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DEVOTED CHOICE 001 AR (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for DEVOTED CHOICE 001 AR (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 AR (PPO) in 2026, please refer to our full plan details page.
DEVOTED CHOICE 001 AR (PPO) is a PPO plan offered by Devoted Health, Inc. available for enrollment in 2025 to people living in Arkansas. The overall rating for this plan is not yet available for 2026.
It's important to know that DEVOTED CHOICE 001 AR (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 AR (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 AR (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 $9550.00 (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 $9550.00 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 AR (PPO) Medicare plan features an Enhanced Alternative drug benefit with a $375.00 prescription drug deductible. Once this deductible is met, you will benefit from no copay for Tier 1 preferred generic drugs filled at standard pharmacies or through standard mail. Other tiers require a coinsurance, which is 19% for Tier 2 standard generics, 25% for Tier 3 preferred brands, and 28% for Tier 4 non-preferred drugs. This initial cost-sharing structure remains in place until your total drug costs reach $2,100.00. After your yearly out-of-pocket drug expenses hit this $2,100.00 threshold, you enter the catastrophic coverage phase where you pay nothing for covered Medicare Part D drugs. Additionally, those who qualify for the low-income subsidy can reduce their Part D costs to zero dollars.
Additional Benefits
The DEVOTED CHOICE 001 AR (PPO) plan offers comprehensive medical coverage with predictable cost-sharing, featuring no copay or coinsurance for preventive services and annual physicals. For inpatient hospital stays, members pay a $295 copay per day for days 1 through 6, and no copay for days 7 through 90. Primary care visits range from no copay up to $50, while specialist visits and emergency room services incur copays of $35 and $130 respectively with no coinsurance. Additional benefits include dental coverage up to a $3,500 annual limit with no copay for restorative services, and vision care providing a $350 yearly allowance for eyewear with no copay. Hearing exams require a $35 copay, while skilled nursing facility stays feature no copay for the first 20 days. Members also receive a $100 allowance every three months for over-the-counter items, though services like cardiac rehabilitation and transportation are not covered.
Inpatient Hospital See details
DEVOTED CHOICE 001 AR (PPO) partially covers inpatient hospital benefits, with covered acute and psychiatric stays requiring prior authorization and costing a $295 copay for days 1 to 6, no copay for days 7 to 90, and no coinsurance. Non-Medicare-covered stays, acute upgrades, and additional psychiatric days are not covered.
Outpatient Services See details
Outpatient Services are covered by DEVOTED CHOICE 001 AR (PPO) with no coinsurance, featuring no copay for ambulatory surgical center services and a $35 copay for outpatient substance abuse sessions. Outpatient hospital services require a copay ranging from $0 to $395, while observation services incur a $295 copay per stay.
Partial Hospitalization See details
DEVOTED CHOICE 001 AR (PPO) covers partial hospitalization services with a $70.00 copay and no coinsurance. Prior authorization is required to receive this covered benefit.
Ambulance and Transportation Services See details
Ambulance and transportation services are partially covered under the DEVOTED CHOICE 001 AR (PPO) plan, as transportation services to plan-approved or any health-related locations are not covered. Ground ambulance services require a copay ranging from no copay to $350 along with coinsurance, while air ambulance services require a copay and 20% coinsurance, with prior authorization required for all ambulance services.
Emergency Services See details
Emergency services are covered under the DEVOTED CHOICE 001 AR (PPO) plan with a $130 copay and no coinsurance, with the copay waived if you are admitted to the hospital within 24 hours. Urgently needed services require no copay to a $45 copay and no coinsurance, while worldwide emergency services are covered up to a $25,000 limit with copays up to $350 and coinsurance up to 20%.
Primary Care See details
Primary care benefits are partially covered by DEVOTED CHOICE 001 AR (PPO) with no coinsurance, though podiatry and routine chiropractic care are not covered. Covered services require copays ranging from no copay up to $50, including a $35 copay for specialists and mental health sessions.
Preventive Services See details
DEVOTED CHOICE 001 AR (PPO) covers Medicare-covered preventive services, annual physicals, and select wellness programs with no copay and no coinsurance. This benefit is partially covered, as several sub-services—including in-home safety assessments, personal emergency response systems, therapeutic massages, and caregiver support—are not covered.
Hearing Services See details
Hearing services are partially covered by DEVOTED CHOICE 001 AR (PPO), which excludes coverage for OTC hearing aids as well as inner ear, outer ear, and over the ear prescription hearing aids. Covered routine hearing exams require a $35 copay and no coinsurance, while covered prescription hearing aids require a copay of $399 to $699 and no coinsurance.
Vision Services See details
DEVOTED CHOICE 001 AR (PPO) covers vision services, including one routine eye exam per year with no copay up to a $35 copay and no coinsurance. Eyewear is also covered with no copay or coinsurance, offering a combined maximum benefit of $350 per year for frames, lenses, and contacts.
Dental Services See details
DEVOTED CHOICE 001 AR (PPO) partially covers dental services up to a $3,500 annual maximum, requiring a $35 copay and no coinsurance for Medicare-covered dental, and no copay with between no coinsurance and 50% coinsurance for restorative and endodontic services. Maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
DEVOTED CHOICE 001 AR (PPO) covers Home Infusion bundled Services with prior authorization, featuring no copay and coinsurance ranging from no coinsurance to 20% for chemotherapy, radiation, and other Part B drugs. Covered Part B insulin drugs require a $35 copay and coinsurance ranging from no coinsurance to 20%.
Dialysis Services See details
DEVOTED CHOICE 001 AR (PPO) covers Dialysis Services with no copay and a 20% coinsurance. Prior authorization is required to receive these covered services.
Medical Equipment See details
DEVOTED CHOICE 001 AR (PPO) partially covers medical equipment, as diabetic therapeutic shoes and inserts are not covered. Covered items—including durable medical equipment, prosthetics, and medical or diabetic supplies—require prior authorization and feature no copays, with coinsurance ranging from no coinsurance up to 25%.
Diagnostic and Radiological Services See details
DEVOTED CHOICE 001 AR (PPO) covers diagnostic and radiological services with prior authorization, offering lab services and outpatient X-rays with no copay or coinsurance. Diagnostic procedures require a copay of $0 to $95 with no coinsurance, diagnostic radiology has a copay of $0 to $300 with no coinsurance, and therapeutic radiology requires a 20% coinsurance.
Home Health Services See details
Home Health Services are covered under the DEVOTED CHOICE 001 AR (PPO) plan, though prior authorization is required before services can be received.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the DEVOTED CHOICE 001 AR (PPO) plan, meaning there is no copay or coinsurance coverage for cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services.
Skilled Nursing Facility (SNF) See details
DEVOTED CHOICE 001 AR (PPO) partially covers Skilled Nursing Facility (SNF) services with prior authorization, offering no copay or coinsurance for days 1 to 20, and a $218 daily copay with no coinsurance for days 21 to 100. Additional days beyond the Medicare-covered limit are not covered by the plan.
Other Services See details
Other Services are partially covered by DEVOTED CHOICE 001 AR (PPO), offering a $100 allowance every three months for over-the-counter items and coverage for additional preventive services. Acupuncture, meal benefits, and dual eligible SNP services are not covered under this plan.
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