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DEVOTED CHOICE 001 MS (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for DEVOTED CHOICE 001 MS (PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on DEVOTED CHOICE 001 MS (PPO) in 2026, please refer to our full plan details page.
DEVOTED CHOICE 001 MS (PPO) is a PPO plan offered by Devoted Health, Inc. available for enrollment in 2025 to people living in Mississippi. The overall rating for this plan is not yet available for 2026.
It's important to know that DEVOTED CHOICE 001 MS (PPO) 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 CHOICE 001 MS (PPO).
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 CHOICE 001 MS (PPO), 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 combined Maximum Out-Of-Pocket cost of $8950.00 (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 $8950.00 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:
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Drug Coverage
The DEVOTED CHOICE 001 MS (PPO) Medicare plan features an annual drug deductible of $375. For Tier 1 (Preferred Generic) and Tier 2 (Generic) drugs, members enjoy no copay for 1-month, 2-month, or 3-month supplies filled at standard pharmacies or through standard mail order. For brand-name and specialty drugs, cost sharing is determined by coinsurance at standard pharmacies and standard mail order. Tier 3 (Preferred Brand) drugs carry a 19% coinsurance, Tier 4 (Non-Preferred Drug) medications carry a 25% coinsurance, and Tier 5 (Specialty Tier) drugs require a 28% coinsurance for a 1-month supply.
Additional Benefits
The DEVOTED CHOICE 001 MS (PPO) Medicare plan offers affordable medical coverage with no copay for primary care doctor visits and a $35 copay for specialists. For hospital care, inpatient stays require a $275 daily copay for the first 8 to 9 days and no copay thereafter, while outpatient services range from no copay to a $375 copay. Emergency room visits have a $130 copay, which is waived if you are admitted, and urgent care ranges from no copay to a $45 copay. Additional perks include comprehensive dental coverage up to a $3,500 annual limit with no copay for preventive services. Routine vision exams and eyewear are covered with up to a $350 annual allowance, while routine hearing exams require a $35 copay and prescription hearing aids have copays starting at $399. Members also receive a $100 quarterly allowance for over-the-counter items and enjoy no copay for home health services.
Inpatient Hospital See details
DEVOTED CHOICE 001 MS (PPO) covers inpatient hospital services with no coinsurance, featuring a $275 daily copay for days 1 through 9 of acute care (with no copay for days 10 and beyond) and a $275 daily copay for days 1 through 8 of psychiatric care (with no copay for days 9 through 90). Prior authorization is required, and certain services like room upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
DEVOTED CHOICE 001 MS (PPO) outpatient services are covered with no coinsurance, featuring a $0 to $375 copay for outpatient hospital services and a $275 copay per stay for observation services. Outpatient substance abuse sessions have a $35 copay and no coinsurance, while ambulatory surgical center and outpatient blood services are covered with no copay and no coinsurance.
Partial Hospitalization See details
Partial hospitalization is covered by DEVOTED CHOICE 001 MS (PPO) with a $70.00 copayment and no coinsurance. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
DEVOTED CHOICE 001 MS (PPO) covers ground ambulance services with a copay of up to $360 (and no copay for some services) and air ambulance services with a 20% coinsurance, subject to prior authorization. Transportation services to health-related locations are not covered by this plan.
Emergency Services See details
Emergency services are covered by DEVOTED CHOICE 001 MS (PPO) with a $130 copay (waived if admitted within 24 hours) and no coinsurance, while urgent care ranges from no copay to a $45 copay with no coinsurance. Worldwide emergency and urgent services are covered up to a $25,000 maximum, requiring a $130 copay and no coinsurance for medical care, and a $360 copay with 20% coinsurance for emergency transportation.
Primary Care See details
DEVOTED CHOICE 001 MS (PPO) offers primary care physician services with no copay and no coinsurance, and specialist visits with a $35 copay and no coinsurance. Other covered services, including physical, occupational, speech, mental health, psychiatric, and telehealth services, feature copays ranging from no copay to $50 and no coinsurance, while chiropractic and podiatry services are not covered.
Preventive Services See details
DEVOTED CHOICE 001 MS (PPO) preventive services are partially covered with no copay and no coinsurance for covered benefits such as annual physical exams, fitness benefits, and nutritional counseling. However, several sub-services are not covered under this plan, including personal emergency response systems (PERS), medical nutrition therapy, therapeutic massage, and in-home support services.
Hearing Services See details
Hearing services are partially covered by DEVOTED CHOICE 001 MS (PPO), featuring a $35 copay and no coinsurance for annual routine hearing exams with no deductible. Up to two prescription hearing aids per year are covered with no coinsurance and a copay ranging from $399 to $699, but OTC hearing aids and inner ear, outer ear, and over the ear prescription hearing aids are not covered.
Vision Services See details
DEVOTED CHOICE 001 MS (PPO) provides partially covered vision services with no deductibles or coinsurance. One routine eye exam is covered annually with a $0 to $35 copay, and eyewear is covered with no copay up to a $350 yearly limit, though other eye exam services are not covered.
Dental Services See details
Dental services are partially covered by DEVOTED CHOICE 001 MS (PPO) up to a $3,500 annual limit for both in- and out-of-network care, featuring no copays or coinsurance for preventive care. Medicare-covered dental services require a $35 copay and no coinsurance, while other covered comprehensive services have no copay and up to 50% coinsurance, excluding orthodontics, implants, and maxillofacial prosthetics which are not covered.
Home Infusion bundled Services See details
DEVOTED CHOICE 001 MS (PPO) covers home infusion bundled services with no copay, though prior authorization is required. Associated Medicare Part B chemotherapy, radiation, and other drugs require no copay and coinsurance ranging from no coinsurance to 20%, while Medicare Part B insulin drugs require a $35 copay and coinsurance ranging from no coinsurance to 20%.
Dialysis Services See details
DEVOTED CHOICE 001 MS (PPO) covers dialysis services with no copay and a 20% coinsurance. Prior authorization is required to receive coverage for these services.
Medical Equipment See details
DEVOTED CHOICE 001 MS (PPO) offers partially covered medical equipment with no copay, requiring a 20% coinsurance for durable medical equipment and no coinsurance to 20% coinsurance for prosthetics, medical supplies, and diabetic supplies. Prior authorization is required for covered equipment, and diabetic therapeutic shoes and inserts are not covered.
Diagnostic and Radiological Services See details
Diagnostic and radiological services under DEVOTED CHOICE 001 MS (PPO) are covered with no coinsurance for diagnostic services, which feature no copay for lab services and a $0 to $95 copay for other diagnostic procedures. Outpatient X-rays and diagnostic radiological services have no copay, while therapeutic radiological services require a minimum 20% coinsurance.
Home Health Services See details
Home Health Services are covered under DEVOTED CHOICE 001 MS (PPO) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by DEVOTED CHOICE 001 MS (PPO) with no coinsurance, though prior authorization is required. While some services are covered, cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and SET for PAD services are not covered in practice and require copayments between $25 and $35.
Skilled Nursing Facility (SNF) See details
DEVOTED CHOICE 001 MS (PPO) covers Skilled Nursing Facility (SNF) services with no coinsurance, featuring no copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required, and additional days beyond the standard 100 Medicare-covered days are not covered.
Other Services See details
Other services are partially covered by DEVOTED CHOICE 001 MS (PPO), offering additional preventive services and over-the-counter (OTC) items up to $100 every three months with no copay and no coinsurance. Acupuncture and meal benefits are not covered under this plan.
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