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DEVOTED DUAL CHOICE PLUS 003 AR (PPO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for DEVOTED DUAL CHOICE PLUS 003 AR (PPO 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 CHOICE PLUS 003 AR (PPO D-SNP) in 2026, please refer to our full plan details page.
DEVOTED DUAL CHOICE PLUS 003 AR (PPO D-SNP) is a PPO D-SNP 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 DUAL CHOICE PLUS 003 AR (PPO 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 CHOICE PLUS 003 AR (PPO 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 CHOICE PLUS 003 AR (PPO 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 CHOICE PLUS 003 AR (PPO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $4.00. 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 has a $925.00 health deductible. This means, every calendar year, you pay this amount towards covered services before your insurance coverage kicks in.
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 combined Maximum Out-Of-Pocket cost of $13900.00 (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 $13900.00 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 DUAL CHOICE PLUS 003 AR (PPO D-SNP) offers an enhanced alternative drug benefit with an annual prescription drug deductible of $615.00. During the initial coverage phase, you will pay a 25% coinsurance for standard pharmacy and standard mail services across Tier 1 through Tier 4 drugs, which include generic and brand-name options. For Tier 5 specialty drugs, you will benefit from having no copay at standard pharmacies and standard mail. If you qualify for the low-income subsidy or Extra Help, your Part D premium may be reduced to $4.00. After your yearly out-of-pocket drug costs reach $2,100.00, you enter the catastrophic coverage phase where you will pay nothing for Medicare Part D covered drugs.
Additional Benefits
The DEVOTED DUAL CHOICE PLUS 003 AR (PPO D-SNP) offers comprehensive medical coverage featuring no copays for primary care, preventive services, and outpatient care, though coinsurance may apply. Inpatient hospital stays require a copay of $2,230 for acute care or $2,080 for psychiatric care, both with no coinsurance. Emergency room visits have a $115 copay, which is waived if you are admitted, while urgently needed care is available with no copay. For supplemental care, this plan provides valuable routine benefits including up to $3,000 in annual dental coverage and a $400 annual allowance for eyewear with no copay, no coinsurance, and no deductible. Members also benefit from a $50 quarterly over-the-counter allowance and prescription hearing aid coverage with copays ranging from $399 to $699. Medical equipment, diagnostic services, and routine hearing exams are also covered with no copays, though coinsurance up to 50% may apply.
Inpatient Hospital See details
Inpatient Hospital benefits are partially covered by DEVOTED DUAL CHOICE PLUS 003 AR (PPO D-SNP), requiring a $2,230 copay per stay and no coinsurance for acute care, and a $2,080 copay per stay and no coinsurance for psychiatric care. Upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
DEVOTED DUAL CHOICE PLUS 003 AR (PPO D-SNP) covers outpatient services with no copays and coinsurance ranging from no coinsurance up to 50%. These covered benefits include outpatient hospital, observation, ambulatory surgical center, substance abuse, and blood services, most of which require prior authorization.
Partial Hospitalization See details
DEVOTED DUAL CHOICE PLUS 003 AR (PPO D-SNP) covers partial hospitalization services with no copay and a 30% coinsurance. Prior authorization is required for these benefits.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are partially covered by DEVOTED DUAL CHOICE PLUS 003 AR (PPO D-SNP), as transportation services to health-related locations are not covered. Covered ground ambulance services require no copay and no coinsurance to 50% coinsurance, while air ambulance services require no copay and 50% coinsurance.
Emergency Services See details
DEVOTED DUAL CHOICE PLUS 003 AR (PPO 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 are covered with no copay and 0% to 30% coinsurance, while worldwide emergency services are covered up to a $25,000 maximum limit.
Primary Care See details
DEVOTED DUAL CHOICE PLUS 003 AR (PPO D-SNP) provides partially covered Primary Care benefits with no copays and coinsurance ranging from 0% to 30% for covered services. Under this plan, podiatry services and routine chiropractic care are not covered.
Preventive Services See details
Preventive Services are partially covered by DEVOTED DUAL CHOICE PLUS 003 AR (PPO D-SNP) with no copay and no coinsurance for covered options like annual physicals and fitness benefits. Uncovered sub-services include in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, readmission prevention, chemotherapy wigs, therapeutic massage, adult day health, home-based palliative care, in-home support, caregiver support, extra smoking cessation, disease management, telemonitoring, remote access technologies, and counseling.
Hearing Services See details
Hearing services are partially covered by DEVOTED DUAL CHOICE PLUS 003 AR (PPO D-SNP), excluding OTC hearing aids and inner ear, outer ear, and over-the-ear prescription hearing aids. Covered routine exams require a 50% coinsurance and no copay, fitting evaluations have no copay and no coinsurance, and eligible prescription hearing aids require a $399 to $699 copay and no coinsurance.
Vision Services See details
Vision services are covered by DEVOTED DUAL CHOICE PLUS 003 AR (PPO D-SNP), which offers one routine eye exam per year with no copay and 0% to 50% coinsurance. Members also receive a $400 annual allowance for eyewear, including contacts and eyeglasses, with no copay, no coinsurance, and no deductible.
Dental Services See details
DEVOTED DUAL CHOICE PLUS 003 AR (PPO D-SNP) covers Medicare-covered dental services with a 30% coinsurance, and provides up to $3,000 in annual coverage for other dental services. While preventive and comprehensive treatments like cleanings, x-rays, and extractions are covered, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by DEVOTED DUAL CHOICE PLUS 003 AR (PPO D-SNP) with prior authorization. Covered Medicare Part B chemotherapy, radiation, and other Part B drugs have no copay and 0% to 20% coinsurance, while Medicare Part B insulin drugs require a $35 copay and 0% to 20% coinsurance.
Dialysis Services See details
DEVOTED DUAL CHOICE PLUS 003 AR (PPO D-SNP) covers dialysis services with a 20% coinsurance and no copay. Prior authorization is required to receive these covered services.
Medical Equipment See details
DEVOTED DUAL CHOICE PLUS 003 AR (PPO D-SNP) covers medical equipment with no copays, though prior authorization is required. Durable medical equipment, diabetic supplies, and diabetic therapeutic shoes or inserts require a 20% coinsurance, while prosthetic devices and medical supplies range from no coinsurance to 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by DEVOTED DUAL CHOICE PLUS 003 AR (PPO D-SNP) with no copays, though prior authorization is required. Coinsurance ranges from no coinsurance to 50% for diagnostic tests, 50% for lab services, 30% to 50% for diagnostic radiology, 20% for therapeutic radiology, and 30% for outpatient X-rays.
Home Health Services See details
Home health services are covered by the DEVOTED DUAL CHOICE PLUS 003 AR (PPO D-SNP) plan, though prior authorization is required. Specific copay and coinsurance details for these services are not specified in the plan benefits.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by DEVOTED DUAL CHOICE PLUS 003 AR (PPO D-SNP), with no coverage provided for cardiac, intensive cardiac, pulmonary, or SET for PAD rehabilitation services.
Skilled Nursing Facility (SNF) See details
DEVOTED DUAL CHOICE PLUS 003 AR (PPO D-SNP) covers Skilled Nursing Facility (SNF) services with prior authorization, offering no copay for days 1 through 20, a $218 daily copay for days 21 through 100, and no coinsurance. The plan does not require a prior 3-day inpatient hospital stay, though additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Other Services are partially covered by DEVOTED DUAL CHOICE PLUS 003 AR (PPO D-SNP), which offers additional preventive services and a $50 quarterly allowance for over-the-counter items with no copay or coinsurance. Acupuncture, meal benefits, and dual eligible SNPs with highly integrated services are not covered.
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1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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