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DEVOTED CORE 034 IA (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for DEVOTED CORE 034 IA (HMO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on DEVOTED CORE 034 IA (HMO) in 2026, please refer to our full plan details page.
DEVOTED CORE 034 IA (HMO) is a HMO plan offered by Devoted Health, Inc. available for enrollment in 2026 to people living in Iowa. This plan received an overall rating of 5 out of 5 stars in 2026.
It's important to know that DEVOTED CORE 034 IA (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 034 IA (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 034 IA (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 $375.00 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 $3900.00 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 CORE 034 IA (HMO) Medicare plan has an annual drug deductible of $375. For Tier 1 (Preferred Generic) and Tier 2 (Generic) drugs, you will pay no copay for 1-month, 2-month, or 3-month supplies at standard pharmacies and through standard mail order. This ensures that many common medications are available at no cost to you. For higher-tier medications, costs are based on a coinsurance percentage rather than a flat copay. You will pay a 19% coinsurance for Tier 3 (Preferred Brand) drugs and a 25% coinsurance for Tier 4 (Non-Preferred Drug) prescriptions. Tier 5 (Specialty Tier) drugs carry a 28% coinsurance for a 1-month supply at standard pharmacies and standard mail order.
Additional Benefits
The DEVOTED CORE 034 IA (HMO) plan offers robust coverage for everyday healthcare needs with no copay and no coinsurance for primary care visits, preventive services, and home health services. For inpatient hospital stays, members pay a daily copay of $405 for days 1 through 6 of acute stays, with no copay required for days 7 through 90. Outpatient hospital services feature no coinsurance and copays ranging from no copay up to $495, while emergency room visits carry a $150 copay which is waived upon admission. This plan also includes valuable dental, vision, and hearing benefits to help reduce out-of-pocket expenses. Dental care is covered up to a $3,000 annual maximum with no copay or coinsurance for preventive services, while vision benefits provide a $350 annual allowance for eyewear with no copay or deductible. Additionally, members can take advantage of a $70 quarterly allowance for over-the-counter items and prescription hearing aids starting at a $399 copay with no coinsurance.
Inpatient Hospital See details
DEVOTED CORE 034 IA (HMO) offers partially covered inpatient hospital services with no coinsurance, requiring a copay of $405 per day for days 1–6 of acute stays and $395 per day for days 1–6 of psychiatric stays, with no copay for days 7–90. Upgrades, non-Medicare-covered stays, and additional psychiatric hospital days are not covered.
Outpatient Services See details
Outpatient services covered by DEVOTED CORE 034 IA (HMO) feature no coinsurance, offering no copay for ambulatory surgical center and outpatient blood services. Outpatient hospital services require a copay ranging from no copay to $495, while observation services cost a $395 copay per stay and outpatient substance abuse sessions have a $30 copay.
Partial Hospitalization See details
DEVOTED CORE 034 IA (HMO) covers partial hospitalization services with a $130.00 copay and no coinsurance. Prior authorization is required for these covered services.
Ambulance and Transportation Services See details
DEVOTED CORE 034 IA (HMO) covers ground ambulance services with a copay of no copay to $315 and air ambulance services with a 20% coinsurance, both requiring prior authorization. Although transportation services are technically covered, they are not covered in practice as both plan-approved and health-related location transportation are excluded.
Emergency Services See details
DEVOTED CORE 034 IA (HMO) covers emergency services with a $150 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services range from no copay to a $45 copay with no coinsurance, while worldwide emergency services are covered up to a $25,000 limit with a $150 copay and no coinsurance for emergency and urgent care, and a $315 copay plus 20% coinsurance for emergency transportation.
Primary Care See details
DEVOTED CORE 034 IA (HMO) provides primary care physician services with no copay and no coinsurance, while specialist, physical therapy, and occupational therapy services require a $30 to $50 copay and no coinsurance. Mental health, psychiatric, and opioid treatment services have a $30 copay with no coinsurance, telehealth ranges from a $0 to $50 copay with no coinsurance, and chiropractic and podiatry services are not covered.
Preventive Services See details
Preventive Services are partially covered by DEVOTED CORE 034 IA (HMO) with no copay and no coinsurance for covered benefits like annual physicals, fitness programs, and health education. Sub-services that are not covered under this plan include in-home safety assessments, personal emergency response systems, 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 sessions, enhanced disease management, telemonitoring, remote access technologies, and counseling services.
Hearing Services See details
Hearing services offered by DEVOTED CORE 034 IA (HMO) are partially covered, as OTC hearing aids and inner ear, outer ear, or over-the-ear prescription hearing aids are not covered. Covered benefits include annual routine exams for a $30 copay and no coinsurance, unlimited fitting evaluations with no copay and no coinsurance, and up to two prescription hearing aids per year for a copay of $399 to $699 and no coinsurance.
Vision Services See details
DEVOTED CORE 034 IA (HMO) provides partially covered vision services, including one routine eye exam per year with a $0 to $30 copay, no coinsurance, and no deductible, though other eye exam services are not covered. Eyewear is covered with no copay, no coinsurance, and no deductible, providing up to a $350 annual maximum allowance for contacts, frames, lenses, and upgrades.
Dental Services See details
DEVOTED CORE 034 IA (HMO) offers partially covered dental services up to a $3,000 annual maximum, with no copay and no coinsurance for preventive care like cleanings, exams, and x-rays. Medicare-covered dental services require a $50 copay and no coinsurance, while other covered comprehensive services have no copay and 0% to 50% coinsurance; however, orthodontics, implant services, and maxillofacial prosthetics are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by DEVOTED CORE 034 IA (HMO) with no copay, though prior authorization is required. Associated Medicare Part B chemotherapy, radiation, and other drugs have no copay and no coinsurance to 20% coinsurance, while Part B insulin drugs require a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered under the DEVOTED CORE 034 IA (HMO) plan with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
DEVOTED CORE 034 IA (HMO) covers medical equipment with no copays, though prior authorization is required. Durable medical equipment carries a 20% to 40% coinsurance, while prosthetics and medical supplies range from no coinsurance to 20% coinsurance. Diabetic equipment is partially covered, offering diabetic supplies with no coinsurance to 50% coinsurance, but diabetic therapeutic shoes and inserts are not covered.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered under DEVOTED CORE 034 IA (HMO), though prior authorization is required. Outpatient X-rays and lab services have no copay, diagnostic procedures and tests range from no copay up to $95 with no coinsurance, and therapeutic radiological services require a 20% coinsurance.
Home Health Services See details
Home Health Services are covered under the DEVOTED CORE 034 IA (HMO) plan with no copay and no coinsurance. Prior authorization is required to access this benefit.
Cardiac Rehabilitation Services See details
Cardiac rehabilitation services are covered under the DEVOTED CORE 034 IA (HMO) plan with a $30 copay, no coinsurance, and prior authorization requirements. Although some services are covered, standard cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by DEVOTED CORE 034 IA (HMO) with no coinsurance, requiring prior authorization but no prior three-day hospital stay. There is no copay for days 1 through 20, a $218 daily copay for days 21 through 100, and additional days beyond Medicare-covered services are not covered.
Other Services See details
DEVOTED CORE 034 IA (HMO) partially covers other services with no copay and no coinsurance, providing additional preventive services and a $70 quarterly allowance for over-the-counter items. Acupuncture and meal benefits are not covered.
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