A non-government entity
DEVOTED CORE 019 TX (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for DEVOTED CORE 019 TX (HMO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on DEVOTED CORE 019 TX (HMO) in 2026, please refer to our full plan details page.
DEVOTED CORE 019 TX (HMO) is a HMO 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 CORE 019 TX (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 019 TX (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 019 TX (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 $220.00 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 $3650.00 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:
Sign up for DEVOTED CORE 019 TX (HMO)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
Drug Coverage
The DEVOTED CORE 019 TX (HMO) prescription drug plan features an annual drug deductible of $220. For Tier 1 preferred generic and Tier 2 generic medications, you will have no copay for 1-month, 2-month, or 3-month supplies. This cost-saving benefit applies to both standard pharmacies and standard mail-order services. For higher-tier medications, your costs are determined by coinsurance. Tier 3 preferred brand drugs require a 19% coinsurance, while Tier 4 non-preferred drugs carry a 25% coinsurance for standard retail and mail-order fills. Tier 5 specialty drugs have a 28% coinsurance for a 1-month supply.
Additional Benefits
The DEVOTED CORE 019 TX (HMO) plan offers robust medical coverage with affordable, predictable costs, featuring no copay and no coinsurance for primary care visits and preventive services. If you need specialist care, visits require a $30 copay, while inpatient hospital stays carry a $325 copay per stay with no coinsurance. Emergency room visits require a $150 copay, which is waived if you are admitted within 24 hours, and outpatient ambulatory surgical center services are available with no copay. This plan also includes valuable everyday benefits, such as dental coverage up to a $3,000 annual maximum and a $350 yearly allowance for contacts and eyeglasses with no copay. Additionally, members benefit from no copay on home health services, a $100 quarterly allowance for over-the-counter items, and no copay for the first 20 days of skilled nursing facility stays. Prescription hearing aids are also covered with copays ranging from $399 to $699 per device.
Inpatient Hospital See details
DEVOTED CORE 019 TX (HMO) covers inpatient acute and psychiatric hospital stays with a $325 copayment per stay and no coinsurance, though prior authorization is required. This benefit is partially covered, as it excludes upgrades, non-Medicare-covered stays, and additional days for psychiatric care.
Outpatient Services See details
Outpatient services are covered by DEVOTED CORE 019 TX (HMO) with no coinsurance, featuring no copay for ambulatory surgical center and blood services. Outpatient hospital services require a copay of $0 to $425, while observation services cost $325 per stay and outpatient substance abuse sessions have a $30 copay.
Partial Hospitalization See details
Partial hospitalization services are covered by DEVOTED CORE 019 TX (HMO) with a $55.00 copay and no coinsurance. Prior authorization is required to access this benefit.
Ambulance and Transportation Services See details
DEVOTED CORE 019 TX (HMO) covers ambulance services with prior authorization, featuring a copay ranging from no copay to $325 with no coinsurance for ground services, and a 20% coinsurance with no copay for air services. Transportation services are not covered under this plan.
Emergency Services See details
DEVOTED CORE 019 TX (HMO) covers emergency services with a $150 copay and no coinsurance, which is waived if admitted to the hospital within 24 hours, and urgently needed services with a copay ranging from no copay to $45 and no coinsurance. Worldwide emergency and urgent care are covered up to a $25,000 maximum with a $150 copay and no coinsurance, while worldwide emergency transportation requires a $325 copay and 20% coinsurance.
Primary Care See details
DEVOTED CORE 019 TX (HMO) covers primary care physician services with no copay and no coinsurance, and specialist visits with a $30 copay and no coinsurance. Covered therapy, mental health, and psychiatric services require a $30 to $50 copay and no coinsurance, while podiatry is not covered and some chiropractic services are covered but routine and other chiropractic services are not.
Preventive Services See details
Preventive services are partially covered by DEVOTED CORE 019 TX (HMO) with no copay and no coinsurance for covered services like annual physical exams, fitness benefits, and nutritional counseling. While many wellness benefits are included, several sub-services such as in-home safety assessments, personal emergency response systems, and therapeutic massages are not covered.
Hearing Services See details
DEVOTED CORE 019 TX (HMO) hearing services are partially covered, featuring routine hearing exams for a $30 copay and no coinsurance, limited to one yearly visit. Prescription hearing aids are covered with no coinsurance and copayments between $399 and $699 for up to two devices per year, though OTC hearing aids and inner ear, outer ear, or over-the-ear prescription models are not covered.
Vision Services See details
DEVOTED CORE 019 TX (HMO) provides partially covered vision services, as other eye exam services are not covered. Covered benefits include one annual routine eye exam with a $0 to $30 copay and no coinsurance, as well as contacts and eyeglasses with no copay, no coinsurance, and a $350 combined maximum annual limit.
Dental Services See details
DEVOTED CORE 019 TX (HMO) provides partially covered dental services up to a $3,000 annual maximum, featuring a $30 copay and no coinsurance for Medicare-covered dental, and no copay with 0% to 50% coinsurance for other covered services. Maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by DEVOTED CORE 019 TX (HMO) with no copay, though prior authorization is required. Associated Medicare Part B chemotherapy, radiation, and other drugs require between no coinsurance and 20% coinsurance, while Part B insulin has a $35 copay and between no coinsurance and 20% coinsurance.
Dialysis Services See details
DEVOTED CORE 019 TX (HMO) covers dialysis services with no copay and a 20% coinsurance. Prior authorization is required for these covered services.
Medical Equipment See details
DEVOTED CORE 019 TX (HMO) partially covers medical equipment with no copays, though diabetic therapeutic shoes and inserts are not covered. Covered durable medical equipment requires 20% to 50% coinsurance, while prosthetics, medical supplies, and diabetic supplies range from no coinsurance up to 20% or 50% coinsurance.
Diagnostic and Radiological Services See details
DEVOTED CORE 019 TX (HMO) covers diagnostic and radiological services with prior authorization, featuring no copays for lab services and outpatient X-rays. Diagnostic tests have no coinsurance and a $0 to $150 copay, diagnostic radiological services have copays starting at $0, and therapeutic radiological services require a copay and a minimum 20% coinsurance.
Home Health Services See details
DEVOTED CORE 019 TX (HMO) covers home health services with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by DEVOTED CORE 019 TX (HMO) with no coinsurance and a $30 copay, subject to prior authorization. While some services are covered, standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for PAD rehabilitation services are not covered.
Skilled Nursing Facility (SNF) See details
DEVOTED CORE 019 TX (HMO) covers Skilled Nursing Facility (SNF) services with no coinsurance, offering no copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required, and additional days beyond the standard 100-day benefit period are not covered.
Other Services See details
DEVOTED CORE 019 TX (HMO) partially covers other services, offering additional preventive services and over-the-counter (OTC) items with no copay and no coinsurance. Covered OTC items include a maximum benefit of $100 every three months, though acupuncture and meal benefits are not covered under this plan.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
*/SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
MedicareAdvantageRX.com is owned and operated by Dog Media Solutions LLC.
This is a promotional communication.
Every year, Medicare evaluates plans based on a 5-star rating system.
Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
Enrollment in Medicare/Medicare Advantage may be limited to certain times of the year unless you qualify for a Special Enrollment Period
We do not offer every plan available in your area. Currently, we represent 18 organizations, which offer 52,101 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
We represent Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan's contract renewal.
Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.
Please contact Medicare.gov ,1-800-MEDICARE , or your local State Health Insurance Program (SHIP) to get information on all of your options.
Medicare has neither approved nor endorsed any information on this site.
Speak with a licensed insurance agent: 1-877-649-2073 / TTY 711 | 8am - 11pm ET | 7 days a week
© 2023 Dog Media Solutions LLC. All rights reserved