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Devoted CORE Austin (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Devoted CORE Austin (HMO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Devoted CORE Austin (HMO) in 2025, please refer to our full plan details page.
Devoted CORE Austin (HMO) is a HMO plan offered by Devoted Health, Inc. available for enrollment in 2025 to people living in Austin. This plan received an overall rating of 4.5 out of 5 stars in 2025.
It's important to know that Devoted CORE Austin (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 Austin (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 Austin (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 $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 Austin (HMO) plan has an Enhanced Alternative drug benefit. The plan has a $590 deductible for prescription drugs. Once the deductible is met, you will pay different amounts depending on the drug tier. For example, there is no copay for preferred generic drugs through standard or mail order pharmacies. You will pay 25% coinsurance for standard generic, preferred brand, and non-preferred drugs.
Additional Benefits
The Devoted CORE Austin (HMO) plan offers a wide range of benefits with varying cost-sharing. You'll find no copays for primary care visits, and home health services. You'll have a $35 copay for specialist visits, hearing exams, vision exams, dental services, and mental health services. Inpatient hospital stays have a $325 copay for days 1-5, and no copay for days 6-90. Emergency services have a $125 copay, and outpatient services have copays ranging from $0 to $425. The plan also includes coverage for hearing aids, vision, and dental services with specific copays and annual limits.
Inpatient Hospital See details
Inpatient Hospital benefits, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, are covered. For Inpatient Hospital-Acute, you will pay a $325 copay for days 1-5, and no copay for days 6-90. For Inpatient Hospital Psychiatric, you will pay a $325 copay for days 1-5, and no copay for days 6-90. Additional days for Inpatient Hospital-Acute are covered, but non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute are not covered. Additional days and non-Medicare-covered stays for Inpatient Hospital Psychiatric are also not covered.
Outpatient Services See details
Outpatient Services, including all outpatient hospital services, are covered under the Devoted CORE Austin (HMO) plan. Outpatient Hospital Services have a copay between $0 and $425, Observation Services have a $325 copay per stay, and Ambulatory Surgical Center (ASC) Services have no copay. Individual and Group Sessions for Outpatient Substance Abuse have a copay between $35.00 and $35.00. Outpatient Blood Services are also covered with a waived three-pint deductible.
Partial Hospitalization See details
Partial Hospitalization is covered by the Devoted CORE Austin (HMO) plan, but requires prior authorization. You will have a $60 copay for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, with prior authorization required for all ambulance services. Ground ambulance services have a copay ranging from $0 to $325, while air ambulance services have a 20% coinsurance. 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. Emergency Services have a $125 copay, and Urgently Needed Services have a copay between $0 and $45; Worldwide Emergency Services have a $125 copay for Worldwide Emergency Coverage and a $325 copay with 20% coinsurance for Worldwide Emergency Transportation.
Primary Care See details
The Devoted CORE Austin (HMO) plan covers primary care physician services with no copay, chiropractic services with a $20 copay, and occupational therapy services with a copay between $35 and $45. Physician specialist services have a $35 copay, and physical therapy and speech-language pathology services have a copay between $35 and $50. Mental health and psychiatric services, including individual and group sessions, have a $35 copay. The plan also covers additional telehealth benefits with a copay between $0 and $35 and opioid treatment program services with a $35 copay. However, routine chiropractic care and podiatry services are not covered.
Preventive Services See details
The Devoted CORE Austin (HMO) plan covers preventive services, including annual physical exams, health education, weight management programs, alternative therapies, nutritional/dietary benefits, fitness benefits, home and bathroom safety devices and modifications, glaucoma screenings, diabetes self-management training, barium enemas, digital rectal exams, and EKG following the welcome visit. In-home safety assessments, personal emergency response systems, 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 are not covered.
Hearing Services See details
Hearing Services include routine hearing exams with a $35 copay, and fitting/evaluation for hearing aids, which is unlimited. Prescription hearing aids are covered, with a copay between $399 and $699 for all types of hearing aids, but prescription hearing aids for the inner, outer, and over the ear are not covered. OTC hearing aids are not covered.
Vision Services See details
Vision services include coverage for eye exams with a $35 copay, and routine eye exams once per year. Eyewear is covered up to a combined maximum of $1000 per year, and contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades are also covered.
Dental Services See details
Dental Services include coverage for Medicare Dental Services with a $35 copay, along with other services like oral exams, x-rays, and cleanings. This plan offers an annual maximum benefit of $1,000 for other dental services. Maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs with a $35 copay and 20% coinsurance, Medicare Part B Chemotherapy/Radiation Drugs with 0-20% coinsurance, and Other Medicare Part B Drugs with 0-20% coinsurance. Prior authorization is required.
Dialysis Services See details
Dialysis Services are covered by the Devoted CORE Austin (HMO) plan, with a coinsurance between 20% and 20%.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with 0-20% coinsurance and no copay, Prosthetic Devices with 0-20% coinsurance and no copay, and Medical Supplies with 20% coinsurance and no copay. 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 include coverage for all diagnostic services, with a copay for Medicare-covered diagnostic procedures, tests, and lab services, and a copay for Medicare-covered diagnostic and therapeutic radiological services. The plan offers no copay for lab services and outpatient X-ray services, and a coinsurance of at most 20% for therapeutic radiological services.
Home Health Services See details
Home Health Services are covered by Devoted CORE Austin (HMO) with no copay and no coinsurance. However, additional hours of care and personal care services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services are not covered. The copay for covered services is listed separately.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Devoted CORE Austin (HMO) plan, with a $0 copay for days 1-20, and a $214 copay for days 21-100. 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 services cover $0 preventive services.
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