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Devoted DUAL PLUS Austin (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Devoted DUAL PLUS Austin (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 PLUS Austin (HMO D-SNP) in 2025, please refer to our full plan details page.
Devoted DUAL PLUS Austin (HMO D-SNP) is a HMO D-SNP 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 DUAL PLUS Austin (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 PLUS Austin (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 PLUS Austin (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 PLUS Austin (HMO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $12.60. 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 $9350.00 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 PLUS Austin (HMO D-SNP) plan has a $590 deductible for prescription drugs. After you meet your deductible, you will pay the costs for your drugs based on the tier and pharmacy you use until your total drug costs reach $2000. If you qualify for the low-income subsidy, you'll pay $12.60 per month for your Part D premium. Once your yearly out-of-pocket drug costs reach $2000, you will pay nothing for your Part D covered drugs.
Additional Benefits
The Devoted DUAL PLUS Austin (HMO D-SNP) plan offers a range of benefits with varying cost structures. Inpatient hospital stays have a $2,000 copay, while outpatient services have coinsurance between 40% and 45%. Emergency services have a $110 copay. Preventive services, like annual physical exams, have no copay. Hearing services include routine exams with 45% coinsurance and hearing aids with a copay between $399 and $699. Vision services include routine eye exams with 45% coinsurance and eyewear with a combined maximum of $500 every year. Dental services cover oral exams, x-rays, and cleanings up to $500 annually.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric. Both services have a $2,000 copay per admission or stay. The plan covers additional days for Inpatient Hospital-Acute, but does not cover non-Medicare-covered stays or upgrades for Inpatient Hospital-Acute, and does not cover additional days or non-Medicare-covered stays for Inpatient Hospital Psychiatric.
Outpatient Services See details
Outpatient services, including outpatient hospital services, observation services, ambulatory surgical center (ASC) services, outpatient substance abuse services, and outpatient blood services are covered. Outpatient hospital services have a coinsurance of 40% - 45%, observation services have a coinsurance of 45%, individual and group sessions for outpatient substance abuse have a coinsurance of 45%, and outpatient blood services have a waived three-pint deductible.
Partial Hospitalization See details
Partial Hospitalization is covered by the Devoted DUAL PLUS Austin (HMO D-SNP) plan, but requires prior authorization. You will pay 35% coinsurance for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by Devoted DUAL PLUS Austin (HMO D-SNP). Ground Ambulance Services have a coinsurance of 0% - 45%, while Air Ambulance Services have a 45% coinsurance; Transportation Services to any health-related location are not covered.
Emergency Services See details
Emergency Services, including Urgently Needed Services and Worldwide Emergency Services, are covered. Emergency Services have a $110 copay, while Urgently Needed Services have a 35% coinsurance, and Worldwide Emergency Services have a maximum plan benefit coverage of $25,000.
Primary Care See details
Primary Care Physician Services, Occupational Therapy Services, Physician Specialist Services, Other Health Care Professional, Physical Therapy and Speech-Language Pathology Services, Opioid Treatment Program Services, and Additional Telehealth Benefits are covered, while Routine Chiropractic Care, Individual and Group Sessions for Mental Health Specialty Services, Podiatry Services, and Individual and Group Sessions for Psychiatric Services are not covered. Occupational Therapy Services and Physical Therapy and Speech-Language Pathology Services have no copay or coinsurance.
Preventive Services See details
The Devoted DUAL PLUS Austin (HMO D-SNP) 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, glaucoma screenings, diabetes self-management training, barium enemas, digital rectal exams, and EKG following Welcome Visit. This plan does not cover in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge in-home medication reconciliation, readmission 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 routine hearing exams with a 45% coinsurance, and fitting/evaluation for hearing aids with no coinsurance. Prescription hearing aids are covered with a copay between $399 and $699, while inner ear, outer ear, and over-the-ear prescription hearing aids are not covered. OTC hearing aids are not covered.
Vision Services See details
Vision services are covered, including routine eye exams with a 45% coinsurance and eyewear with a combined maximum of $500 every year. Contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades are also covered.
Dental Services See details
The Devoted DUAL PLUS Austin (HMO D-SNP) plan covers a range of dental services, including oral exams, dental x-rays, and cleanings, with a maximum annual benefit of $500. Some services are covered, but maxillofacial prosthetics, implant services, and orthodontics are not covered.
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. For Medicare Part B Insulin Drugs, there is a $35 copay and a coinsurance between 20% and 20%. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, there is a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by the Devoted DUAL PLUS Austin (HMO D-SNP) plan. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical equipment coverage includes Durable Medical Equipment (DME) with no copay and 0-20% coinsurance, Prosthetics/Medical Supplies with no copay and coinsurance for Medicare-covered supplies, and Diabetic Equipment. Durable Medical Equipment for use outside the home and Diabetic Therapeutic Shoes/Inserts are not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered. Diagnostic Procedures/Tests and Lab Services have a coinsurance of at most 45%, while Diagnostic Radiological Services have a coinsurance of at most 45%, Therapeutic Radiological Services have a coinsurance of at most 20%, and Outpatient X-Ray Services have a coinsurance of at most 35%; there is no copay for any of these services.
Home Health Services See details
Home Health Services are covered by the Devoted DUAL PLUS Austin (HMO D-SNP) plan with no copay and no coinsurance, but additional hours of care and personal care services are not covered. Authorization is required for this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the Devoted DUAL PLUS Austin (HMO D-SNP) plan. This includes Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Devoted DUAL PLUS Austin (HMO D-SNP) plan. There is no copay for days 1-20, but there is 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 includes Other 2, which covers $0 preventive services, and does not require authorization or a referral, but does not include 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.
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