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DEVOTED DUAL PLUS 003 CO (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for DEVOTED DUAL PLUS 003 CO (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 003 CO (HMO D-SNP) in 2026, please refer to our full plan details page.
DEVOTED DUAL PLUS 003 CO (HMO D-SNP) is a HMO D-SNP plan offered by Devoted Health, Inc. available for enrollment in 2025 to people living in Colorado. This plan received an overall rating of 4 out of 5 stars in 2026.
It's important to know that DEVOTED DUAL PLUS 003 CO (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 003 CO (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 003 CO (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 003 CO (HMO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $17.60. 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 003 CO (HMO D-SNP) prescription drug plan features an annual drug deductible of $615. For medications in Tiers 1 through 5, which cover generic, brand-name, and specialty drugs, you will pay a 25% coinsurance when filling prescriptions at a standard pharmacy or through standard mail order. This 25% coinsurance applies to one-month, two-month, and three-month supplies, though specialty drugs in Tier 5 are limited to a one-month supply. For Tier 6 Select Care Drugs, the plan features no copay for one-month, two-month, and three-month supplies filled at standard pharmacies or standard mail order. This makes managing essential select care medications highly affordable under this plan.
Additional Benefits
The DEVOTED DUAL PLUS 003 CO (HMO D-SNP) plan offers comprehensive medical coverage featuring no copay and no coinsurance for primary care visits and preventive services. For inpatient hospital stays, members pay a copay of $2,230 per stay for acute care and $2,080 for psychiatric care, while outpatient hospital services require no copay but carry coinsurance up to 50%. Emergency room visits require a $115 copay, which is waived if you are admitted within 24 hours. Specialty benefits include dental coverage up to a $2,000 annual limit and a $400 annual allowance for eyewear, both with no copays. Routine hearing exams have no copay with 50% coinsurance, while prescription hearing aids require a copay between $399 and $699. Additionally, the plan features a $50 quarterly allowance for over-the-counter items and covers skilled nursing facility stays with no copay for the first 20 days.
Inpatient Hospital See details
DEVOTED DUAL PLUS 003 CO (HMO D-SNP) covers inpatient hospital services with no coinsurance, requiring a $2,230 copay per stay for acute care and a $2,080 copay per stay for psychiatric care, both of which require prior authorization. This benefit is partially covered because upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Outpatient services are covered under the DEVOTED DUAL PLUS 003 CO (HMO D-SNP) plan with no copays, though coinsurance and prior authorizations are required for most services. Outpatient hospital and ambulatory surgical center services range from no coinsurance to 50% coinsurance, while outpatient substance abuse and blood services require 30% coinsurance.
Partial Hospitalization See details
DEVOTED DUAL PLUS 003 CO (HMO D-SNP) covers partial hospitalization with no copay and a 30% coinsurance. Prior authorization is required for these services.
Ambulance and Transportation Services See details
DEVOTED DUAL PLUS 003 CO (HMO D-SNP) covers ambulance services with no copay, requiring 50% coinsurance for air ambulance services and no coinsurance to 50% coinsurance for ground ambulance services. For transportation, some services are covered but transportation to plan-approved health-related locations and any health-related locations are not covered.
Emergency Services See details
DEVOTED DUAL PLUS 003 CO (HMO D-SNP) covers emergency services with a $115 copay, which is waived if admitted to the hospital within 24 hours, and no coinsurance. Urgently needed services are covered with no copay and a 0% to 30% coinsurance up to $40, while worldwide emergency, urgent, and transportation services are covered up to $25,000 with no copay and no coinsurance.
Primary Care See details
DEVOTED DUAL PLUS 003 CO (HMO D-SNP) covers primary care physician services with no copay and no coinsurance. Most other services, including specialist visits, physical therapy, and mental health care, feature no copay but require a 30% coinsurance and prior authorization. Chiropractic services are partially covered, excluding other chiropractic services but offering up to 20 routine visits per year with no copay and 30% coinsurance.
Preventive Services See details
DEVOTED DUAL PLUS 003 CO (HMO D-SNP) preventive services are partially covered with no copay and no coinsurance for covered services like annual physicals, kidney education, and fitness benefits. However, the plan does not cover in-home safety assessments, PERS, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, chemotherapy wigs, adult day health, home-based palliative care, in-home support, caregiver support, additional smoking cessation, enhanced disease management, telemonitoring, remote access technologies, and counseling services.
Hearing Services See details
DEVOTED DUAL PLUS 003 CO (HMO D-SNP) partially covers hearing services, offering routine hearing exams with no copay and 50% coinsurance, and prescription hearing aids with a $399 to $699 copay and no coinsurance. OTC hearing aids, along with inner ear, outer ear, and over the ear prescription hearing aids, are not covered.
Vision Services See details
Vision services are partially covered by DEVOTED DUAL PLUS 003 CO (HMO D-SNP), offering one routine eye exam per year with no copay and 0% to 50% coinsurance, though other eye exam services are not covered. Eyewear is covered with no copay and no coinsurance, providing a $400 annual maximum benefit for contacts, eyeglasses, frames, lenses, and upgrades.
Dental Services See details
DEVOTED DUAL PLUS 003 CO (HMO D-SNP) partially covers dental services, offering Medicare-covered dental with no copay and 30% coinsurance, alongside other dental services with no copay and no coinsurance up to a $2,000 annual limit. While routine cleanings, exams, and select restorative treatments are covered, the plan does not cover other diagnostic or preventive services, maxillofacial prosthetics, implants, or orthodontics.
Home Infusion bundled Services See details
DEVOTED DUAL PLUS 003 CO (HMO D-SNP) covers home infusion bundled services with no copay, though prior authorization is required. Associated Medicare Part B chemotherapy, radiation, and other drugs carry a coinsurance ranging from no coinsurance to 20%, while Part B insulin requires a $35 copay and a coinsurance ranging from no coinsurance to 20%.
Dialysis Services See details
Dialysis Services are covered under the DEVOTED DUAL PLUS 003 CO (HMO D-SNP) plan with no copay and a 20% coinsurance. Prior authorization is required to receive these covered services.
Medical Equipment See details
DEVOTED DUAL PLUS 003 CO (HMO D-SNP) covers medical equipment, including durable medical equipment, prosthetics, medical supplies, and diabetic equipment, with no copay and coinsurance ranging from no coinsurance to 20%. Prior authorization is required for these benefits, and some items are subject to vendor or manufacturer limitations.
Diagnostic and Radiological Services See details
DEVOTED DUAL PLUS 003 CO (HMO D-SNP) covers diagnostic and radiological services with no copays, though prior authorization is required for all services. Diagnostic procedures and tests have no coinsurance, while lab services require 50% coinsurance, therapeutic radiological services require 20% coinsurance, and both diagnostic radiological and outpatient X-ray services require 30% coinsurance.
Home Health Services See details
Home health services are covered by DEVOTED DUAL PLUS 003 CO (HMO D-SNP) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
DEVOTED DUAL PLUS 003 CO (HMO D-SNP) covers Cardiac Rehabilitation Services 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) rehabilitation services are not covered and carry a 30% coinsurance.
Skilled Nursing Facility (SNF) See details
DEVOTED DUAL PLUS 003 CO (HMO D-SNP) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring prior authorization but no prior three-day inpatient hospital stay. There is no copay for days 1 through 20, followed by a daily copay of $218 for days 21 through 100, with additional days beyond the Medicare-covered limit not covered.
Other Services See details
DEVOTED DUAL PLUS 003 CO (HMO D-SNP) partially covers other services, providing acupuncture, additional preventive services, and over-the-counter (OTC) items with no copay and no coinsurance. Meal benefits are not covered under this plan, and the OTC benefit is limited to a maximum of $50 every three months.
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