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DEVOTED C-SNP PLUS 036 IA (HMO C-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for DEVOTED C-SNP PLUS 036 IA (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 036 IA (HMO C-SNP) in 2026, please refer to our full plan details page.
DEVOTED C-SNP PLUS 036 IA (HMO C-SNP) is a HMO C-SNP 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 C-SNP PLUS 036 IA (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 036 IA (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 036 IA (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 036 IA (HMO C-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $41.50. 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 036 IA (HMO C-SNP) prescription drug plan features an annual drug deductible of $615. For standard pharmacy and standard mail-order services, Tier 6 Select Care Drugs are covered with no copay for all supply durations. Tier 1 Preferred Generics require an $18 copay for a 1-month supply ($54 for 3 months), while Tier 2 Generics have a $19 copay for a 1-month supply ($57 for 3 months). For higher-tier medications, costs are based on coinsurance rather than flat copays at standard pharmacies and mail-order facilities. Tier 3 Preferred Brands and Tier 5 Specialty drugs require a 25% coinsurance payment. Tier 4 Non-Preferred drugs carry a 31% coinsurance for 1-month, 2-month, and 3-month prescription fills.
Additional Benefits
The DEVOTED C-SNP PLUS 036 IA (HMO C-SNP) plan offers comprehensive medical coverage featuring no copays for primary care visits, preventive services, and home health care. For specialist visits, outpatient services, and diagnostic tests, members will pay no copay alongside coinsurance rates that typically range from 20% to 50%. Inpatient hospital stays require no coinsurance but carry a set copayment of $2,230 per stay for acute care or $2,080 per stay for psychiatric care. Additional benefits include dental coverage up to a $4,000 annual maximum and routine vision exams, both featuring no copays and no coinsurance for preventive care. Prescription hearing aids are available with copays ranging from $399 to $699, while routine eyewear is covered with no copay up to a $300 annual limit. Additionally, members can take advantage of a $50 quarterly over-the-counter allowance and skilled nursing facility stays with no copay for the first 20 days.
Inpatient Hospital See details
Inpatient hospital services are covered by DEVOTED C-SNP PLUS 036 IA (HMO C-SNP) with no coinsurance, requiring prior authorization and a copayment of $2,230 per stay for acute care or $2,080 per stay for psychiatric care. This benefit is partially covered because upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Outpatient services are covered by DEVOTED C-SNP PLUS 036 IA (HMO C-SNP) with no copay, featuring no coinsurance to 50% coinsurance for outpatient hospital, observation, and ambulatory surgical center services. Outpatient substance abuse and blood services are also covered with no copay and 30% coinsurance, with prior authorization required for most services.
Partial Hospitalization See details
DEVOTED C-SNP PLUS 036 IA (HMO C-SNP) covers partial hospitalization services with no copay and a 20% coinsurance, subject to prior authorization requirements.
Ambulance and Transportation Services See details
DEVOTED C-SNP PLUS 036 IA (HMO C-SNP) covers ambulance services with no copay, requiring no coinsurance to 50% coinsurance for ground transport and a 50% coinsurance for air transport. While transportation is listed as covered, transportation services to plan-approved or any health-related locations are not covered.
Emergency Services See details
DEVOTED C-SNP PLUS 036 IA (HMO C-SNP) covers emergency services with a $115 copay and no coinsurance, with the copay waived if you are admitted to the hospital within 24 hours. Urgently needed services require no copay and 0% to 20% coinsurance (up to $40 per visit), while worldwide emergency, urgent, and transportation services are covered with no copay or coinsurance up to a $25,000 maximum benefit.
Primary Care See details
DEVOTED C-SNP PLUS 036 IA (HMO C-SNP) offers primary care physician services with no copay and no coinsurance, while chiropractic services are not covered. Other covered primary care services—including specialist visits, therapy, mental health, psychiatric, podiatry, and telehealth services—require no copay and a 30% coinsurance (up to 30% for telehealth and other healthcare professionals).
Preventive Services See details
DEVOTED C-SNP PLUS 036 IA (HMO C-SNP) covers preventive services with no copay and no coinsurance, including annual physical exams, kidney disease education, and fitness benefits. This benefit is partially covered, as services such as in-home safety assessments, personal emergency response systems, therapeutic massage, and counseling are not covered.
Hearing Services See details
Hearing services are partially covered by DEVOTED C-SNP PLUS 036 IA (HMO C-SNP), including routine exams with no copay and 50% coinsurance, and prescription hearing aids with no coinsurance and a $399 to $699 copay. However, OTC hearing aids as well as inner ear, outer ear, and over the ear prescription hearing aids are not covered.
Vision Services See details
Vision services are partially covered by DEVOTED C-SNP PLUS 036 IA (HMO C-SNP), offering one routine eye exam per year with no copay and 0% to 50% coinsurance, though other eye exam services are not covered. Eyewear is covered with no copay, no coinsurance, and no deductible, providing up to a $300 annual maximum for contacts, frames, lenses, and upgrades.
Dental Services See details
Dental services are partially covered by DEVOTED C-SNP PLUS 036 IA (HMO C-SNP) with a $4,000 annual maximum for preventive and comprehensive care with no copay and no coinsurance, while Medicare-covered dental services have no copay and a 30% coinsurance. Other diagnostic, other preventive, maxillofacial prosthetics, implants, and orthodontics are not covered under this plan.
Home Infusion bundled Services See details
DEVOTED C-SNP PLUS 036 IA (HMO C-SNP) covers home infusion bundled services with no copay, although prior authorization is required. Medicare Part B drugs for these services, including chemotherapy and other infusion drugs, carry no coinsurance to 20% coinsurance, while Part B insulin drugs require a $35 copay alongside no coinsurance to 20% coinsurance.
Dialysis Services See details
DEVOTED C-SNP PLUS 036 IA (HMO C-SNP) covers Dialysis Services with no copay and a 20% coinsurance. Prior authorization is required to receive this covered benefit.
Medical Equipment See details
DEVOTED C-SNP PLUS 036 IA (HMO C-SNP) provides partially covered medical equipment with no copays, though prior authorization is required. Durable medical equipment and diabetic supplies require 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
Diagnostic and radiological services are covered by DEVOTED C-SNP PLUS 036 IA (HMO C-SNP) with prior authorization and no copays. Diagnostic procedures and tests carry no coinsurance, while therapeutic radiological services have a 20% coinsurance, and lab services, diagnostic radiological services, and outpatient X-rays require a 50% coinsurance.
Home Health Services See details
DEVOTED C-SNP PLUS 036 IA (HMO C-SNP) covers Home Health Services with no copay and no coinsurance. Prior authorization is required to receive these covered services.
Cardiac Rehabilitation Services See details
DEVOTED C-SNP PLUS 036 IA (HMO C-SNP) covers some Cardiac Rehabilitation Services with no copay and a 30% coinsurance, with prior authorization required. However, Cardiac Rehabilitation, Intensive Cardiac Rehabilitation, Pulmonary Rehabilitation, and SET for PAD services are not covered.
Skilled Nursing Facility (SNF) See details
DEVOTED C-SNP PLUS 036 IA (HMO C-SNP) 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, no prior three-day hospital stay is needed, and additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
DEVOTED C-SNP PLUS 036 IA (HMO C-SNP) provides partial coverage for other services with no copay and no coinsurance, including a $50 quarterly over-the-counter item allowance, non-Medicare covered diabetic shoes, and additional preventive services. Acupuncture and meal benefits are not covered under this plan.
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