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DEVOTED C-SNP PREMIUM 010 CO (HMO C-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for DEVOTED C-SNP PREMIUM 010 CO (HMO 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 PREMIUM 010 CO (HMO C-SNP) in 2026, please refer to our full plan details page.
DEVOTED C-SNP PREMIUM 010 CO (HMO C-SNP) is a HMO C-SNP plan offered by Devoted Health, Inc. available for enrollment in 2026 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 C-SNP PREMIUM 010 CO (HMO 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 PREMIUM 010 CO (HMO 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 PREMIUM 010 CO (HMO 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 PREMIUM 010 CO (HMO C-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $35.20. 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 $5200.00 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 C-SNP PREMIUM 010 CO (HMO C-SNP) medicare plan features an annual drug deductible of $615. For prescription coverage, you will pay no copay for Tier 6 Select Care Drugs filled through standard pharmacies or standard mail order. Tier 1 Preferred Generics require an $18 copay for a 1-month supply, while Tier 2 Generics have a $20 copay for a 1-month supply. Higher-tier medications are covered under a coinsurance structure for standard pharmacy and mail-order services. You will pay a 23% coinsurance for Tier 3 Preferred Brand drugs and a 26% coinsurance for Tier 4 Non-Preferred drugs. Tier 5 Specialty Tier drugs require a 25% coinsurance for a 1-month supply.
Additional Benefits
The DEVOTED C-SNP PREMIUM 010 CO (HMO C-SNP) plan offers comprehensive medical coverage featuring no copays or coinsurance for primary care visits, home health services, and annual preventive exams. Specialist visits require a 35 dollar copay, while inpatient hospital stays charge a 305 dollar daily copay for the first six days before dropping to no copay for days seven through 90. Emergency room visits carry a 130 dollar copay, which is waived if you are admitted to the hospital within 24 hours. This plan also includes valuable supplemental benefits, such as dental coverage up to a 2,000 dollar yearly limit with no copay for other covered dental services and a 35 dollar copay for Medicare-covered dental care. Vision benefits feature no copay for eyewear up to a 300 dollar annual maximum, and hearing services include routine exams with a 35 dollar copay alongside partial coverage for prescription hearing aids. Additionally, members can access up to 50 dollars in over-the-counter items every three months with no copay.
Inpatient Hospital See details
DEVOTED C-SNP PREMIUM 010 CO (HMO C-SNP) partially covers inpatient acute and psychiatric hospital stays with no coinsurance, charging a $305 daily copay for days 1 through 6 and no copay for days 7 through 90. Prior authorization is required, and non-Medicare-covered stays, room upgrades, and additional psychiatric days are not covered.
Outpatient Services See details
DEVOTED C-SNP PREMIUM 010 CO (HMO C-SNP) covers outpatient services with no coinsurance, including no copay for ambulatory surgical center and blood services. Outpatient hospital services require a copay ranging from $0 to $405, observation services require a $305 copay per stay, and outpatient substance abuse sessions have a $35 copay.
Partial Hospitalization See details
DEVOTED C-SNP PREMIUM 010 CO (HMO C-SNP) covers partial hospitalization services with a $60.00 copay and no coinsurance. Prior authorization is required to receive coverage for this benefit.
Ambulance and Transportation Services See details
DEVOTED C-SNP PREMIUM 010 CO (HMO C-SNP) covers ambulance services with no coinsurance, requiring a $290 copay for air ambulance services and a copay ranging from no copay to $270 for ground ambulance services. Some transportation services are covered, but transportation to plan-approved health-related locations or any health-related locations is not covered.
Emergency Services See details
DEVOTED C-SNP PREMIUM 010 CO (HMO C-SNP) covers emergency services with a $130 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services feature no coinsurance and a copay ranging from no copay to $45, while worldwide emergency services are covered up to a $25,000 maximum with no coinsurance and copays ranging from $130 to $290.
Primary Care See details
DEVOTED C-SNP PREMIUM 010 CO (HMO C-SNP) covers primary care physician services with no copay and no coinsurance, and specialist visits with a $35 copay and no coinsurance. Therapy services range from a $35 to $50 copay with no coinsurance, while chiropractic care is partially covered with a $15 copay and no coinsurance, as other chiropractic services are not covered.
Preventive Services See details
DEVOTED C-SNP PREMIUM 010 CO (HMO C-SNP) covers preventive services, such as annual physical exams and kidney disease education, with no copay and no coinsurance. Additional preventive services are partially covered with no copay and no coinsurance, excluding in-home safety assessments, personal emergency response systems, post-discharge medication reconciliation, re-admission prevention, chemotherapy wigs, adult day health, home-based palliative care, in-home support, caregiver support, additional smoking cessation sessions, enhanced disease management, telemonitoring, remote access technologies, and counseling services.
Hearing Services See details
Hearing services are covered by DEVOTED C-SNP PREMIUM 010 CO (HMO C-SNP) with no deductible, featuring a $35 copay and no coinsurance for annual routine exams and unlimited fitting evaluations. Prescription hearing aids are partially covered with a $399 to $699 copay and no coinsurance for up to two aids per year, though OTC, inner ear, outer ear, and over the ear hearing aids are not covered.
Vision Services See details
Vision services are partially covered by DEVOTED C-SNP PREMIUM 010 CO (HMO C-SNP), 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 no deductible, up to a $300 annual maximum for contacts, lenses, frames, and upgrades.
Dental Services See details
DEVOTED C-SNP PREMIUM 010 CO (HMO C-SNP) partially covers dental services, offering Medicare-covered dental for a $35.00 copay and no coinsurance, alongside other covered services with no copay and no coinsurance up to a $2,000 yearly maximum. Sub-services that are not covered under this plan include other diagnostic dental services, other preventive dental services, maxillofacial prosthetics, implant services, and orthodontics.
Home Infusion bundled Services See details
Home infusion bundled services are covered by DEVOTED C-SNP PREMIUM 010 CO (HMO C-SNP) with no copay, though prior authorization is required. Medicare Part B chemotherapy, radiation, and other drugs have no copay and up to 20% coinsurance, while Part B insulin drugs require a $35 copay and up to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered by DEVOTED C-SNP PREMIUM 010 CO (HMO C-SNP) with no copay and a 20% coinsurance. Prior authorization is required for these services.
Medical Equipment See details
Medical Equipment benefits under DEVOTED C-SNP PREMIUM 010 CO (HMO C-SNP) are partially covered with no copay, though prior authorization is required. Durable medical equipment requires 20% to 30% coinsurance, while prosthetics, medical supplies, and diabetic supplies range from no coinsurance up to 20% or 30% coinsurance. Diabetic therapeutic shoes and inserts are not covered, and some equipment is limited to specified manufacturers or preferred vendors.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by DEVOTED C-SNP PREMIUM 010 CO (HMO C-SNP), with prior authorization required. Diagnostic services feature no coinsurance, offering lab services with no copay and diagnostic tests with a $0 to $95 copay, while radiological services require a $0 copay for x-rays and diagnostic radiology alongside a minimum 20% coinsurance for therapeutic radiology.
Home Health Services See details
Home Health Services are covered by the DEVOTED C-SNP PREMIUM 010 CO (HMO C-SNP) plan with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered with no coinsurance under the DEVOTED C-SNP PREMIUM 010 CO (HMO C-SNP) plan, but some services are covered while standard cardiac, intensive cardiac, pulmonary, and SET for PAD services are not covered. These non-covered rehabilitation services require prior authorization and carry copayments ranging from $25 to $35.
Skilled Nursing Facility (SNF) See details
DEVOTED C-SNP PREMIUM 010 CO (HMO C-SNP) covers Skilled Nursing Facility (SNF) care with no coinsurance, requiring prior authorization but no prior three-day hospital stay. Patients 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
Other Services are partially covered by DEVOTED C-SNP PREMIUM 010 CO (HMO C-SNP), offering no copay and no coinsurance for acupuncture, diabetic shoes, additional preventive services, and up to $50 in over-the-counter items every three months. Meal benefits are not covered under this plan.
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