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Devoted CORE Greater Houston (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Devoted CORE Greater Houston (HMO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Devoted CORE Greater Houston (HMO) in 2025, please refer to our full plan details page.
Devoted CORE Greater Houston (HMO) is a HMO plan offered by Devoted Health, Inc. available for enrollment in 2025 to people living in Houston. This plan received an overall rating of 4.5 out of 5 stars in 2025.
It's important to know that Devoted CORE Greater Houston (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 Greater Houston (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 Greater Houston (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 $4150.00 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 Greater Houston (HMO) plan has a $590 deductible for prescription drugs. In the initial coverage phase, after you meet your deductible, you will pay either a copay or coinsurance for your prescriptions. For preferred generic drugs, there is no copay when using a standard or mail pharmacy. For standard generic, preferred brand, and non-preferred drugs, you pay 25% coinsurance.
Additional Benefits
The Devoted CORE Greater Houston (HMO) plan offers a wide range of benefits, including inpatient and outpatient hospital services, with varying copays depending on the service. You'll find coverage for primary care, preventive services, hearing, vision, and dental, as well as home health and skilled nursing facility care. This plan also covers ambulance and emergency services, with copays and coinsurance amounts that vary by service. Prescription hearing aids and eyewear are included, and dental services have a $1,000 maximum benefit per year.
Inpatient Hospital See details
Inpatient Hospital services are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, with prior authorization required. For Inpatient Hospital-Acute, you will pay a $225 copay for days 1-5, and no copay for days 6-90, and for Inpatient Hospital Psychiatric, you will pay a $225 copay for days 1-7, and no copay for days 8-90.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services, with a copay between $0 and $325, and observation services with a $225 copay. Ambulatory Surgical Center (ASC) Services have no copay, and outpatient substance abuse services, including individual and group sessions, have a copay of $25. Outpatient blood services are also covered.
Partial Hospitalization See details
Partial Hospitalization is covered by the Devoted CORE Greater Houston (HMO) plan. This benefit requires prior authorization and has a copay of $55.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Devoted CORE Greater Houston (HMO) plan. Ground ambulance services have a copay of $0-$325, while air ambulance services have a 20% coinsurance, and 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 by the Devoted CORE Greater Houston (HMO) plan. Emergency Services have a $140 copay, and Urgently Needed Services have a copay between $0 and $45. Worldwide Emergency Transportation has a 20% coinsurance and a $325 copay, while Worldwide Emergency Coverage and Worldwide Urgent Coverage have a $140 copay.
Primary Care See details
The Devoted CORE Greater Houston (HMO) plan covers primary care physician services, chiropractic services with a $20 copay, occupational therapy services with a $0-$50 copay, and physician specialist services with a $0-$25 copay. Mental health specialty services and psychiatric services have a $25 copay for individual and group sessions, while physical therapy and speech-language pathology services have a $0-$50 copay. The plan also covers additional telehealth benefits with a $0-$25 copay and opioid treatment program services with a $25 copay.
Preventive Services See details
Preventive Services include coverage for Medicare-covered preventive services, annual physical exams, health education, Personal Emergency Response System (PERS), weight management programs, alternative therapies, nutritional/dietary benefits, fitness benefits, home and bathroom safety devices and modifications, Kidney Disease Education Services, Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit. This plan does not cover In-Home Safety Assessment, Medical Nutrition Therapy (MNT), 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 (including Web/Phone-based technologies and Nursing Hotline), and Counseling Services.
Hearing Services See details
Hearing Services include routine hearing exams with a $20 copay, fitting/evaluation for hearing aids with no copay, and prescription hearing aids with a copay between $0-$299. Prescription Hearing Aids - Inner Ear, Prescription Hearing Aids - Outer Ear, and Prescription Hearing Aids - Over the Ear are not covered, as well as OTC Hearing Aids.
Vision Services See details
Vision services include coverage for eye exams with a $20 copay, and eyewear with a combined maximum benefit of $1,000 every year. Contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades are also covered.
Dental Services See details
The Devoted CORE Greater Houston (HMO) plan covers dental services, including Medicare Dental Services with a $25 copay and other dental services, with a $1,000 maximum benefit per year. 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 are covered. Maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, requiring prior authorization. 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 0-20% coinsurance.
Dialysis Services See details
Dialysis Services are covered under the Devoted CORE Greater Houston (HMO) plan, with a coinsurance of 20%.
Medical Equipment See details
Medical Equipment is covered, with Durable Medical Equipment (DME) subject to a 0-35% coinsurance and Prosthetic Devices covered with a 0-20% coinsurance. Medical Supplies have a 20% coinsurance, and Diabetic Equipment is covered, though Diabetic Supplies and Diabetic Therapeutic Shoes/Inserts are not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered by the Devoted CORE Greater Houston (HMO) plan. Diagnostic Procedures/Tests have a copay between $0 and $150, while Lab Services have no copay. Diagnostic Radiological Services have a copay up to $200. Therapeutic Radiological Services have a coinsurance of at least 20%, and Outpatient X-Ray Services have no copay.
Home Health Services See details
Home Health Services are covered by the Devoted CORE Greater Houston (HMO) plan with no copay and no coinsurance, but additional hours of care and personal care services are not covered. This benefit requires authorization.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the Devoted CORE Greater Houston (HMO) plan. 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 with prior authorization required. For days 1-20, there is no copay, and for days 21-100, the copay is $214 per day; additional days beyond Medicare-covered for SNF and non-Medicare-covered stays for SNF are not covered.
Other Services See details
Other Services are not covered, including 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.
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