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DEVOTED CORE 008 PA (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for DEVOTED CORE 008 PA (HMO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on DEVOTED CORE 008 PA (HMO) in 2026, please refer to our full plan details page.
DEVOTED CORE 008 PA (HMO) is a HMO plan offered by Devoted Health, Inc. available for enrollment in 2026 to people living in Eastern Pennsylvania. The overall rating for this plan is not yet available for 2026.
It's important to know that DEVOTED CORE 008 PA (HMO) 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 CORE 008 PA (HMO).
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 CORE 008 PA (HMO), 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 Maximum Out-Of-Pocket cost of $6700.00 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 CORE 008 PA (HMO) Medicare plan features an annual prescription drug deductible of $375. For Tier 1 preferred generic and Tier 2 generic medications, members pay no copay for one-month, two-month, or three-month supplies filled at standard pharmacies or through standard mail order. This provides affordable access to essential everyday medications. Higher-tier medications on this plan require coinsurance instead of flat copayments. Tier 3 preferred brand drugs carry a 19% coinsurance, and Tier 4 non-preferred drugs require a 25% coinsurance for standard pharmacy and mail-order fills. Specialty drugs in Tier 5 incur a 28% coinsurance for a one-month supply.
Additional Benefits
The DEVOTED CORE 008 PA (HMO) plan offers comprehensive medical coverage featuring no copay for primary care visits and preventive services, while specialist visits require a $30 copay. For inpatient hospital stays, members pay a $240 daily copay for initial days and no copay for subsequent days. Emergency room visits carry a $130 copay, which is waived if you are admitted within 24 hours, and urgent care costs range from no copay to $45. This plan also includes key supplemental benefits, such as up to $3,500 in dental coverage with no copay and 0% to 50% coinsurance. Vision services feature no copay for eyewear up to a $400 annual limit, while prescription hearing aids are covered with copays ranging from $399 to $699. Additionally, members receive a $75 allowance every three months for over-the-counter items with no copay or coinsurance.
Inpatient Hospital See details
DEVOTED CORE 008 PA (HMO) covers inpatient hospital care with no coinsurance, requiring prior authorization. Acute stays have a $240 daily copay for days 1 to 6 and no copay for subsequent days, while psychiatric stays require a $240 daily copay for days 1 to 5 and no copay for days 6 to 90; however, upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
DEVOTED CORE 008 PA (HMO) covers outpatient services with no coinsurance, offering ambulatory surgical center and blood services with no copay. Outpatient hospital copays range from $0 to $340, observation services cost a $240 copay per stay, and outpatient substance abuse sessions have a $30 copay, with prior authorization required for most services.
Partial Hospitalization See details
DEVOTED CORE 008 PA (HMO) covers partial hospitalization services with a $60.00 copay and no coinsurance. Prior authorization is required to access this benefit.
Ambulance and Transportation Services See details
Ambulance services are covered by DEVOTED CORE 008 PA (HMO) with prior authorization, requiring no copay to a $315 copay for ground transport and a 20% coinsurance for air transport. Transportation services to health-related locations are not covered.
Emergency Services See details
DEVOTED CORE 008 PA (HMO) covers emergency services with a $130 copay and no coinsurance, with the copay waived if you are admitted to the hospital within 24 hours. Urgently needed services have a copay ranging from no copay to $45 with no coinsurance, and worldwide emergency services are covered up to a $25,000 lifetime limit, featuring a $130 copay for emergency or urgent care and a $315 copay plus 20% coinsurance for emergency transportation.
Primary Care See details
DEVOTED CORE 008 PA (HMO) provides primary care physician visits with no copay and no coinsurance, while specialist, mental health, psychiatric, and opioid treatment services require a $30 copay with no coinsurance. Physical, occupational, and speech therapy services carry a $30 to $50 copay with no coinsurance, telehealth services range from a $0 to $45 copay with no coinsurance, and chiropractic and podiatry services are not covered.
Preventive Services See details
Preventive services are covered by DEVOTED CORE 008 PA (HMO) with no copay and no coinsurance, including annual physical exams, kidney disease education, and diabetes self-management. The benefit is partially covered, excluding in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, readmission prevention, chemotherapy wigs, therapeutic massage, adult day health, palliative care, in-home support, caregiver support, additional smoking cessation counseling, enhanced disease management, telemonitoring, remote access technologies, and counseling.
Hearing Services See details
DEVOTED CORE 008 PA (HMO) covers hearing services, offering one routine hearing exam per year for a $30 copay and no coinsurance, as well as unlimited fitting evaluations. Up to two prescription hearing aids are covered annually with no coinsurance and copays ranging from $399 to $699, though over-the-counter (OTC) hearing aids and inner, outer, or over-the-ear prescription models are not covered.
Vision Services See details
DEVOTED CORE 008 PA (HMO) covers vision services with no deductibles and no coinsurance, offering one routine eye exam per year for a $0 to $30 copay, though other eye exam services are not covered. Eyewear is covered with no copay and no coinsurance up to a $400 annual maximum for contacts, frames, lenses, and upgrades.
Dental Services See details
Dental services are partially covered under the DEVOTED CORE 008 PA (HMO) plan, offering up to $3,500 in annual coverage with no copay and 0% to 50% coinsurance for most preventive and comprehensive services, while Medicare-covered dental requires a $30 copay and no coinsurance. Maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
DEVOTED CORE 008 PA (HMO) covers home infusion bundled services with no copay, although prior authorization is required. Associated Medicare Part B chemotherapy, radiation, and other drugs carry no coinsurance to 20% coinsurance, while Part B insulin has a $35 copay and up to 20% coinsurance.
Dialysis Services See details
DEVOTED CORE 008 PA (HMO) covers dialysis services with no copay and a 20% coinsurance. Prior authorization is required before receiving these services.
Medical Equipment See details
Medical Equipment is partially covered by DEVOTED CORE 008 PA (HMO), featuring no copays for covered items, though prior authorization is required. Durable medical equipment incurs a 20% to 25% coinsurance, prosthetics and medical supplies range from no coinsurance to 20% coinsurance, and diabetic supplies range from no coinsurance to 25% coinsurance, while diabetic therapeutic shoes and inserts are not covered.
Diagnostic and Radiological Services See details
DEVOTED CORE 008 PA (HMO) covers diagnostic and radiological services with prior authorization required. Diagnostic tests and procedures have no coinsurance and a copay ranging from $0 to $95, lab services and outpatient X-rays feature no copay, and therapeutic radiological services require a minimum 20% coinsurance.
Home Health Services See details
DEVOTED CORE 008 PA (HMO) covers Home Health Services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by DEVOTED CORE 008 PA (HMO) with no coinsurance, though prior authorization is required. There is a $30 copay for cardiac, intensive cardiac, and pulmonary rehabilitation services, and a $25 copay for supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) services.
Skilled Nursing Facility (SNF) See details
DEVOTED CORE 008 PA (HMO) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring prior authorization but no prior three-day inpatient hospital stay. You will pay no copay for days 1 through 20 and 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 CORE 008 PA (HMO) partially covers Other Services, offering additional preventive services and Over-the-Counter (OTC) items up to $75 every three months with no copay and no coinsurance. Acupuncture, meal benefits, and other additional services are not covered under this plan.
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