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DEVOTED C-SNP CHOICE PLUS 006 SC (PPO C-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for DEVOTED C-SNP CHOICE PLUS 006 SC (PPO C-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on DEVOTED C-SNP CHOICE PLUS 006 SC (PPO C-SNP) in 2026, please refer to our full plan details page.
DEVOTED C-SNP CHOICE PLUS 006 SC (PPO C-SNP) is a PPO C-SNP plan offered by Devoted Health, Inc. available for enrollment in 2026 to people living in South Carolina. This plan received an overall rating of 4.5 out of 5 stars in 2026.
It's important to know that DEVOTED C-SNP CHOICE PLUS 006 SC (PPO C-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
DEVOTED C-SNP CHOICE PLUS 006 SC (PPO C-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 C-SNP CHOICE PLUS 006 SC (PPO C-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 C-SNP CHOICE PLUS 006 SC (PPO C-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $35.70. 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 has a $840.00 health deductible. This means, every calendar year, you pay this amount towards covered services before your insurance coverage kicks in.
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 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:
Sign up for DEVOTED C-SNP CHOICE PLUS 006 SC (PPO C-SNP)
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Drug Coverage
The DEVOTED C-SNP CHOICE PLUS 006 SC (PPO C-SNP) Medicare plan has an annual prescription drug deductible of $615. For Tier 6 Select Care Drugs, members enjoy no copay for one-month, two-month, or three-month supplies at standard pharmacies and standard mail order. Tier 1 Preferred Generic drugs carry an $18 copay for a one-month supply, while Tier 2 Generic drugs have a $19 copay for a one-month supply at standard pharmacies and standard mail order. Higher tier prescriptions require coinsurance rather than flat copayments under this plan. Tier 3 Preferred Brand drugs and Tier 5 Specialty Tier drugs both require a 25% coinsurance, while Tier 4 Non-Preferred drugs require a 31% coinsurance for standard pharmacy and standard mail-order fills. Reviewing these cost-sharing details helps you determine if this plan provides the most affordable coverage for your specific prescription needs.
Additional Benefits
The DEVOTED C-SNP CHOICE PLUS 006 SC (PPO C-SNP) plan offers comprehensive medical coverage featuring no copay and no coinsurance for primary care visits and covered preventive care. For inpatient hospital stays, members pay a flat copay of $2,230 per stay for acute care and $2,080 per stay for psychiatric care with no coinsurance. Outpatient services and diagnostic tests require no copays, though some services may carry coinsurance up to 50%. This plan also includes key supplemental benefits, such as dental coverage up to a $4,000 annual maximum with no copay and no coinsurance for most covered services. Additionally, members benefit from no copay for routine eye exams, a $300 annual eyewear allowance, and an over-the-counter allowance of $50 every three months. Prescription hearing aids are covered with copays ranging from $399 to $699 per device.
Inpatient Hospital See details
DEVOTED C-SNP CHOICE PLUS 006 SC (PPO C-SNP) covers inpatient acute hospital stays with a $2,230 copay per stay and no coinsurance, while psychiatric stays require a $2,080 copay per stay and no coinsurance. Both services require prior authorization, and while unlimited additional days are covered for acute stays, additional psychiatric days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Outpatient services under DEVOTED C-SNP CHOICE PLUS 006 SC (PPO C-SNP) are covered with no copays, though prior authorization is required. Outpatient hospital and ambulatory surgical center services feature coinsurance ranging from no coinsurance up to 50%, while outpatient substance abuse and blood services require a 30% coinsurance.
Partial Hospitalization See details
DEVOTED C-SNP CHOICE PLUS 006 SC (PPO C-SNP) covers partial hospitalization services with no copay and a 20% coinsurance. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Ambulance and transportation services under the DEVOTED C-SNP CHOICE PLUS 006 SC (PPO C-SNP) plan feature no copay for ambulance services, with ground ambulance requiring no coinsurance to 50% coinsurance and air ambulance requiring 50% coinsurance, subject to prior authorization. For transportation services, some services are covered, but transportation to plan-approved or any health-related locations is not covered.
Emergency Services See details
Emergency services are covered by DEVOTED C-SNP CHOICE PLUS 006 SC (PPO C-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 20% coinsurance (up to $40 per visit), while worldwide emergency, urgent, and transportation services are covered up to a $25,000 maximum with no copay and no coinsurance.
Primary Care See details
DEVOTED C-SNP CHOICE PLUS 006 SC (PPO C-SNP) covers primary care physician services with no copay and no coinsurance, while specialist, occupational, physical, speech, mental health, psychiatric, and telehealth services have no copay and up to 30% coinsurance. Chiropractic services are partially covered, excluding routine and other chiropractic care, while routine podiatry is covered for up to 4 annual visits with no copay and 30% coinsurance.
Preventive Services See details
Preventive Services under the DEVOTED C-SNP CHOICE PLUS 006 SC (PPO C-SNP) plan are partially covered with no copay and no coinsurance for covered care, including annual physicals, kidney disease education, and fitness benefits. However, several additional services are not covered, such as in-home safety assessments, personal emergency response systems (PERS), therapeutic massage, and in-home support services.
Hearing Services See details
Hearing services are covered by DEVOTED C-SNP CHOICE PLUS 006 SC (PPO C-SNP), featuring one annual routine exam with no copay and 50% coinsurance (prior authorization required), plus unlimited fitting evaluations. Prescription hearing aids are partially covered with no coinsurance and a $399 to $699 copay for up to two devices per year, excluding OTC, inner ear, outer ear, and over-the-ear models.
Vision Services See details
DEVOTED C-SNP CHOICE PLUS 006 SC (PPO C-SNP) covers vision services, featuring one routine eye exam per year with no copay and 0% to 50% coinsurance, though other eye exam services are not covered. Eyewear is also covered with no copay, no coinsurance, and a $300 combined annual maximum allowance for contacts, frames, lenses, and upgrades.
Dental Services See details
DEVOTED C-SNP CHOICE PLUS 006 SC (PPO C-SNP) offers partially covered dental services, featuring no copay and a 30% coinsurance for Medicare-covered dental, and no copay and no coinsurance for other covered dental services up to a $4,000 annual maximum. Specific sub-services that are not covered include other diagnostic dental, other preventive dental, maxillofacial prosthetics, implant services, and orthodontics.
Home Infusion bundled Services See details
DEVOTED C-SNP CHOICE PLUS 006 SC (PPO C-SNP) covers Home Infusion bundled Services with no copay, although prior authorization is required. Medicare Part B chemotherapy, radiation, and other drugs carry a coinsurance ranging from no coinsurance to 20%, while Part B insulin drugs require a $35 copay and a coinsurance of no coinsurance to 20%.
Dialysis Services See details
DEVOTED C-SNP CHOICE PLUS 006 SC (PPO C-SNP) covers dialysis services with no copay and a 20% coinsurance. Prior authorization is required for these covered services.
Medical Equipment See details
DEVOTED C-SNP CHOICE PLUS 006 SC (PPO C-SNP) partially covers medical equipment with no copay, though prior authorization is required. Durable medical equipment and diabetic supplies require a 20% coinsurance, while prosthetic devices and medical supplies range from no coinsurance to 20% coinsurance, but diabetic therapeutic shoes and inserts are not covered.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by DEVOTED C-SNP CHOICE PLUS 006 SC (PPO C-SNP) with prior authorization required and no copays. Diagnostic procedures and tests have no coinsurance, while you will pay a 50% coinsurance for lab services, diagnostic radiological services, and outpatient X-rays, and a 20% coinsurance for therapeutic radiological services.
Home Health Services See details
DEVOTED C-SNP CHOICE PLUS 006 SC (PPO C-SNP) covers home health services with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by DEVOTED C-SNP CHOICE PLUS 006 SC (PPO C-SNP) with no copay, though prior authorization is required. While some services are covered, standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) services are not covered and require a 30% coinsurance.
Skilled Nursing Facility (SNF) See details
DEVOTED C-SNP CHOICE PLUS 006 SC (PPO C-SNP) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring prior authorization but no prior three-day hospital stay. There is no copay for days 1 through 20, a $218 copay per day for days 21 through 100, and additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Other services are partially covered by DEVOTED C-SNP CHOICE PLUS 006 SC (PPO C-SNP), offering over-the-counter (OTC) items up to $50 every three months, non-Medicare covered diabetic shoes, and additional preventive services with no copay and no coinsurance. Acupuncture, meal benefits, and dual-eligible SNP services are not covered under this plan.
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