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DEVOTED C-SNP PLUS 031 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 031 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 031 TX (HMO C-SNP) in 2026, please refer to our full plan details page.
DEVOTED C-SNP PLUS 031 TX (HMO C-SNP) is a HMO C-SNP plan offered by Devoted Health, Inc. available for enrollment in 2026 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 C-SNP PLUS 031 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 031 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 031 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 031 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 031 TX (HMO C-SNP) Medicare plan features an annual drug deductible of $615. Beneficiaries pay no copay for Tier 6 Select Care Drugs filled through standard pharmacies or standard mail order. For Tier 1 Preferred Generic drugs, standard pharmacy and mail order costs are an $18 copay for a one-month supply, while Tier 2 Generic drugs have a $19 copay. Brand-name and specialty medications are subject to coinsurance under this plan. Standard pharmacy and standard mail order services charge a 25% coinsurance for Tier 3 Preferred Brand drugs and Tier 5 Specialty drugs. Tier 4 Non-Preferred drugs require a 31% coinsurance for all available supply lengths.
Additional Benefits
The DEVOTED C-SNP PLUS 031 TX (HMO C-SNP) plan offers robust healthcare coverage with no copay and no coinsurance for primary care visits, preventive care services, and home health care. For inpatient hospital stays, you will pay a flat copay of $2,230 per stay for acute care or $2,080 per stay for psychiatric care, both with no coinsurance. Outpatient services and emergency care are also highly accessible, featuring no copays for outpatient hospital visits and a $115 copay for emergency room visits, which is waived if you are admitted. This plan also provides valuable supplemental benefits, including dental coverage up to $3,000 annually with no copay and no coinsurance for most preventive and comprehensive services. Vision and hearing benefits are partially covered, offering no copays for routine exams and up to $300 yearly for eyewear with no copay or coinsurance. Additionally, members receive an over-the-counter item allowance of $50 every three months with no copay or coinsurance to help manage everyday health needs.
Inpatient Hospital See details
DEVOTED C-SNP PLUS 031 TX (HMO C-SNP) covers inpatient acute hospital stays with a $2,230 copay per stay and no coinsurance, and inpatient psychiatric stays with a $2,080 copay per stay and no coinsurance. Prior authorization is required for both services, and certain exclusions apply as upgrades, psychiatric additional days, and non-Medicare-covered stays are not covered.
Outpatient Services See details
DEVOTED C-SNP PLUS 031 TX (HMO C-SNP) covers outpatient services with no copays, though coinsurance ranges from no coinsurance up to 50% depending on the service. Outpatient hospital and ambulatory surgical center services have no copay and no coinsurance to 50% coinsurance, while outpatient substance abuse and blood services feature no copay and 30% coinsurance.
Partial Hospitalization See details
DEVOTED C-SNP PLUS 031 TX (HMO C-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 C-SNP PLUS 031 TX (HMO C-SNP) covers ambulance services with no copay, requiring no coinsurance to 50% coinsurance for ground transport and 50% coinsurance for air transport. Prior authorization is required for these ambulance services, and transportation services to health-related locations are not covered.
Emergency Services See details
DEVOTED C-SNP PLUS 031 TX (HMO C-SNP) covers emergency services with a $115 copay, which is waived if admitted to the hospital within 24 hours, and no coinsurance. 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 a $25,000 lifetime maximum with no copay and no coinsurance.
Primary Care See details
DEVOTED C-SNP PLUS 031 TX (HMO C-SNP) offers primary care physician services with no copay and no coinsurance, though chiropractic services are not covered. Specialist visits, physical and occupational therapies, mental health, and podiatry services are covered with no copay and 30% coinsurance, while telehealth and other health professionals require no copay and 0% to 30% coinsurance.
Preventive Services See details
Preventive services under DEVOTED C-SNP PLUS 031 TX (HMO C-SNP) are covered with no copay and no coinsurance, including annual physicals, kidney disease education, and fitness benefits. This benefit is partially covered, excluding in-home safety assessments, personal emergency response systems, post-discharge medication reconciliation, re-admission prevention, chemotherapy 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.
Hearing Services See details
DEVOTED C-SNP PLUS 031 TX (HMO C-SNP) offers partially covered hearing services, featuring routine hearing exams with no copay and 50% coinsurance, and prescription hearing aids with a $399 to $699 copay and no coinsurance. Over-the-counter (OTC) hearing aids, as well as inner ear, outer ear, and over the ear prescription hearing aids, are not covered.
Vision Services See details
DEVOTED C-SNP PLUS 031 TX (HMO C-SNP) partially covers vision services, offering one annual routine eye exam with no copay and 0% to 50% coinsurance, while other eye exam services are not covered. Eyewear is covered with no copay, no coinsurance, and no deductible, up to a $300 yearly maximum for contacts, frames, lenses, and upgrades.
Dental Services See details
DEVOTED C-SNP PLUS 031 TX (HMO C-SNP) partially covers dental services up to a $3,000 annual maximum, offering no copay and no coinsurance for most covered preventive and comprehensive services, while Medicare-covered dental services require no copay and a 30% coinsurance. Excluded services that are not covered under this plan include other diagnostic dental, other preventive dental, maxillofacial prosthetics, implants, and orthodontics.
Home Infusion bundled Services See details
DEVOTED C-SNP PLUS 031 TX (HMO C-SNP) covers home infusion bundled services with no copay and no coinsurance, though prior authorization is required. Associated Medicare Part B chemotherapy, radiation, and other drugs have no copay and a coinsurance ranging from no coinsurance to 20%, while Part B insulin requires a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered by DEVOTED C-SNP PLUS 031 TX (HMO C-SNP) with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
Medical equipment is partially covered by DEVOTED C-SNP PLUS 031 TX (HMO C-SNP) with no copay and coinsurance ranging from no coinsurance to 20%, subject to prior authorization. While durable medical equipment, prosthetics, and diabetic supplies are covered, diabetic therapeutic shoes and inserts are not covered.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by DEVOTED C-SNP PLUS 031 TX (HMO C-SNP) with no copays, though prior authorization is required. Diagnostic procedures and tests have no coinsurance, while therapeutic radiological services require a 20% coinsurance, and lab services, diagnostic radiological services, and outpatient X-rays all carry a 50% coinsurance.
Home Health Services See details
Home health services are covered by DEVOTED C-SNP PLUS 031 TX (HMO C-SNP) with no copay and no coinsurance. Prior authorization is required to access this benefit.
Cardiac Rehabilitation Services See details
DEVOTED C-SNP PLUS 031 TX (HMO C-SNP) covers some Cardiac Rehabilitation Services with no copay, subject to prior authorization. However, standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) rehabilitation services are not covered and require a 30% coinsurance.
Skilled Nursing Facility (SNF) See details
DEVOTED C-SNP PLUS 031 TX (HMO C-SNP) covers Skilled Nursing Facility (SNF) services with no coinsurance, featuring no copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required, no prior three-day inpatient hospital stay is needed, and additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
DEVOTED C-SNP PLUS 031 TX (HMO C-SNP) partially covers other services, providing over-the-counter (OTC) items (up to $50 every three months), diabetic shoes, and additional preventive services with no copay and no coinsurance. Acupuncture and meal benefits are not covered under this plan.
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