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DEVOTED DUAL FULL 012 CO (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for DEVOTED DUAL FULL 012 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 FULL 012 CO (HMO D-SNP) in 2026, please refer to our full plan details page.
DEVOTED DUAL FULL 012 CO (HMO D-SNP) is a HMO D-SNP plan offered by Devoted Health, Inc. available for enrollment in 2026 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 FULL 012 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 FULL 012 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 FULL 012 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 FULL 012 CO (HMO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $27.10. 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 FULL 012 CO (HMO D-SNP) Medicare plan features an annual prescription drug deductible of $615. For Tiers 1 through 4, which include preferred generic, generic, preferred brand, and non-preferred drugs, you will pay a 25% coinsurance for 1-month, 2-month, and 3-month supplies at standard pharmacies and standard mail order. Tier 5 specialty drugs also carry a 25% coinsurance for a 1-month supply at standard pharmacies and standard mail order. For Tier 6 select care drugs, there is no copay for 1-month, 2-month, and 3-month supplies filled at standard pharmacies or standard mail order. This plan provides structured cost-sharing options to help you plan your annual prescription drug expenses.
Additional Benefits
The DEVOTED DUAL FULL 012 CO (HMO D-SNP) plan offers comprehensive healthcare coverage with no copay and no coinsurance for primary care visits, home health services, and routine preventive care. For hospital stays, members pay a $2,230 copay per acute inpatient stay and a $2,080 copay per psychiatric stay, both with no coinsurance. Outpatient services and diagnostic tests also feature no copays, though coinsurance rates ranging from 0% to 50% may apply depending on the specific service. This plan also includes valuable supplemental benefits, such as up to $3,000 annually for preventive and comprehensive dental care with no copay and no coinsurance. Routine vision and hearing exams are covered with no copays and up to 50% coinsurance, while prescription hearing aids require a copay between $399 and $699. Additionally, members receive a $400 annual allowance for eyewear and a $50 allowance every three months for over-the-counter items, both with no copays or coinsurance.
Inpatient Hospital See details
DEVOTED DUAL FULL 012 CO (HMO D-SNP) partially covers inpatient hospital services, excluding upgrades, non-Medicare-covered stays, and additional psychiatric days. Covered acute inpatient stays require a $2,230 copay per stay with no coinsurance, while psychiatric stays require a $2,080 copay per stay with no coinsurance.
Outpatient Services See details
Outpatient Services are covered by DEVOTED DUAL FULL 012 CO (HMO D-SNP) with no copays, though prior authorization is required for most services. Outpatient hospital and ambulatory surgical center services require a coinsurance ranging from no coinsurance to 50%, while outpatient substance abuse and blood services require 30% coinsurance with no deductible.
Partial Hospitalization See details
Partial hospitalization is covered by the DEVOTED DUAL FULL 012 CO (HMO D-SNP) plan with no copay and a 30% coinsurance. Prior authorization is required for these services.
Ambulance and Transportation Services See details
DEVOTED DUAL FULL 012 CO (HMO D-SNP) covers ground ambulance services with no copay and a 0% to 50% coinsurance, and air ambulance services with no copay and a 50% coinsurance, both requiring prior authorization. For transportation services, only some services are covered, as transportation to plan-approved health-related locations and any health-related locations are not covered.
Emergency Services See details
DEVOTED DUAL FULL 012 CO (HMO D-SNP) covers emergency services with a $115 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services have no copay and a 0% to 30% coinsurance (up to $40), while worldwide emergency, urgent, and transportation services are covered with no copay and no coinsurance up to a $25,000 lifetime maximum.
Primary Care See details
DEVOTED DUAL FULL 012 CO (HMO D-SNP) covers primary care physician services with no copay and no coinsurance. Specialist visits, mental health, psychiatry, therapies, and telehealth services are covered with no copay and coinsurance ranging from 0% to 30%, while podiatry and chiropractic services are not covered.
Preventive Services See details
Preventive services are partially covered by DEVOTED DUAL FULL 012 CO (HMO D-SNP) with no copay and no coinsurance for covered care, such as annual physicals, fitness benefits, and kidney disease education. Several services are not covered under this benefit, including in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, wigs, adult day health, home-based palliative care, in-home support, caregiver support, smoking cessation, disease management, telemonitoring, remote access, and counseling.
Hearing Services See details
DEVOTED DUAL FULL 012 CO (HMO D-SNP) covers hearing services, offering routine hearing exams with no copay and a 50% coinsurance, alongside unlimited fitting evaluations. Up to two prescription hearing aids per year are covered with no coinsurance and a copay of $399 to $699, though OTC hearing aids and inner ear, outer ear, and over the ear prescription models are not covered.
Vision Services See details
DEVOTED DUAL FULL 012 CO (HMO D-SNP) partially covers eye exams, providing one routine exam per year with no copay and 0% to 50% coinsurance, while other eye exam services are not covered. Eyewear is covered with no copay, no coinsurance, and a $400 annual maximum benefit for contacts, lenses, frames, and upgrades.
Dental Services See details
DEVOTED DUAL FULL 012 CO (HMO D-SNP) partially covers dental services, offering up to $3,000 annually for preventive and comprehensive care with no copay and no coinsurance, while Medicare-covered dental services have a 30% coinsurance and no copay. Excluded from coverage are other diagnostic and preventive dental services, maxillofacial prosthetics, implant services, and orthodontics.
Home Infusion bundled Services See details
DEVOTED DUAL FULL 012 CO (HMO D-SNP) covers home infusion bundled services with no copay and no coinsurance, though prior authorization is required. Associated Medicare Part B chemotherapy and other drugs have no copay and a 0% to 20% coinsurance, while Part B insulin drugs require a $35 copay and 0% to 20% coinsurance.
Dialysis Services See details
The DEVOTED DUAL FULL 012 CO (HMO D-SNP) plan covers dialysis services with no copay and a 20% coinsurance. Prior authorization is required before receiving these services.
Medical Equipment See details
DEVOTED DUAL FULL 012 CO (HMO D-SNP) covers medical equipment with no copays, although prior authorization is required. Members pay a 20% coinsurance for durable medical equipment and diabetic supplies, and between no coinsurance and 20% coinsurance for prosthetics and medical supplies.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered under the DEVOTED DUAL FULL 012 CO (HMO D-SNP) plan with no copays, though prior authorization is required. Diagnostic procedures and tests have no coinsurance, while lab services require a 50% coinsurance, therapeutic radiological services require a 20% coinsurance, and both diagnostic radiological and outpatient X-ray services require a 30% coinsurance.
Home Health Services See details
Home health services are covered by DEVOTED DUAL FULL 012 CO (HMO D-SNP) with no copay and no coinsurance. Prior authorization is required to receive this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by DEVOTED DUAL FULL 012 CO (HMO D-SNP) with no copay and a 30% coinsurance, with prior authorization required. While some services are covered, cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by DEVOTED DUAL FULL 012 CO (HMO D-SNP) with no coinsurance, requiring prior authorization but no prior three-day hospital stay. There is no copay for days 1 through 20, a $218 daily copay for days 21 through 100, and additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
DEVOTED DUAL FULL 012 CO (HMO D-SNP) provides partial coverage for other services, including unlimited acupuncture and additional preventive services with no copay and no coinsurance. Over-the-counter (OTC) items are also covered with no copay and no coinsurance up to $50 every three months, while meal benefits are not covered.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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