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Devoted CORE Tennessee (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Devoted CORE Tennessee (HMO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Devoted CORE Tennessee (HMO) in 2025, please refer to our full plan details page.
Devoted CORE Tennessee (HMO) is a HMO plan offered by Devoted Health, Inc. available for enrollment in 2025 to people living in Chattanooga. This plan received an overall rating of 4 out of 5 stars in 2025.
It's important to know that Devoted CORE Tennessee (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 Tennessee (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 Tennessee (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 $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 Maximum Out-Of-Pocket cost of $4500.00 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 Tennessee (HMO) plan has an "Enhanced Alternative" drug benefit. The plan has a deductible of $590.00. In the initial coverage phase, after you pay your deductible, you will pay either a 25% coinsurance or no copay depending on the drug tier and pharmacy. Once your total drug costs reach $2000.00, you enter the catastrophic coverage phase where you pay nothing for Part D covered drugs.
Additional Benefits
The Devoted CORE Tennessee (HMO) plan offers a wide range of benefits with varying costs. Inpatient hospital stays have a $295 copay for days 1-5, and no copay for days 6-90. Outpatient services have copays ranging from $0 to $395, while primary care visits have copays between $20 and $30. The plan covers a variety of services including hearing, vision, and dental with copays for exams and some treatments. It also includes ambulance, emergency, and home health services, as well as cardiac rehabilitation and skilled nursing facility stays. However, certain services like routine chiropractic care, podiatry, and some dental services are not covered.
Inpatient Hospital See details
Inpatient Hospital benefits, including Acute and Psychiatric, are covered. For days 1-5, the copay is $295, and for days 6-90, there is no copay.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services, with a copay between $0 and $395, and observation services with a $295 copay. Ambulatory Surgical Center (ASC) Services have no copay, and individual and group sessions for outpatient substance abuse have a $30 copay. Outpatient blood services are also covered, including services not usually covered by Medicare plans.
Partial Hospitalization See details
Partial Hospitalization is covered with a $85 copay, and prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Devoted CORE Tennessee (HMO) plan. Ground ambulance services have a copay between $0 and $300, while air ambulance services have a 20% coinsurance; however, 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 under the Devoted CORE Tennessee (HMO) plan. Emergency Services have a $125 copay, while Urgently Needed Services have a copay between $0 and $45. Worldwide Emergency Transportation has a $300 copay and 20% coinsurance, while Worldwide Emergency Coverage and Worldwide Urgent Coverage each have a $125 copay.
Primary Care See details
The Devoted CORE Tennessee (HMO) plan covers primary care physician services, chiropractic services, occupational therapy, physician specialist services, mental health specialty services, other health care professional services, psychiatric services, physical therapy and speech-language pathology services, opioid treatment program services, and additional telehealth benefits. Chiropractic services have a $20 copay, while occupational therapy has a copay between $30 and $45. Physician specialist services have a $30 copay, and physical therapy and speech-language pathology services have a copay between $30 and $50. Individual and group sessions for mental health and psychiatric services have a $30 copay. Other health care professional services have a copay between $0 and $30, and opioid treatment program services have a $30 copay. Additional telehealth benefits have a copay between $0 and $30. Routine chiropractic care and podiatry services are not covered.
Preventive Services See details
Preventive Services are covered, including services not usually covered by Medicare plans. Some services are not covered, including In-Home Safety Assessment, Medical Nutrition Therapy, Post discharge In-Home Medication Reconciliation, Re-admission Prevention, Wigs for Hair Loss Related 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.
Hearing Services See details
Hearing services include hearing exams with a $30 copay, and fitting/evaluation for hearing aids. Prescription hearing aids are covered with a copay between $399 and $699. Prescription hearing aids for the inner ear, outer ear, and over the ear are not covered, nor are OTC hearing aids.
Vision Services See details
The Devoted CORE Tennessee (HMO) plan covers vision services, including routine eye exams with a $30 copay. The plan also covers eyewear, with a combined maximum benefit of $1000 every year, as well as contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades.
Dental Services See details
Devoted CORE Tennessee (HMO) covers dental services, including oral exams with a $30 copay, dental x-rays, and other diagnostic and preventive services. The plan has a $1,000 maximum benefit per year and covers orthodontic services under Diagnostic and Preventive Dental. Maxillofacial Prosthetics, Implant Services, and Orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, and require prior authorization. For Medicare Part B Insulin Drugs, there is a $35 copay and 20% coinsurance; for Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, coinsurance ranges from 0% to 20%.
Dialysis Services See details
Dialysis Services are covered by the Devoted CORE Tennessee (HMO) plan with a coinsurance between 20% and 20%.
Medical Equipment See details
Medical Equipment benefits include coverage for Durable Medical Equipment with a coinsurance between 0% and 25%, Prosthetic Devices with a coinsurance between 0% and 20%, and Medical Supplies with a 20% coinsurance; however, Durable Medical Equipment for use outside the home, Diabetic Supplies, and Diabetic Therapeutic Shoes/Inserts are not covered. There is no copay for any of these benefits.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services include coverage for all diagnostic services, diagnostic procedures/tests with a copay between $0 and $95, and lab services with no copay. Radiological Services include coverage for Diagnostic Radiological Services with a copay up to $300, Therapeutic Radiological Services with a coinsurance of at least 20%, and Outpatient X-Ray Services with no copay.
Home Health Services See details
Home Health Services are covered by the Devoted CORE Tennessee (HMO) plan with no copay and no coinsurance, though authorization is required. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by the Devoted CORE Tennessee (HMO) plan. However, the plan does not cover Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, or Additional Cardiac Rehabilitation Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by Devoted CORE Tennessee (HMO), 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
Other Services, under the Devoted CORE Tennessee (HMO) plan, are not covered for 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, and Self-Directed Personal Assistance Services. Other 2 benefits are covered, with no copay for preventive services.
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