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DEVOTED CORE 001 CO (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for DEVOTED CORE 001 CO (HMO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on DEVOTED CORE 001 CO (HMO) in 2026, please refer to our full plan details page.
DEVOTED CORE 001 CO (HMO) is a HMO plan offered by Devoted Health, Inc. available for enrollment in 2025 to people living in Greater Colorado. This plan received an overall rating of 4 out of 5 stars in 2026.
It's important to know that DEVOTED CORE 001 CO (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 001 CO (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 001 CO (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 $4900.00 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 001 CO (HMO) prescription drug plan features an annual drug deductible of $375. Under this plan, Tier 1 preferred generic drugs have no copay for one-, two-, or three-month supplies at standard pharmacies and standard mail order. Tier 2 generic drugs require a low copay starting at $5.00 for a one-month supply, with a three-month supply costing $15.00 at standard pharmacies or a discounted $12.50 through standard mail order. For brand-name and specialty medications, your cost-sharing is based on coinsurance rather than flat copays. Tier 3 preferred brands require a 24% coinsurance, and Tier 4 non-preferred drugs carry a 25% coinsurance for standard pharmacy and mail-order fills. Tier 5 specialty drugs are covered at a 28% coinsurance for a one-month supply at standard pharmacies and standard mail order.
Additional Benefits
The DEVOTED CORE 001 CO (HMO) plan offers comprehensive health coverage with no copay and no coinsurance for primary care, preventive care, and home health services. For inpatient hospital stays, members pay a $225 daily copay for the first six days and no copay for the remaining days, with no coinsurance. Emergency room visits require a $130 copay, while specialist visits and routine eye exams feature copays up to $50 and $35 respectively with no coinsurance. Dental benefits are covered up to a $3,500 annual limit with no copay and coinsurance up to 50% for most services. Durable medical equipment and dialysis services also feature no copay, though coinsurance ranges from 20% to 50%. Additionally, the plan includes a quarterly $100 allowance for over-the-counter items with no copay or coinsurance.
Inpatient Hospital See details
DEVOTED CORE 001 CO (HMO) covers inpatient hospital services with no coinsurance, requiring a $225 daily copay for days 1 through 6 and no copay for days 7 through 90. This benefit is partially covered, as upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
DEVOTED CORE 001 CO (HMO) outpatient services are covered with no coinsurance, featuring no copay for ambulatory surgical center and blood services. Patients will pay a copay of $0 to $325 for outpatient hospital services, $225 per stay for observation services, and $35 per session for outpatient substance abuse services.
Partial Hospitalization See details
DEVOTED CORE 001 CO (HMO) covers partial hospitalization services with a $60.00 copay and no coinsurance. Prior authorization is required for this covered benefit.
Ambulance and Transportation Services See details
DEVOTED CORE 001 CO (HMO) covers prior-authorized ground ambulance services with no coinsurance and a copay ranging from no copay to $270, and air ambulance services with no coinsurance and a $290 copay. Transportation services to health-related locations are not covered under this plan.
Emergency Services See details
DEVOTED CORE 001 CO (HMO) covers emergency services with a $130 copay, which is waived if admitted within 24 hours, and no coinsurance. Urgently needed services have a copay ranging from no copay to $45 with no coinsurance, and worldwide emergency services are covered up to $25,000 with no coinsurance and copays ranging from $130 to $290.
Primary Care See details
DEVOTED CORE 001 CO (HMO) primary care benefits are partially covered, featuring no copay and no coinsurance for primary care physician visits. Other covered services like specialists, therapy, and mental health care have copays ranging from $0 to $50 with no coinsurance, while podiatry and non-routine chiropractic services are not covered.
Preventive Services See details
Preventive services are covered by DEVOTED CORE 001 CO (HMO) with no copay and no coinsurance for annual physical exams, kidney disease education, and screenings. Additional preventive benefits are partially covered with no copay, though alternative therapies and therapeutic massage require up to 50% coinsurance, and services such as personal emergency response systems (PERS), counseling, and in-home support are not covered.
Hearing Services See details
Hearing services are partially covered by DEVOTED CORE 001 CO (HMO), featuring a $35 copay and no coinsurance for annual routine exams, and copays ranging from $399 to $699 with no coinsurance for up to two prescription hearing aids per year. Fitting and evaluation services are covered with no copay and no coinsurance, but OTC hearing aids and inner ear, outer ear, and over-the-ear prescription hearing aid types are not covered.
Vision Services See details
DEVOTED CORE 001 CO (HMO) provides partially covered vision services, featuring one routine eye exam per year with a $0 to $35 copay and no coinsurance, though other eye exam services are not covered. Eyewear is covered with no copay, no coinsurance, and a $350 annual maximum benefit for contacts, eyeglasses, lenses, frames, and upgrades.
Dental Services See details
Dental services are partially covered by DEVOTED CORE 001 CO (HMO) up to a $3,500 annual maximum, featuring no copay and 0% to 50% coinsurance for most preventive and comprehensive care. Medicare-covered dental services require a $35 copay and no coinsurance, though maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by DEVOTED CORE 001 CO (HMO) with no copay, though prior authorization is required. Associated Medicare Part B chemotherapy, radiation, and other drugs carry no coinsurance to 20% coinsurance, while Medicare Part B insulin is covered with a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered by DEVOTED CORE 001 CO (HMO) with no copay and a 20% coinsurance. Prior authorization is required for these services.
Medical Equipment See details
DEVOTED CORE 001 CO (HMO) covers medical equipment with no copay, though prior authorization is required. Coinsurance is 20% to 50% for durable medical equipment, no coinsurance to 20% for prosthetics and medical supplies, and no coinsurance to 50% for diabetic supplies. This benefit is partially covered because diabetic therapeutic shoes and inserts are not covered.
Diagnostic and Radiological Services See details
DEVOTED CORE 001 CO (HMO) covers diagnostic services with no coinsurance, offering lab services with no copay and diagnostic procedures with a copay between $0 and $95. Radiological services require prior authorization and feature outpatient X-rays and diagnostic radiological services starting at no copay, while therapeutic radiological services require a minimum 20% coinsurance.
Home Health Services See details
Home Health Services are covered by the DEVOTED CORE 001 CO (HMO) plan with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by DEVOTED CORE 001 CO (HMO) with no copay and no coinsurance, though in practice only some services are covered. Specifically, cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered by the plan.
Skilled Nursing Facility (SNF) See details
DEVOTED CORE 001 CO (HMO) covers Skilled Nursing Facility (SNF) services with no coinsurance, offering no copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required, a prior 3-day inpatient hospital stay is not required, and additional days beyond the standard 100 days are not covered.
Other Services See details
Other services are partially covered by DEVOTED CORE 001 CO (HMO), which excludes meal benefits. Covered benefits include acupuncture with no copay and 50% coinsurance, additional preventive services with no copay and no coinsurance, and over-the-counter (OTC) items with no copay and no coinsurance up to a maximum benefit of $100 every three months.
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