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DEVOTED DUAL 017 TX (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for DEVOTED DUAL 017 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 017 TX (HMO D-SNP) in 2026, please refer to our full plan details page.
DEVOTED DUAL 017 TX (HMO D-SNP) is a HMO D-SNP plan offered by Devoted Health, Inc. available for enrollment in 2025 to people living in El Paso and Hudspeth Counties. This plan received an overall rating of 5 out of 5 stars in 2026.
It's important to know that DEVOTED DUAL 017 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 017 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 017 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 017 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 017 TX (HMO D-SNP) Medicare plan features an annual prescription drug deductible of $615. For Tier 1 through Tier 4 drugs, which cover preferred generics, generics, preferred brands, and non-preferred drugs, you will pay a 25% coinsurance for 1-month, 2-month, or 3-month supplies at standard pharmacies and standard mail-order services. For Tier 5 specialty tier drugs, a 25% coinsurance applies to 1-month supplies filled at standard pharmacies or standard mail-order outlets. Tier 6 select care drugs offer the greatest savings under this plan, featuring no copay for 1-month, 2-month, and 3-month supplies at standard pharmacies and standard mail-order services.
Additional Benefits
The DEVOTED DUAL 017 TX (HMO D-SNP) plan offers robust healthcare coverage with no copays for primary care visits, preventive services, outpatient care, and home health services. While inpatient hospital stays require a $2,080 copayment per admission, most outpatient and diagnostic services feature no copays and coinsurance ranging from 0% to 20%. Emergency care is covered with a $115 copay, which is waived upon hospital admission, and urgently needed care has no copay. In addition to medical care, members receive strong supplemental benefits, including up to $3,000 in dental coverage and up to $400 annually for eyewear with no copays or coinsurance. The plan also covers routine hearing exams and prescription hearing aids with minimal out-of-pocket costs, alongside a $50 quarterly allowance for over-the-counter items. These benefits are designed to provide comprehensive, affordable care with predictable costs for members.
Inpatient Hospital See details
DEVOTED DUAL 017 TX (HMO D-SNP) covers inpatient acute and psychiatric hospital stays with a $2,080 copayment per admission and no coinsurance, though prior authorization is required. This benefit is partially covered as upgrades and non-Medicare-covered stays are not covered, and unlimited additional days are only available for acute care.
Outpatient Services See details
DEVOTED DUAL 017 TX (HMO D-SNP) covers outpatient services with no copays, including outpatient hospital, ambulatory surgical center, substance abuse, and blood services. Coinsurance ranges from no coinsurance to 20% depending on the service, and no deductible applies to the first three pints of outpatient blood.
Partial Hospitalization See details
DEVOTED DUAL 017 TX (HMO D-SNP) covers partial hospitalization services with no copay and a 20% coinsurance. Prior authorization is required to access this benefit.
Ambulance and Transportation Services See details
DEVOTED DUAL 017 TX (HMO D-SNP) covers ambulance services with no copay, requiring no coinsurance to 20% coinsurance for ground transport and 20% coinsurance for air transport. Transportation services to plan-approved or other health-related locations are not covered under this plan.
Emergency Services See details
Emergency services are covered under the DEVOTED DUAL 017 TX (HMO D-SNP) plan with a $115 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services feature no copay and a 0% to 20% coinsurance (up to $40 per visit), while worldwide emergency services are covered with no copay or coinsurance up to a $25,000 maximum benefit limit.
Primary Care See details
Primary Care services under DEVOTED DUAL 017 TX (HMO D-SNP) feature no copay, with no coinsurance for primary care doctor visits and up to 20% coinsurance for specialists, mental health, and physical therapy. Podiatry services and routine chiropractic care are not covered.
Preventive Services See details
Preventive services are covered by DEVOTED DUAL 017 TX (HMO D-SNP) with no copay and no coinsurance for annual physical exams, kidney disease education, and other preventive screenings. However, this benefit is only partially covered, as it excludes in-home safety assessments, personal emergency response systems (PERS), medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, wigs, therapeutic massage, adult day health, home-based palliative care, in-home support, caregiver support, additional smoking cessation counseling, enhanced disease management, telemonitoring, remote access technologies, and counseling services.
Hearing Services See details
DEVOTED DUAL 017 TX (HMO D-SNP) partially covers hearing services, offering one routine exam per year with no copay and 20% coinsurance, and up to two prescription hearing aids with no coinsurance and a $0 to $299 copay. However, over-the-counter (OTC) hearing aids and inner ear, outer ear, and over-the-ear prescription hearing aids are not covered.
Vision Services See details
DEVOTED DUAL 017 TX (HMO D-SNP) offers partially covered vision services with no deductibles, though other eye exam services are not covered. Routine eye exams have no copay and a 0% to 20% coinsurance, and covered eyewear has no copay and no coinsurance up to a $400 annual maximum.
Dental Services See details
Dental Services are partially covered by DEVOTED DUAL 017 TX (HMO D-SNP), offering up to $3,000 in annual coverage for preventive and comprehensive care with no copay and no coinsurance, while Medicare-covered dental services require no copay and a 20% coinsurance. While many treatments like cleanings, exams, and fillings are covered, other diagnostic services, other preventive services, maxillofacial prosthetics, implants, and orthodontics are not covered.
Home Infusion bundled Services See details
DEVOTED DUAL 017 TX (HMO D-SNP) covers Home Infusion bundled Services with no copay, though prior authorization is required. Covered Medicare Part B drugs, including chemotherapy and insulin, have coinsurance ranging from no coinsurance to 20%, with insulin also carrying a $35 copay.
Dialysis Services See details
DEVOTED DUAL 017 TX (HMO D-SNP) covers Dialysis Services with no copay and a 20% coinsurance, though prior authorization is required for these services.
Medical Equipment See details
DEVOTED DUAL 017 TX (HMO D-SNP) covers medical equipment, including durable medical equipment, prosthetics, medical supplies, and diabetic equipment, with no copay. Coinsurance ranges from no coinsurance up to 18% depending on the item, and prior authorization is required.
Diagnostic and Radiological Services See details
DEVOTED DUAL 017 TX (HMO D-SNP) covers diagnostic and radiological services with prior authorization and no copayments. Diagnostic procedures and tests carry no coinsurance, while lab services, outpatient X-rays, and diagnostic or therapeutic radiological services require a 20% coinsurance.
Home Health Services See details
Home Health Services are covered by DEVOTED DUAL 017 TX (HMO D-SNP) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered under DEVOTED DUAL 017 TX (HMO D-SNP) with no copay and require prior authorization, although only some services are covered. Standard cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) are not covered and require a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is covered by DEVOTED DUAL 017 TX (HMO D-SNP) with no coinsurance, featuring no copay for days 1 to 20 and a $218 daily copay for days 21 to 100. Prior authorization is required, a prior three-day hospital stay is not required, and additional days beyond the standard 100 days are not covered.
Other Services See details
DEVOTED DUAL 017 TX (HMO D-SNP) covers select other services, including 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 services are not covered under this plan.
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