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DEVOTED DUAL 010 TX (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for DEVOTED DUAL 010 TX (HMO D-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on DEVOTED DUAL 010 TX (HMO D-SNP) in 2026, please refer to our full plan details page.
DEVOTED DUAL 010 TX (HMO D-SNP) is a HMO D-SNP plan offered by Devoted Health, Inc. available for enrollment in 2025 to people living in Houston. This plan received an overall rating of 5 out of 5 stars in 2026.
It's important to know that DEVOTED DUAL 010 TX (HMO D-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
DEVOTED DUAL 010 TX (HMO D-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 DUAL 010 TX (HMO D-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 DUAL 010 TX (HMO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $4.80. 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 Maximum Out-Of-Pocket cost of $9250.00 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 DUAL 010 TX (HMO D-SNP) Medicare plan features an annual prescription drug deductible of $615. For standard pharmacies and standard mail-order services, you will pay a 25% coinsurance on Tier 1 preferred generics, Tier 2 generics, Tier 3 preferred brands, and Tier 4 non-preferred drugs. Tier 5 specialty drugs also require a 25% coinsurance for a 1-month supply. Additionally, Tier 6 select care drugs are covered with no copay for 1-month, 2-month, and 3-month supplies at standard pharmacies and standard mail order. This Medicare Advantage plan provides a clear cost structure for beneficiaries seeking predictable prescription drug coverage in Texas.
Additional Benefits
The DEVOTED DUAL 010 TX (HMO D-SNP) plan offers robust medical coverage, featuring no copay and no coinsurance for primary care visits and preventive services like annual physicals. For inpatient hospital stays, members pay a $2,080 copayment per admission with no coinsurance, while outpatient services generally require no copays and coinsurance ranging up to 20 percent. Specialist visits, diagnostic tests, and urgent care also feature no copayments, though coinsurance of up to 20 percent may apply. This plan provides valuable extra benefits, including up to $2,000 annually for dental care and a $400 annual allowance for eyewear with no copays or coinsurance. Members also receive routine hearing exams with no copay, alongside prescription hearing aid coverage with copayments ranging from $399 to $699. Additionally, the plan covers home health services with no copay and provides a $50 allowance every three months for over-the-counter items.
Inpatient Hospital See details
DEVOTED DUAL 010 TX (HMO D-SNP) covers inpatient hospital services with a $2,080 copayment per admission and no coinsurance, requiring prior authorization for both acute and psychiatric stays. This benefit is partially covered because upgrades, non-Medicare-covered stays, and additional days for psychiatric stays are not covered.
Outpatient Services See details
DEVOTED DUAL 010 TX (HMO D-SNP) covers outpatient services with no copays, though coinsurance ranging from no coinsurance to 20% applies to outpatient hospital and ambulatory surgical center services. A 20% coinsurance applies to observation, outpatient substance abuse, and blood services, with prior authorization required for most of these benefits.
Partial Hospitalization See details
Partial hospitalization services are covered by DEVOTED DUAL 010 TX (HMO D-SNP) with no copay and a 20% coinsurance, though prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered by DEVOTED DUAL 010 TX (HMO D-SNP) with no copay, requiring a 0% to 20% coinsurance for ground ambulance and a 20% coinsurance for air ambulance. Although transportation is technically covered, transportation to plan-approved or any health-related locations is not covered.
Emergency Services See details
DEVOTED DUAL 010 TX (HMO D-SNP) covers emergency services with a $115 copay, which is waived if admitted to the hospital within 24 hours, and no coinsurance. Urgently needed services are covered with no copay and a 0% to 20% coinsurance (up to $40 per visit), while worldwide emergency, urgent, and transportation services are covered up to a $25,000 limit with no copay and no coinsurance.
Primary Care See details
DEVOTED DUAL 010 TX (HMO D-SNP) covers primary care physician services with no copay and no coinsurance, while specialist, therapy, psychiatric, mental health, and opioid treatment services require no copay and 20% coinsurance. Telehealth and other health professional services feature no copay and 0% to 20% coinsurance, though podiatry is not covered, and for chiropractic care, some services are covered but routine and other chiropractic services are not covered.
Preventive Services See details
Preventive services are partially covered by DEVOTED DUAL 010 TX (HMO D-SNP) with no copay and no coinsurance for covered options like annual physicals, fitness benefits, and kidney disease education. However, the plan does not cover in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, readmission prevention, wigs, therapeutic massage, adult day health, home-based palliative care, in-home support, caregiver support, additional smoking cessation, enhanced disease management, telemonitoring, remote access technologies, or counseling.
Hearing Services See details
DEVOTED DUAL 010 TX (HMO D-SNP) hearing services are partially covered, featuring one routine hearing exam per year with no copay and a 20% coinsurance, alongside unlimited fitting evaluations with no copay or coinsurance. Prescription hearing aids are covered with no coinsurance and a copay ranging from $399 to $699 for up to two aids per year, though OTC hearing aids and inner ear, outer ear, and over the ear prescription hearing aids are not covered.
Vision Services See details
DEVOTED DUAL 010 TX (HMO D-SNP) offers partially covered vision services, featuring one annual routine eye exam with no copay and 0% to 20% coinsurance, while other eye exam services are not covered. Eyewear is covered with no copay and no coinsurance up to a $400 annual maximum for contacts, eyeglasses, lenses, frames, and upgrades.
Dental Services See details
DEVOTED DUAL 010 TX (HMO D-SNP) partially covers dental services, offering up to a $2,000 annual limit for preventive and comprehensive care with no copay and no coinsurance, while Medicare-covered dental has no copay and a 20% coinsurance. Sub-services not covered under this plan include other diagnostic, other preventive, maxillofacial prosthetics, implants, and orthodontics.
Home Infusion bundled Services See details
Home infusion bundled services are covered by DEVOTED DUAL 010 TX (HMO D-SNP) with no copay and no coinsurance, subject to prior authorization and step therapy. Medicare Part B chemotherapy, radiation, and other drugs carry no copay and 0% to 20% coinsurance, while Part B insulin requires a $35 copay and 0% to 20% coinsurance that counts toward the plan deductible.
Dialysis Services See details
DEVOTED DUAL 010 TX (HMO D-SNP) covers dialysis services with no copay and a 20% coinsurance. Prior authorization is required for this benefit.
Medical Equipment See details
DEVOTED DUAL 010 TX (HMO D-SNP) covers medical equipment with no copay, though prior authorization is required for these services. Covered durable medical equipment and diabetic shoes carry an 18% coinsurance, while diabetic supplies require 18% to 20% coinsurance, and prosthetic devices and medical supplies range from no coinsurance to 18% coinsurance.
Diagnostic and Radiological Services See details
DEVOTED DUAL 010 TX (HMO D-SNP) covers diagnostic and radiological services with prior authorization and no copays. Diagnostic procedures and tests carry no coinsurance, while lab services, diagnostic and therapeutic radiological services, and outpatient X-rays require a 20% coinsurance.
Home Health Services See details
DEVOTED DUAL 010 TX (HMO D-SNP) covers home health services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services under DEVOTED DUAL 010 TX (HMO D-SNP) require prior authorization and have no copay, though only some services are covered in practice. Specifically, cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) services are not covered and require a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is covered by DEVOTED DUAL 010 TX (HMO D-SNP) with no coinsurance and no prior three-day hospital stay required, though prior authorization is necessary. There is no copay for days 1 through 20, followed by a $218 daily copay for days 21 through 100, with no coverage provided for additional days beyond the standard Medicare limit.
Other Services See details
DEVOTED DUAL 010 TX (HMO D-SNP) provides coverage for select other services with no copay and no coinsurance, including additional preventive services and up to $50 every three months for over-the-counter (OTC) items. Acupuncture, meal benefits, and highly integrated services are not covered under this plan.
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