A non-government entity
DEVOTED C-SNP CHOICE PREMIUM 007 AR (PPO C-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for DEVOTED C-SNP CHOICE PREMIUM 007 AR (PPO C-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on DEVOTED C-SNP CHOICE PREMIUM 007 AR (PPO C-SNP) in 2026, please refer to our full plan details page.
DEVOTED C-SNP CHOICE PREMIUM 007 AR (PPO C-SNP) is a PPO C-SNP plan offered by Devoted Health, Inc. available for enrollment in 2026 to people living in Arkansas. The overall rating for this plan is not yet available for 2026.
It's important to know that DEVOTED C-SNP CHOICE PREMIUM 007 AR (PPO C-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
DEVOTED C-SNP CHOICE PREMIUM 007 AR (PPO C-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 C-SNP CHOICE PREMIUM 007 AR (PPO C-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 C-SNP CHOICE PREMIUM 007 AR (PPO C-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $8.90. 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 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 combined Maximum Out-Of-Pocket cost of $9850.00 (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 $9850.00 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:
Sign up for DEVOTED C-SNP CHOICE PREMIUM 007 AR (PPO C-SNP)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
Drug Coverage
The DEVOTED C-SNP CHOICE PREMIUM 007 AR (PPO C-SNP) plan features a prescription drug deductible of $615 and provides basic alternative drug coverage. During the initial coverage phase, standard retail and standard mail-order pharmacies charge a $19 copay for Tier 1 preferred generics, 21% coinsurance for Tier 2 standard generics, 33% coinsurance for Tier 3 preferred brands, and 25% coinsurance for Tier 4 non-preferred drugs. Beneficiaries will pay no copay for Tier 5 specialty drugs during this phase. After your yearly out-of-pocket drug costs reach $2,100, you enter the catastrophic coverage phase and pay nothing for covered Part D drugs. Additionally, those who qualify for the low-income subsidy can receive a premium reduction, paying just $8.90 for Part D coverage.
Additional Benefits
The DEVOTED C-SNP CHOICE PREMIUM 007 AR (PPO C-SNP) plan offers comprehensive medical coverage with doctor visits ranging from no copay up to $50 and no coinsurance. Inpatient hospital stays require a $375 daily copay for the first six days, while outpatient hospital services feature copays up to $475. Emergency care is available with a $130 copay, and routine lab services and outpatient X-rays are covered with no copay or coinsurance. This plan also includes valuable everyday benefits, such as a $2,000 annual limit for covered dental services and a $300 yearly allowance for eyewear with no coinsurance. Routine hearing exams require a $40 copay, while prescription hearing aids are covered with copays between $399 and $699. Additionally, members benefit from a $50 quarterly allowance for over-the-counter items and no copay for the first 20 days of skilled nursing facility care.
Inpatient Hospital See details
Inpatient hospital benefits are partially covered by DEVOTED C-SNP CHOICE PREMIUM 007 AR (PPO C-SNP), requiring a $375 daily copay for days 1 through 6 and no copay or coinsurance for days 7 through 90. Prior authorization is required, and specific services such as hospital upgrades, non-Medicare-covered stays, and additional days for psychiatric stays are not covered.
Outpatient Services See details
DEVOTED C-SNP CHOICE PREMIUM 007 AR (PPO C-SNP) covers outpatient services with no coinsurance, featuring a $0 to $475 copay for outpatient hospital services and a $375 copay per stay for observation services. Ambulatory surgical center services are covered with no copay, and outpatient substance abuse sessions require a $40 copay.
Partial Hospitalization See details
DEVOTED C-SNP CHOICE PREMIUM 007 AR (PPO C-SNP) covers partial hospitalization services with a $70.00 copay and no coinsurance. Prior authorization is required to access these covered benefits.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are partially covered by DEVOTED C-SNP CHOICE PREMIUM 007 AR (PPO C-SNP), as transportation services to health-related locations are not covered. Covered ground ambulance services require a copay ranging from no copay to $350 along with coinsurance, while air ambulance services require a 20% coinsurance and a copay.
Emergency Services See details
Emergency services are covered by DEVOTED C-SNP CHOICE PREMIUM 007 AR (PPO C-SNP) with a $130 copay and no coinsurance, with the copay waived if admitted to the hospital within 24 hours. Urgently needed services range from no copay to a $45 copay with no coinsurance, while worldwide emergency services are covered up to $25,000 with copays between $130 and $350 and up to 20% coinsurance.
Primary Care See details
DEVOTED C-SNP CHOICE PREMIUM 007 AR (PPO C-SNP) covers primary care, specialist, and therapy services with copays ranging from no copay up to $50 and no coinsurance. Chiropractic services are partially covered, as routine chiropractic care is not covered under this plan.
Preventive Services See details
Preventive Services are partially covered by DEVOTED C-SNP CHOICE PREMIUM 007 AR (PPO C-SNP), offering Medicare-covered zero-dollar preventive care and annual physicals with no copay or coinsurance. Sub-services that are not covered under this plan include in-home safety assessments, personal emergency response systems, post-discharge medication reconciliation, re-admission prevention, wigs for chemotherapy hair loss, therapeutic massage, adult day health, home-based palliative care, in-home support, caregiver support, additional smoking cessation counseling, enhanced disease management, telemonitoring, remote access technologies, and counseling services.
Hearing Services See details
Hearing services are partially covered by DEVOTED C-SNP CHOICE PREMIUM 007 AR (PPO C-SNP), including routine hearing exams for a $40 copay and no coinsurance, and fitting evaluations with no copay and no coinsurance. Up to two prescription hearing aids (all types) are covered annually with a copay of $399 to $699 and no coinsurance, though OTC hearing aids and inner ear, outer ear, and over the ear prescription hearing aids are not covered.
Vision Services See details
DEVOTED C-SNP CHOICE PREMIUM 007 AR (PPO C-SNP) covers vision services with no coinsurance, featuring a $0 to $40 copay for annual routine eye exams. Eyewear, including contacts, frames, lenses, and upgrades, is also covered with no coinsurance up to a combined maximum benefit of $300 per year.
Dental Services See details
Dental services are partially covered by DEVOTED C-SNP CHOICE PREMIUM 007 AR (PPO C-SNP), as maxillofacial prosthetics, implant services, and orthodontics are not covered. Medicare-covered dental services require a $40 copay and no coinsurance, while other covered dental services are subject to a $2,000 annual maximum.
Home Infusion bundled Services See details
Home infusion bundled services are covered by DEVOTED C-SNP CHOICE PREMIUM 007 AR (PPO C-SNP) with prior authorization required. Medicare Part B insulin drugs require a $35 copay and no coinsurance to 20% coinsurance, while chemotherapy, radiation, and other Part B drugs require no copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered by DEVOTED C-SNP CHOICE PREMIUM 007 AR (PPO C-SNP) with a 20% coinsurance and no copay. Prior authorization is required for these services.
Medical Equipment See details
DEVOTED C-SNP CHOICE PREMIUM 007 AR (PPO C-SNP) partially covers medical equipment, since diabetic therapeutic shoes and inserts are not covered. Covered items, including durable medical equipment, prosthetics, and diabetic supplies, have no copay and coinsurance ranging from no coinsurance up to 50%.
Diagnostic and Radiological Services See details
DEVOTED C-SNP CHOICE PREMIUM 007 AR (PPO C-SNP) covers diagnostic and radiological services, with prior authorization required. Members pay no copay and no coinsurance for lab services and outpatient X-rays, a $0 to $95 copay with no coinsurance for diagnostic tests, a $0 to $300 copay with no coinsurance for diagnostic radiology, and a 20% coinsurance with no copay for therapeutic radiological services.
Home Health Services See details
Home Health Services are covered under the DEVOTED C-SNP CHOICE PREMIUM 007 AR (PPO C-SNP) plan, though prior authorization is required. Specific copay and coinsurance amounts for these services are not detailed in the plan summary.
Cardiac Rehabilitation Services See details
DEVOTED C-SNP CHOICE PREMIUM 007 AR (PPO C-SNP) does not cover Cardiac Rehabilitation Services, as cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are all excluded from coverage. Since these services are not covered, there are no copays or coinsurance benefits available for them under this plan.
Skilled Nursing Facility (SNF) See details
DEVOTED C-SNP CHOICE PREMIUM 007 AR (PPO C-SNP) covers Skilled Nursing Facility (SNF) services with prior authorization, offering no copay for days 1 through 20 and a $218 copay for days 21 through 100 with no coinsurance. This benefit is partially covered, as additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Other Services are partially covered by DEVOTED C-SNP CHOICE PREMIUM 007 AR (PPO C-SNP), which provides a $50 quarterly allowance for over-the-counter items, as well as coverage for non-Medicare diabetic shoes and additional preventive services with no copays or coinsurance specified. Acupuncture, meal benefits, and highly integrated dual-eligible SNP services are not covered.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
*/SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
MedicareAdvantageRX.com is owned and operated by Dog Media Solutions LLC.
This is a promotional communication.
Every year, Medicare evaluates plans based on a 5-star rating system.
Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
Enrollment in Medicare/Medicare Advantage may be limited to certain times of the year unless you qualify for a Special Enrollment Period
We do not offer every plan available in your area. Currently, we represent 18 organizations, which offer 52,101 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
We represent Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan's contract renewal.
Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.
Please contact Medicare.gov ,1-800-MEDICARE , or your local State Health Insurance Program (SHIP) to get information on all of your options.
Medicare has neither approved nor endorsed any information on this site.
Speak with a licensed insurance agent: 1-877-649-2073 / TTY 711 | 8am - 11pm ET | 7 days a week
© 2023 Dog Media Solutions LLC. All rights reserved