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Devoted CHOICE DUAL PLUS Arkansas (PPO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Devoted CHOICE DUAL PLUS Arkansas (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 CHOICE DUAL PLUS Arkansas (PPO D-SNP) in 2025, please refer to our full plan details page.
Devoted CHOICE DUAL PLUS Arkansas (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 2025.
It's important to know that Devoted CHOICE DUAL PLUS Arkansas (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 CHOICE DUAL PLUS Arkansas (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 CHOICE DUAL PLUS Arkansas (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 CHOICE DUAL PLUS Arkansas (PPO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $20.90. 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 $500.00 health deductible. This means, every calendar year, you pay this amount towards covered services before your insurance coverage kicks in.
This plan has a $590.00 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 $14000.00 (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 $14000.00 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 DUAL PLUS Arkansas (PPO D-SNP) plan has a $590 deductible for prescription drugs. If you qualify for the low-income subsidy, you will pay $20.90 per month for Part D. Once you meet your deductible, you will pay the costs for drugs in each tier until your total drug costs reach $2000, at which point you enter the next coverage phase. After your yearly out-of-pocket drug costs reach $2000, you pay nothing for Medicare Part D covered drugs.
Additional Benefits
The Devoted CHOICE DUAL PLUS Arkansas (PPO D-SNP) plan offers comprehensive coverage, including inpatient hospital stays with a $1350 copay per admission, emergency services with a $110 copay, and home health services with no copay. Primary care, preventive services, and medical equipment have no copay. The plan also provides coverage for outpatient services, hearing and vision services, and dental services, with coinsurance or copays applying to specific services. Services like ambulance, partial hospitalization, skilled nursing facilities, and home infusion require prior authorization.
Inpatient Hospital See details
Inpatient Hospital benefits, including Acute and Psychiatric, are covered, with a copay of $1350 per admission or stay. Additional days for Inpatient Hospital-Acute are covered with no limit, while Non-Medicare-covered Stay and Upgrades for Inpatient Hospital-Acute, along with Additional Days and Non-Medicare-covered Stay for Inpatient Hospital Psychiatric, are not covered.
Outpatient Services See details
Outpatient Services, including Outpatient Hospital Services and Observation Services, have a 40% coinsurance, while Ambulatory Surgical Center Services and Outpatient Substance Abuse Services have a 40% coinsurance. Outpatient Blood Services are also covered, with a waived three-pint deductible.
Partial Hospitalization See details
Partial Hospitalization is covered, but requires prior authorization. You will pay 35% coinsurance for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered. All ambulance services are covered with no copay, but with coinsurance of 0-40% for ground ambulance services and 40% for air ambulance services. Transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered. Emergency Services have a $110 copay, and Urgently Needed Services have a 35% coinsurance.
Primary Care See details
The Devoted CHOICE DUAL PLUS Arkansas (PPO D-SNP) plan covers primary care physician services, occupational therapy services, physician specialist services, other health care professional, physical therapy and speech-language pathology services, opioid treatment program services and additional telehealth benefits with no copay or coinsurance. Chiropractic Services, Mental Health Specialty Services, and Psychiatric Services are partially covered, but routine chiropractic care, individual and group sessions for mental health specialty services, and individual and group sessions for psychiatric services are not covered. Podiatry Services are not covered.
Preventive Services See details
Preventive services, including Medicare-covered services, annual physical exams, and additional preventive services, are covered. Health education, weight management programs, alternative therapies, nutritional/dietary benefits, fitness benefits, home and bathroom safety devices, glaucoma screenings, diabetes self-management training, barium enemas, digital rectal exams, and EKGs following a welcome visit are also covered. However, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge in-home medication reconciliation, re-admission prevention, wigs for hair loss due to chemotherapy, therapeutic massage, adult day health services, home-based palliative care, in-home support services, support for caregivers of enrollees, additional sessions of smoking and tobacco cessation counseling, enhanced disease management, telemonitoring services, remote access technologies, and counseling services are not covered.
Hearing Services See details
Hearing services include hearing exams and prescription hearing aids. Hearing exams have a coinsurance of up to 40%, and you can receive one routine hearing exam every year. Prescription hearing aids have a copay between $399 and $699, and you can receive two hearing aids every year; however, inner ear, outer ear, and over-the-ear hearing aids are not covered.
Vision Services See details
Vision services include coverage for eye exams with a 40% coinsurance, as well as eyewear, including contact lenses, eyeglasses (lenses and frames), eyeglass lenses, and eyeglass frames, with a combined maximum benefit of $500 every year. Routine eye exams are limited to one per year.
Dental Services See details
Dental services include coverage for Medicare dental services, oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatment, other preventive dental services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), and oral and maxillofacial surgery. The plan has a maximum benefit of $500 per year for both in-network and out-of-network services, and prior authorization is required for Medicare dental services. Maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, with prior authorization required. Medicare Part B Insulin Drugs have a $35 copay and 20% coinsurance, while Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have between 0% and 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered under the Devoted CHOICE DUAL PLUS Arkansas (PPO D-SNP) plan. The coinsurance for dialysis services is between 20% and 20%.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with no copay and 0-20% coinsurance, Prosthetics/Medical Supplies with no copay and coinsurance for Medicare-covered items, and Diabetic Equipment with coinsurance for Medicare-covered therapeutic shoes or inserts. Durable Medical Equipment for use outside the home and Diabetic Therapeutic Shoes/Inserts are not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered under this plan, with no copay for any services. Diagnostic Procedures/Tests and Lab Services have a coinsurance of at most 40%, while Diagnostic Radiological Services have a coinsurance of at most 40%, Therapeutic Radiological Services have a coinsurance of at most 20%, and Outpatient X-Ray Services have a coinsurance of at most 35%.
Home Health Services See details
Home Health Services are covered by the Devoted CHOICE DUAL PLUS Arkansas (PPO D-SNP) plan with no copay and no coinsurance, but require authorization. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are technically covered, but none of the sub-services are covered, including Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) benefits are covered under the Devoted CHOICE DUAL PLUS Arkansas (PPO D-SNP) plan, but require prior authorization. For days 1-20, there is no copay, and for days 21-100, the copay is $214.
Other Services See details
The "Devoted CHOICE DUAL PLUS Arkansas (PPO D-SNP)" plan does not cover acupuncture, over-the-counter items, meal benefits, Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, or Self-Directed Personal Assistance Services. "Other 2" benefits include $0 preventive services.
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