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DEVOTED DUAL 015 TX (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for DEVOTED DUAL 015 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 015 TX (HMO D-SNP) in 2026, please refer to our full plan details page.
DEVOTED DUAL 015 TX (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 5 out of 5 stars in 2026.
It's important to know that DEVOTED DUAL 015 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 015 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 015 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 015 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 015 TX (HMO D-SNP) Medicare plan features an annual drug deductible of $615. When using preferred pharmacies or preferred mail-order services, members enjoy no copay across all six drug tiers, including generic, brand-name, and specialty medications. This network design helps keep out-of-pocket prescription costs as low as possible. If you choose to use standard pharmacies or standard mail-order services, a 25% coinsurance applies to Tiers 1 through 4, as well as Tier 5 specialty drugs for a one-month supply. Fortunately, Tier 6 select care drugs require no copay regardless of whether you use a preferred or standard pharmacy.
Additional Benefits
The DEVOTED DUAL 015 TX (HMO D-SNP) plan offers comprehensive healthcare coverage with no copay and no coinsurance for primary care visits, preventive services, and home health care. Specialist visits, outpatient services, and dialysis generally require no copay but feature a coinsurance of up to 20%. For hospital stays, inpatient acute care requires a $2,150 copay per admission with no coinsurance, while emergency room visits carry a $115 copay that is waived if you are admitted. In addition to medical care, this plan provides valuable supplemental benefits including dental coverage up to $2,000 annually and eyewear up to $400 annually with no copay and no coinsurance. Routine hearing exams and vision exams are available with no copay and up to 20% coinsurance, alongside a quarterly $50 allowance for over-the-counter items. Skilled nursing facility care is also covered with no copay for the first 20 days and a $218 daily copay for days 21 through 100.
Inpatient Hospital See details
DEVOTED DUAL 015 TX (HMO D-SNP) covers inpatient hospital services with no coinsurance, requiring a $2,150 copay per admission for acute stays and a $2,080 copay per admission for psychiatric stays. This benefit is partially covered, as upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Outpatient services are covered by DEVOTED DUAL 015 TX (HMO D-SNP) with no copays, though coinsurance ranges from 0% to 20% depending on the service. This coverage includes outpatient hospital, ambulatory surgical center, substance abuse, and blood services, which typically require prior authorization.
Partial Hospitalization See details
DEVOTED DUAL 015 TX (HMO D-SNP) covers partial hospitalization services with no copay and a 20% coinsurance. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
DEVOTED DUAL 015 TX (HMO D-SNP) covers ambulance services with no copay, requiring a 0% to 20% coinsurance for ground transport and a 20% coinsurance for air transport. Transportation services are partially covered, but transportation to plan-approved health-related locations and any health-related locations are not covered.
Emergency Services See details
Emergency Services under the DEVOTED DUAL 015 TX (HMO D-SNP) plan are covered with a $115 copay and no coinsurance, with the copay waived if you are admitted to the hospital within 24 hours. 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 $25,000 with no copay and no coinsurance.
Primary Care See details
Primary care services under the DEVOTED DUAL 015 TX (HMO D-SNP) plan feature no copay and no coinsurance, while covered specialist visits, therapies, psychiatric care, and telehealth services have no copay and a 20% coinsurance (0% to 20% for some providers). Podiatry and chiropractic services are not covered by this plan.
Preventive Services See details
Preventive services are covered by DEVOTED DUAL 015 TX (HMO D-SNP) with no copay and no coinsurance, including annual physical exams, kidney disease education, and select screenings. This benefit is partially covered, featuring weight management, fitness benefits, and alternative therapies, while excluding services like in-home safety assessments, personal emergency response systems, and therapeutic massages.
Hearing Services See details
Hearing services are partially covered by DEVOTED DUAL 015 TX (HMO D-SNP), which offers routine hearing exams with no copay and a 20% coinsurance, alongside fitting evaluations with no copay. Prescription hearing aids are covered with no coinsurance and a copay ranging from $399 to $699, but OTC, inner ear, outer ear, and over the ear hearing aids are not covered.
Vision Services See details
Vision services are partially covered by DEVOTED DUAL 015 TX (HMO D-SNP) because other eye exam services are not covered. Covered benefits include one routine eye exam yearly with no copay and 0% to 20% coinsurance, as well as eyewear with no copay, no coinsurance, and a $400 annual maximum allowance.
Dental Services See details
DEVOTED DUAL 015 TX (HMO D-SNP) covers Medicare-approved dental services with no copay and 20% coinsurance, and other dental services up to a $2,000 annual limit with no copay and no coinsurance. Dental benefits are partially covered, as other diagnostic services, other preventive services, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by DEVOTED DUAL 015 TX (HMO D-SNP) with no copay, though prior authorization is required. Medicare Part B chemotherapy, radiation, and other drugs have a coinsurance of 0% to 20%, while Part B insulin drugs require a $35 copay and 0% to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered under the DEVOTED DUAL 015 TX (HMO D-SNP) plan with no copay, subject to a 20% coinsurance and prior authorization requirements.
Medical Equipment See details
DEVOTED DUAL 015 TX (HMO D-SNP) covers medical equipment with no copay, though prior authorization is required. Durable medical equipment and diabetic supplies carry a 20% coinsurance, while prosthetics and other medical supplies range from no coinsurance to 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by DEVOTED DUAL 015 TX (HMO D-SNP) with no copays, though prior authorization is required. While diagnostic procedures and tests feature no coinsurance, a 20% coinsurance applies to lab services, diagnostic and therapeutic radiological services, and outpatient X-ray services.
Home Health Services See details
Home Health Services are covered by DEVOTED DUAL 015 TX (HMO D-SNP) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the DEVOTED DUAL 015 TX (HMO D-SNP) plan, as intensive cardiac, pulmonary, and SET for PAD rehabilitation sub-services are not covered in practice. These services require prior authorization and carry a 20% coinsurance with no copay.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is covered by DEVOTED DUAL 015 TX (HMO D-SNP) with no coinsurance, requiring prior authorization but no prior three-day hospital stay. There is no copay for days 1 through 20, and a $218 daily copay for days 21 through 100, though additional days beyond the standard 100 days are not covered.
Other Services See details
DEVOTED DUAL 015 TX (HMO D-SNP) partially covers other services, providing over-the-counter (OTC) items up to $50 every three months and additional preventive services with no copay and no coinsurance. Acupuncture, meal benefits, and highly integrated dual-eligible SNP services are not covered under this plan.
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