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DEVOTED C-SNP PLUS 024 TX (HMO C-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for DEVOTED C-SNP PLUS 024 TX (HMO C-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on DEVOTED C-SNP PLUS 024 TX (HMO C-SNP) in 2026, please refer to our full plan details page.
DEVOTED C-SNP PLUS 024 TX (HMO C-SNP) is a HMO C-SNP plan offered by Devoted Health, Inc. available for enrollment in 2026 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 C-SNP PLUS 024 TX (HMO C-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
DEVOTED C-SNP PLUS 024 TX (HMO C-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 C-SNP PLUS 024 TX (HMO C-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 C-SNP PLUS 024 TX (HMO C-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 C-SNP PLUS 024 TX (HMO C-SNP) medicare plan features an annual drug deductible of $615. For Tier 1 preferred generics, standard pharmacy and mail-order copays are $18 for a 1-month supply, while Tier 2 generics cost $19 for a 1-month supply. Notably, Tier 6 select care drugs are available with no copay for 1-month, 2-month, and 3-month supplies. Higher tier medications require coinsurance rather than flat copays under this plan. Tier 3 preferred brands and Tier 5 specialty drugs both require a 25% coinsurance, while Tier 4 non-preferred drugs carry a 31% coinsurance for standard pharmacy and mail-order fills. Multi-month supply options are also available for Tiers 1 through 4 to help manage your ongoing prescription costs.
Additional Benefits
The DEVOTED C-SNP PLUS 024 TX (HMO C-SNP) plan offers comprehensive medical coverage with no copay and no coinsurance for primary care doctor visits and preventive services. For inpatient hospital stays, members pay no coinsurance but will owe a $2,230 copay per stay for acute care. Emergency room visits require a $115 copay, which is waived upon hospital admission, while outpatient services feature no copayments and 0% to 50% coinsurance. Specialty care under this plan includes dental, vision, and hearing benefits, often featuring no copays alongside varying coinsurance rates. For example, preventive and comprehensive dental services have no copay and no coinsurance up to a $2,000 annual limit, while routine eyewear is covered up to $300. Additionally, skilled nursing facility stays have no copay for the first 20 days, and members receive a $50 over-the-counter item allowance every three months.
Inpatient Hospital See details
DEVOTED C-SNP PLUS 024 TX (HMO C-SNP) covers inpatient hospital services with no coinsurance, requiring a $2,230 copay per stay for acute care and a $2,080 copay per stay for psychiatric care. Prior authorization is required, and certain services such as upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
DEVOTED C-SNP PLUS 024 TX (HMO C-SNP) covers outpatient services with no copayments, though coinsurance ranges from 0% to 50% depending on the service. Prior authorization is required for most covered benefits, which include outpatient hospital, ambulatory surgical center, substance abuse, and blood services.
Partial Hospitalization See details
DEVOTED C-SNP PLUS 024 TX (HMO C-SNP) covers partial hospitalization services with no copay and a 20% coinsurance. Prior authorization is required to receive this covered benefit.
Ambulance and Transportation Services See details
DEVOTED C-SNP PLUS 024 TX (HMO C-SNP) covers ambulance services with no copay, requiring no coinsurance to 50% coinsurance for ground services and 50% coinsurance for air services. While some transportation services are covered, transportation to plan-approved or any health-related locations is not covered.
Emergency Services See details
Emergency services are covered by DEVOTED C-SNP PLUS 024 TX (HMO C-SNP) with a $115 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services require 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 or coinsurance, with none of these costs applying to a plan-level deductible.
Primary Care See details
DEVOTED C-SNP PLUS 024 TX (HMO C-SNP) provides primary care physician services with no copay and no coinsurance, though chiropractic services are not covered in practice. Other primary care benefits, including specialist visits, mental health services, physical therapy, and podiatry, are covered with no copay and a 30% coinsurance.
Preventive Services See details
DEVOTED C-SNP PLUS 024 TX (HMO C-SNP) covers preventive services with no copay and no coinsurance, including annual physical exams, fitness programs, and nutritional training. These benefits are partially covered, as the plan does not cover sub-services such as in-home safety assessments, personal emergency response systems, therapeutic massages, and home-based palliative care.
Hearing Services See details
DEVOTED C-SNP PLUS 024 TX (HMO C-SNP) partially covers hearing services, featuring one annual routine hearing exam with no copay and a 50% coinsurance, plus unlimited fitting evaluations. Up to two prescription hearing aids are covered yearly with no coinsurance and a $399.00 to $699.00 copay, though OTC hearing aids and inner ear, outer ear, and over the ear prescription models are not covered.
Vision Services See details
DEVOTED C-SNP PLUS 024 TX (HMO C-SNP) partially covers eye exams with no copay and 0% to 50% coinsurance for one routine exam per year, while other eye exam services are not covered. Eyewear is covered with no copay and no coinsurance up to a $300 annual maximum for contacts, frames, lenses, and upgrades.
Dental Services See details
DEVOTED C-SNP PLUS 024 TX (HMO C-SNP) provides dental services with no copay and a 30% coinsurance for Medicare-covered dental, while other covered preventive and comprehensive services have no copay and no coinsurance up to a $2,000 yearly limit. This benefit is partially covered, as other diagnostic dental services, other preventive dental services, maxillofacial prosthetics, implant services, and orthodontics are not covered. Prior authorization is required for select services.
Home Infusion bundled Services See details
DEVOTED C-SNP PLUS 024 TX (HMO C-SNP) covers home infusion bundled services with no copay, though prior authorization is required and step therapy may apply. For covered Medicare Part B drugs, including chemotherapy and other infusion drugs, you will pay no coinsurance up to 20% coinsurance, while Medicare Part B insulin has a $35 copay and up to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered by DEVOTED C-SNP PLUS 024 TX (HMO C-SNP) with no copay and a 20% coinsurance. Prior authorization is required for these services.
Medical Equipment See details
DEVOTED C-SNP PLUS 024 TX (HMO C-SNP) partially covers medical equipment with no copay for all covered items, though prior authorization is required. Durable medical equipment and diabetic supplies carry a 20% coinsurance, while prosthetic devices and medical supplies range from no coinsurance to 20% coinsurance; diabetic therapeutic shoes and inserts are not covered.
Diagnostic and Radiological Services See details
DEVOTED C-SNP PLUS 024 TX (HMO C-SNP) covers diagnostic and radiological services with prior authorization and no copays. Outpatient diagnostic procedures and tests have no coinsurance, while therapeutic radiological services require 20% coinsurance, and lab services, diagnostic radiological services, and outpatient X-rays require 50% coinsurance.
Home Health Services See details
Home Health Services are covered by DEVOTED C-SNP PLUS 024 TX (HMO C-SNP) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered under the DEVOTED C-SNP PLUS 024 TX (HMO C-SNP) plan with no copay and require prior authorization, though only some services are covered. Specifically, cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) services are not covered and require a 30% coinsurance.
Skilled Nursing Facility (SNF) See details
DEVOTED C-SNP PLUS 024 TX (HMO C-SNP) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring prior authorization but no prior three-day hospital stay. There is no copay for days 1 through 20, followed by a $218 daily copay for days 21 through 100, with additional days beyond the Medicare-covered period not covered.
Other Services See details
DEVOTED C-SNP PLUS 024 TX (HMO C-SNP) partially covers other services, offering no copay and no coinsurance for over-the-counter (OTC) items, non-Medicare covered diabetic shoes, and additional preventive services. Acupuncture, meal benefits, and other unspecified services are not covered under this plan, and the covered OTC benefit provides up to $50 of coverage every three months.
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