific copays and maximum annual benefits. The plan also covers services like home infusion, dialysis, and medical equipment with coinsurance, and skilled nursing facility stays with copays for some days.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, with a copay of $1700 per admission or stay. Additional days for Inpatient Hospital-Acute are covered with no limit, while Non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute, and Additional Days and Non-Medicare-covered stays for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services are covered, including all outpatient hospital services, observation services, ambulatory surgical center (ASC) services, outpatient substance abuse services, and outpatient blood services. Outpatient hospital services have a 35% - 40% coinsurance, while observation services have a 35% coinsurance. Ambulatory Surgical Center (ASC) Services, Individual Sessions for Outpatient Substance Abuse, and Group Sessions for Outpatient Substance Abuse services have a 35% - 40% coinsurance.
Partial Hospitalization See details
Partial Hospitalization is covered by Devoted DUAL PLUS Pennsylvania (HMO D-SNP), but requires prior authorization. You will pay 35% coinsurance for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Devoted DUAL PLUS Pennsylvania (HMO D-SNP) plan. Ground ambulance services have a coinsurance of 0% - 35%, while air ambulance services have a 35% coinsurance; there is no copay for ambulance services. 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 DUAL PLUS Pennsylvania (HMO D-SNP) plan. Emergency Services have a $110 copay, while Urgently Needed Services have 35% coinsurance.
Primary Care See details
Primary Care Physician Services, Occupational Therapy Services, Physician Specialist Services, Physical Therapy and Speech-Language Pathology Services, Opioid Treatment Program Services, and Additional Telehealth Benefits are covered with no copay and no coinsurance. Chiropractic Services are partially covered, excluding routine chiropractic care, and Mental Health and Psychiatric Services are partially covered, excluding individual and group sessions. Podiatry Services are not covered.
Preventive Services See details
Preventive Services, including Medicare-covered services, annual physical exams, and additional services like health education, are covered. Some services, such as in-home safety assessments, personal emergency response systems, and counseling services, are not covered.
Hearing Services See details
Hearing Services include hearing exams, and prescription hearing aids. Routine hearing exams have a coinsurance of 35%, and fitting/evaluation for hearing aids is covered, while prescription hearing aids have a copay between $0 and $299. Some services, such as prescription hearing aids - inner ear, outer ear, and over the ear, and OTC hearing aids, are not covered.
Vision Services See details
Vision services include coverage for eye exams with a 35% coinsurance, as well as eyewear benefits, including contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades. The plan offers a combined maximum benefit of $500.00 per year for all eyewear.
Dental Services See details
The Devoted DUAL PLUS Pennsylvania (HMO D-SNP) plan covers a range of dental services, including oral exams, X-rays, and cleanings, with a maximum annual benefit of $500. Orthodontic services are covered under Diagnostic and Preventive Dental, while maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, but prior authorization is required. You will pay a $35 copay for Medicare Part B Insulin Drugs, with 20% coinsurance. Other Medicare Part B drugs have between 0% and 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered by the Devoted DUAL PLUS Pennsylvania (HMO D-SNP) plan. The coinsurance is 20%.
Medical Equipment See details
Medical Equipment is covered, including Durable Medical Equipment (DME) with 0-18% coinsurance and no copay, Prosthetics/Medical Supplies with 20% coinsurance and no copay, and Diabetic Equipment with coinsurance, although Durable Medical Equipment for use outside the home and Diabetic Therapeutic Shoes/Inserts are not covered. Diabetic Supplies have a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered under the Devoted DUAL PLUS Pennsylvania (HMO D-SNP) plan. Diagnostic Procedures/Tests and Lab Services have a coinsurance of up to 35%, while Therapeutic Radiological Services have a coinsurance of up to 20%, and Diagnostic Radiological Services and Outpatient X-Ray Services have a coinsurance of at most 35%.
Home Health Services See details
Home Health Services are covered by the Devoted DUAL PLUS Pennsylvania (HMO D-SNP) plan with no copay and no coinsurance, though authorization is required. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are technically covered, but the plan does not cover Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, or SET for PAD Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Devoted DUAL PLUS Pennsylvania (HMO D-SNP) plan, but require prior authorization. For days 1-20 and 61-100, there is no copay, while days 21-60 have a $214 copay; there is no coinsurance. Additional days beyond Medicare-covered, and non-Medicare-covered stays are not covered.
Other Services See details
The Devoted DUAL PLUS Pennsylvania (HMO D-SNP) plan does not cover acupuncture, over-the-counter items, or meal benefits. Additional "Other Services" are covered, including preventive services with no copay.
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