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DEVOTED CORE 007 TN (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for DEVOTED CORE 007 TN (HMO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on DEVOTED CORE 007 TN (HMO) in 2026, please refer to our full plan details page.
DEVOTED CORE 007 TN (HMO) is a HMO plan offered by Devoted Health, Inc. available for enrollment in 2025 to people living in Nashville. This plan received an overall rating of 3.5 out of 5 stars in 2026.
It's important to know that DEVOTED CORE 007 TN (HMO) 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 CORE 007 TN (HMO).
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 CORE 007 TN (HMO), 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 Maximum Out-Of-Pocket cost of $6400.00 for out-of-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $0.00 for in-network covered services, the plan will pay 100% of in-network covered costs for the rest of the year.
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 CORE 007 TN (HMO) medicare plan features an annual prescription drug deductible of $375. Under this plan, Tier 1 preferred generic drugs have no copay for one, two, or three-month fills at standard pharmacies and standard mail-order services. Tier 2 generic drugs are also budget-friendly, costing a $5 copay for a one-month supply and up to a $15 copay for a three-month supply. For brand-name and specialty medications, the plan utilizes coinsurance rather than flat copays. Tier 3 preferred brand drugs require a 24% coinsurance, and Tier 4 non-preferred drugs carry a 25% coinsurance for standard pharmacy and mail-order fills. Tier 5 specialty drugs are covered at a 28% coinsurance for a one-month supply.
Additional Benefits
The DEVOTED CORE 007 TN (HMO) plan offers comprehensive medical coverage with no copay for primary care visits and a $30 copay for specialist consultations. If you require hospital care, inpatient stays have a $325 daily copay for days one through five and no copay for days six through 90, while emergency room services require a $130 copay that is waived upon admission. Outpatient hospital care features a copay ranging from no copay up to $425, with no coinsurance required. For additional wellness benefits, the plan provides up to $2,500 annually for dental services with no copay for preventive care. Members also enjoy a $200 annual allowance for eyewear with no copay, hearing aid coverage with copays from $399 to $699, and a $50 over-the-counter allowance every three months. Skilled nursing facility stays are also covered with no copay for the first 20 days.
Inpatient Hospital See details
DEVOTED CORE 007 TN (HMO) covers inpatient acute and psychiatric hospital stays with no coinsurance, requiring a $325 daily copay for days 1 through 5 and no copay for days 6 through 90. Prior authorization is required, and coverage is partial as upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
DEVOTED CORE 007 TN (HMO) covers outpatient services with no coinsurance, featuring a $0 to $425 copay for outpatient hospital services and a $325 copay per stay for observation services. Ambulatory surgical center and outpatient blood services are available with no copay and no coinsurance, while outpatient substance abuse sessions require a $30 copay with no coinsurance.
Partial Hospitalization See details
DEVOTED CORE 007 TN (HMO) covers partial hospitalization services with a $60.00 copay and no coinsurance. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
DEVOTED CORE 007 TN (HMO) covers ambulance services with prior authorization, requiring a $0 to $315 copay for ground services and a 20% coinsurance for air services. Transportation services are not covered under this plan.
Emergency Services See details
DEVOTED CORE 007 TN (HMO) covers emergency services with a $130 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services range from no copay to a $45 copay with no coinsurance, and worldwide emergency services are covered up to $25,000 with copays ranging from $130 to $315 and up to 20% coinsurance.
Primary Care See details
DEVOTED CORE 007 TN (HMO) offers primary care physician services with no copay and no coinsurance, while specialist and mental health visits require a $30 copay and no coinsurance. Physical, occupational, and speech therapies have a $30 to $50 copay and no coinsurance, but podiatry is not covered, and chiropractic care is only partially covered, with routine chiropractic care and other chiropractic services not covered.
Preventive Services See details
Preventive services are partially covered under DEVOTED CORE 007 TN (HMO) with no copay and no coinsurance for covered benefits like annual physical exams, fitness benefits, and kidney disease education. Sub-services that are not covered under this plan 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, additional smoking cessation counseling, enhanced disease management, telemonitoring, remote access technologies, and counseling.
Hearing Services See details
Hearing services are covered by DEVOTED CORE 007 TN (HMO), including annual routine exams and fittings for a $30 copay and no coinsurance. Up to two prescription hearing aids are covered per year with copays ranging from $399 to $699 and no coinsurance, though OTC hearing aids and inner ear, outer ear, or over-the-ear prescription hearing aids are not covered.
Vision Services See details
DEVOTED CORE 007 TN (HMO) partially covers vision services, as other eye exam services are not covered. One routine eye exam is covered per year with a $0 to $30 copay and no coinsurance, and eyewear is covered with no copay, no coinsurance, up to a $200 annual maximum.
Dental Services See details
Dental Services are partially covered by DEVOTED CORE 007 TN (HMO), offering up to a $2,500 annual limit with no copay and no coinsurance for preventive care, and no copay with 0% to 50% coinsurance for restorative and endodontic services. Medicare-covered dental services require a $30 copay and no coinsurance, but maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
DEVOTED CORE 007 TN (HMO) covers home infusion bundled services with no copay, though prior authorization is required. Covered Part B chemotherapy, radiation, and other drugs carry no copay and 0% to 20% coinsurance, while Part B insulin is covered with a $35 copay and 0% to 20% coinsurance.
Dialysis Services See details
DEVOTED CORE 007 TN (HMO) covers Dialysis Services with no copay and a 20% coinsurance, although prior authorization is required.
Medical Equipment See details
DEVOTED CORE 007 TN (HMO) covers medical equipment with no copays, though prior authorization is required and coinsurance applies to covered items. Durable medical equipment requires a 20% to 50% coinsurance, prosthetics and medical supplies range from no coinsurance to 20% coinsurance, and diabetic supplies range from no coinsurance to 50% coinsurance, but diabetic therapeutic shoes and inserts are not covered.
Diagnostic and Radiological Services See details
DEVOTED CORE 007 TN (HMO) covers diagnostic and radiological services with prior authorization required. Lab services feature no copay and no coinsurance, diagnostic procedures have no coinsurance with a copay ranging from $0 to $95, and outpatient X-rays have no copay but require coinsurance, while therapeutic radiology services require a minimum 20% coinsurance.
Home Health Services See details
Home health services are covered by DEVOTED CORE 007 TN (HMO) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
DEVOTED CORE 007 TN (HMO) covers some cardiac rehabilitation services with no copay and no coinsurance, though prior authorization is required. However, standard cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) services are not covered.
Skilled Nursing Facility (SNF) See details
DEVOTED CORE 007 TN (HMO) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring prior authorization but allowing admission without a prior three-day inpatient hospital stay. There is no copay for days 1 through 20 and a $218 daily copay for days 21 through 100, though additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Other services are partially covered by DEVOTED CORE 007 TN (HMO), featuring over-the-counter (OTC) items up to $50 every three months and additional preventive services with no copay and no coinsurance. Acupuncture and meal benefits are not covered under this plan.
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