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Devoted BE WELL San Antonio (HMO C-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Devoted BE WELL San Antonio (HMO C-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Devoted BE WELL San Antonio (HMO C-SNP) in 2025, please refer to our full plan details page.
Devoted BE WELL San Antonio (HMO C-SNP) is a HMO C-SNP plan offered by Devoted Health, Inc. available for enrollment in 2025 to people living in San Antonio. This plan received an overall rating of 4.5 out of 5 stars in 2025.
It's important to know that Devoted BE WELL San Antonio (HMO 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 BE WELL San Antonio (HMO 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 BE WELL San Antonio (HMO 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 BE WELL San Antonio (HMO C-SNP), 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 $3900.00 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 BE WELL San Antonio (HMO C-SNP) plan has a $590 deductible for prescription drugs. After the deductible, you'll pay for your prescriptions based on the drug tier and pharmacy type. For example, in the initial coverage phase, you may pay no copay for preferred generic drugs at a standard or mail-order pharmacy. For standard generic, preferred brand, and non-preferred drugs, you pay 25% coinsurance. After your total drug costs reach $2000, you enter the catastrophic coverage phase and pay nothing for your prescriptions.
Additional Benefits
The Devoted BE WELL San Antonio (HMO C-SNP) plan offers coverage for a wide range of services, including inpatient and outpatient hospital care, with varying copays. It also covers services like primary care, vision, hearing, and dental, with copays for exams and specific services. Emergency and ambulance services are included, as well as home health and skilled nursing facility care. Additional benefits of the plan include coverage for preventive services, home infusion, and medical equipment with varying cost-sharing. Diagnostic and radiological services are covered, along with cardiac rehabilitation, while some services like private duty nursing and certain other services are not covered.
Inpatient Hospital See details
Inpatient Hospital benefits, including acute and psychiatric, are covered. For days 1-5, the copay is $325, and for days 6-90, there is no copay.
Outpatient Services See details
Outpatient Services include coverage for Outpatient Hospital Services with a copay of $0-$425, Observation Services with a $325 copay, Ambulatory Surgical Center (ASC) Services with no copay, Outpatient Substance Abuse Services with a $30 copay for both individual and group sessions, and Outpatient Blood Services.
Partial Hospitalization See details
Partial Hospitalization is covered by the Devoted BE WELL San Antonio (HMO C-SNP) plan, and requires prior authorization. You will have a $55 copay for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered under the Devoted BE WELL San Antonio (HMO C-SNP) plan. Ground Ambulance Services have a copay of $0 - $125, while Air Ambulance Services have a 20% coinsurance. Transportation Services to any health-related location are not covered.
Emergency Services See details
Emergency Services are covered by the Devoted BE WELL San Antonio (HMO C-SNP) plan with a $140 copay, and Urgently Needed Services are covered with a copay between $0 and $45. Worldwide Emergency Services are covered, with a $140 copay for Worldwide Emergency Coverage and Worldwide Urgent Coverage, and a $125 copay with 20% coinsurance for Worldwide Emergency Transportation.
Primary Care See details
Primary Care Physician Services, Chiropractic Services, Occupational Therapy Services, Physician Specialist Services, Mental Health Specialty Services, Podiatry Services, Other Health Care Professional, Psychiatric Services, Physical Therapy and Speech-Language Pathology Services, Additional Telehealth Benefits, and Opioid Treatment Program Services are covered under the Devoted BE WELL San Antonio (HMO C-SNP) plan. Chiropractic Services have a $20 copay, Occupational Therapy Services have a copay between $30-$50, Physician Specialist Services have a copay between $0-$30, and Physical Therapy and Speech-Language Pathology Services have a copay between $30-$50. Routine Chiropractic Care is not covered. Individual and Group Sessions for Mental Health and Psychiatric Services, and Opioid Treatment Program Services have a $30 copay.
Preventive Services See details
The Devoted BE WELL San Antonio (HMO C-SNP) plan covers preventive services, including annual physical exams, health education, personal emergency response systems, medical nutrition therapy, weight management programs, alternative therapies, nutritional/dietary benefits, fitness benefits, home and bathroom safety devices, glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKGs, with no copay. However, in-home safety assessments, 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 are not covered.
Hearing Services See details
Hearing Services include routine hearing exams with a $30 copay, and fitting/evaluation for hearing aids. Prescription hearing aids are covered with a copay between $199 and $499, and only the "Prescription Hearing Aids (all types)" are covered.
Vision Services See details
The Devoted BE WELL San Antonio (HMO C-SNP) plan covers vision services, including routine eye exams with a $30 copay, and eyewear with a combined maximum benefit of $1000 per year. The plan also covers contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades.
Dental Services See details
Devoted BE WELL San Antonio (HMO C-SNP) covers dental services, including Medicare dental services with a $30 copay, and other dental services such as oral exams, dental x-rays, other diagnostic dental services, fluoride treatment, other preventive dental services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), and oral and maxillofacial surgery. This plan's orthodontic services have a maximum benefit of $1000 per year, and does not cover maxillofacial prosthetics, implant services, and orthodontics.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Insulin, Medicare Part B Chemotherapy/Radiation Drugs, and Other Medicare Part B Drugs. The cost for Medicare Part B Insulin Drugs includes 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 BE WELL San Antonio (HMO C-SNP) plan. There is a 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with a 0-50% coinsurance and no copay, Prosthetic Devices with 0-20% coinsurance and no copay, and Medical Supplies with 20% coinsurance and no copay; however, Durable Medical Equipment for use outside the home, 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 BE WELL San Antonio (HMO C-SNP) plan. Diagnostic Procedures/Tests have a copay between $0 and $95, Lab Services have no copay, Diagnostic Radiological Services have a copay of at most $300, and Therapeutic Radiological Services have a coinsurance of at least 20%.
Home Health Services See details
Home Health Services are covered by the Devoted BE WELL San Antonio (HMO C-SNP) plan, with no copay or coinsurance. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by the Devoted BE WELL San Antonio (HMO C-SNP) plan, but all of the sub-services are not covered. The plan has a copay, but the specific amount is not listed.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) benefits are covered by the Devoted BE WELL San Antonio (HMO C-SNP) plan, with prior authorization required. For days 1-20, there is no copay, and for days 21-100, the copay is $214.
Other Services See details
Other Services, 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 are not covered. Other 1 covers diabetic shoes, and Other 2 covers $0 preventive services.
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