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DEVOTED DUAL FULL 037 TX (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for DEVOTED DUAL FULL 037 TX (HMO D-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on DEVOTED DUAL FULL 037 TX (HMO D-SNP) in 2026, please refer to our full plan details page.
DEVOTED DUAL FULL 037 TX (HMO D-SNP) is a HMO D-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 DUAL FULL 037 TX (HMO D-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
DEVOTED DUAL FULL 037 TX (HMO D-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 DUAL FULL 037 TX (HMO D-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 DUAL FULL 037 TX (HMO D-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 DUAL FULL 037 TX (HMO D-SNP) plan features an annual prescription drug deductible of $615. Under this plan, standard pharmacies and standard mail order services charge a 25% coinsurance for Tier 1 through Tier 4 medications, which cover preferred generics, generics, preferred brands, and non-preferred drugs. Tier 5 specialty drugs also require a 25% coinsurance for a 1-month supply at standard pharmacies and mail order locations. For Tier 6 select care drugs, beneficiaries enjoy no copay for 1-month, 2-month, and 3-month supplies filled at standard pharmacies or standard mail order. This straightforward cost structure helps you easily estimate your out-of-pocket prescription costs.
Additional Benefits
The DEVOTED DUAL FULL 037 TX (HMO D-SNP) plan provides comprehensive healthcare coverage with no copay and no coinsurance for primary care visits, preventive care, and home health services. For inpatient hospital stays, members pay a copay of $2,230 for acute care and $2,080 for psychiatric care with no coinsurance, while outpatient services and specialist visits feature no copay and a coinsurance of up to 20%. Emergency room visits require a $115 copay, which is waived if you are admitted to the hospital within 24 hours. Additional benefits include partially covered dental services up to a $3,000 annual limit and eyewear coverage up to $400 annually, both featuring no copays. Routine hearing and vision exams also have no copay and a coinsurance of up to 20%, though prescription hearing aids require a copay between $399 and $699. Skilled nursing facility stays are covered with no coinsurance, requiring no copay for the first 20 days and a $218 daily copay for days 21 through 100.
Inpatient Hospital See details
DEVOTED DUAL FULL 037 TX (HMO D-SNP) covers inpatient acute hospital stays with a $2,230 copay per stay and inpatient psychiatric stays with a $2,080 copay per stay, both with no coinsurance. This benefit is partially covered, as additional psychiatric days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
DEVOTED DUAL FULL 037 TX (HMO D-SNP) covers outpatient services with no copay, though a coinsurance of 0% to 20% applies depending on the specific service. This coverage includes outpatient hospital, ambulatory surgical center, substance abuse, and blood services, most of which require prior authorization.
Partial Hospitalization See details
DEVOTED DUAL FULL 037 TX (HMO D-SNP) covers partial hospitalization services with no copay and a 20% coinsurance. Prior authorization is required before you can receive this benefit.
Ambulance and Transportation Services See details
Ambulance services are covered by DEVOTED DUAL FULL 037 TX (HMO D-SNP) with no copay, requiring a 0% to 20% coinsurance for ground ambulance and a 20% coinsurance for air ambulance, both of which require prior authorization. Transportation services to health-related locations are not covered under this plan.
Emergency Services See details
DEVOTED DUAL FULL 037 TX (HMO D-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 are covered with no copay and a 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 limit.
Primary Care See details
DEVOTED DUAL FULL 037 TX (HMO D-SNP) covers primary care physician services with no copay and no coinsurance. Most other covered services, including specialist visits, mental health, psychiatric, and physical therapy services, require no copay and a 20% coinsurance, while chiropractic and podiatry services are not covered.
Preventive Services See details
Preventive services under DEVOTED DUAL FULL 037 TX (HMO D-SNP) are partially covered with no copay and no coinsurance, including annual physicals, kidney education, and fitness benefits. However, several sub-services are not covered, including in-home safety assessments, personal emergency response systems (PERS), medical nutrition therapy, post-discharge medication reconciliation, readmission prevention, chemotherapy wigs, therapeutic massage, adult day health, palliative care, in-home support, caregiver support, additional smoking cessation, enhanced disease management, telemonitoring, remote access, and counseling.
Hearing Services See details
DEVOTED DUAL FULL 037 TX (HMO D-SNP) partially covers hearing services, offering one routine hearing exam per year with no copay and a 20% coinsurance, as well as unlimited fitting evaluations. Up to two prescription hearing aids are covered annually with no coinsurance and a $399 to $699 copay, though over-the-counter (OTC) hearing aids and inner, outer, or over-the-ear prescription models are not covered.
Vision Services See details
Vision Services are partially covered by DEVOTED DUAL FULL 037 TX (HMO D-SNP) because other eye exam services are not covered. Routine eye exams feature no copay and 0% to 20% coinsurance (limited to one per year with prior authorization), while eyewear is covered with no copay and no coinsurance up to a $400 annual maximum.
Dental Services See details
DEVOTED DUAL FULL 037 TX (HMO D-SNP) offers partially covered dental services with a $3,000 annual maximum, requiring no copay and a 20% coinsurance for Medicare-covered dental, and no copay and no coinsurance for other covered dental services. Sub-services that are not covered under this plan include other diagnostic dental services, other preventive dental services, maxillofacial prosthetics, implant services, and orthodontics.
Home Infusion bundled Services See details
Home infusion bundled services are covered by DEVOTED DUAL FULL 037 TX (HMO D-SNP) with no copay, though prior authorization is required. Under this benefit, Part B chemotherapy and other drugs have no copay and coinsurance ranging from no coinsurance to 20%, while Part B insulin requires a $35 copay and coinsurance ranging from no coinsurance to 20%.
Dialysis Services See details
Dialysis Services are covered by DEVOTED DUAL FULL 037 TX (HMO D-SNP) with no copay and a 20% coinsurance. Prior authorization is required to receive these services.
Medical Equipment See details
Medical equipment is covered by DEVOTED DUAL FULL 037 TX (HMO D-SNP) with no copays, though prior authorization is required. Durable medical equipment and diabetic supplies are subject to a 20% coinsurance, while prosthetics and medical supplies range from no coinsurance to 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered under the DEVOTED DUAL FULL 037 TX (HMO D-SNP) plan with prior authorization and no copays. Diagnostic procedures and tests carry no coinsurance, while lab services, diagnostic and therapeutic radiological services, and outpatient X-rays require a 20% coinsurance.
Home Health Services See details
Home health services are covered by DEVOTED DUAL FULL 037 TX (HMO D-SNP) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the DEVOTED DUAL FULL 037 TX (HMO D-SNP) plan, as cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are all not covered and require a 20% coinsurance with no copay.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by DEVOTED DUAL FULL 037 TX (HMO D-SNP) with no coinsurance, requiring prior authorization and no prior three-day inpatient hospital stay. Under this plan, there is no copay for days 1 through 20, a $218 daily copay for days 21 through 100, and additional days beyond the Medicare-covered limit are not covered.
Other Services See details
DEVOTED DUAL FULL 037 TX (HMO D-SNP) partially covers other services, offering additional preventive services and over-the-counter items with a fifty dollar quarterly allowance, both with no copay and no coinsurance. Acupuncture and meal benefits are not covered under this plan.
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