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DEVOTED DUAL FULL 038 TX (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for DEVOTED DUAL FULL 038 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 038 TX (HMO D-SNP) in 2026, please refer to our full plan details page.
DEVOTED DUAL FULL 038 TX (HMO D-SNP) is a HMO D-SNP plan offered by Devoted Health, Inc. available for enrollment in 2026 to people living in El Paso and Hudspeth Counties. This plan received an overall rating of 5 out of 5 stars in 2026.
It's important to know that DEVOTED DUAL FULL 038 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 038 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 038 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 038 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 038 TX (HMO D-SNP) Medicare plan features an annual drug deductible of $615. For prescription drugs in Tiers 1 through 4, which cover preferred generic, generic, preferred brand, and non-preferred drugs, members pay a 25% coinsurance at standard pharmacies and through standard mail order. Tier 5 specialty drugs also carry a 25% coinsurance for a one-month supply at standard pharmacies and standard mail order. For Tier 6 Select Care Drugs, there is no copay for one-month, two-month, or three-month fills at standard pharmacies and standard mail order. This plan offers clear, structured cost-sharing to help beneficiaries understand and manage their yearly medication costs.
Additional Benefits
The DEVOTED DUAL FULL 038 TX (HMO D-SNP) plan offers robust medical coverage with no copay and no coinsurance for primary care visits, preventive services, and home health care. For inpatient hospital stays, members can expect a copay of $2,230 per acute stay and $2,080 per psychiatric stay, while outpatient services and specialist visits feature no copays and up to 20% coinsurance. Emergency care is available with a $115 copay, which is waived if you are admitted to the hospital within 24 hours. This plan also provides valuable supplemental benefits, including up to $4,000 annually for preventive and comprehensive dental care with no copay and no coinsurance. Additionally, members receive up to $400 per year for eyewear with no copay, low-to-no copays for prescription hearing aids, and a $50 allowance every three months for over-the-counter items. Skilled nursing facility stays are also covered with no copay for the first 20 days.
Inpatient Hospital See details
DEVOTED DUAL FULL 038 TX (HMO D-SNP) partially covers inpatient hospital services with no coinsurance, requiring prior authorization alongside a copay of $2,230 per acute stay and $2,080 per psychiatric stay. While unlimited additional days are covered for acute care, non-Medicare-covered stays, upgrades, and additional psychiatric days are not covered.
Outpatient Services See details
DEVOTED DUAL FULL 038 TX (HMO D-SNP) covers outpatient services with no copays, though coinsurance ranges from no coinsurance up to 20% depending on the service. This includes outpatient hospital, ambulatory surgical center, substance abuse, and blood services, most of which require prior authorization.
Partial Hospitalization See details
DEVOTED DUAL FULL 038 TX (HMO D-SNP) covers partial hospitalization services with no copay and a 20% coinsurance. Prior authorization is required for these services.
Ambulance and Transportation Services See details
DEVOTED DUAL FULL 038 TX (HMO D-SNP) covers ground ambulance services with no copay and a 0% to 20% coinsurance, and air ambulance services with no copay and a 20% coinsurance, with prior authorization required. Transportation services to health-related locations are not covered under this plan.
Emergency Services See details
DEVOTED DUAL FULL 038 TX (HMO D-SNP) covers emergency services with a $115 copay and no coinsurance, with the copay waived if admitted to the hospital within 24 hours. Urgently needed services have 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 and no coinsurance.
Primary Care See details
DEVOTED DUAL FULL 038 TX (HMO D-SNP) covers primary care physician services with no copay and no coinsurance, while specialist, therapy, psychiatric, and mental health services require no copay and a 20% coinsurance. Podiatry services are not covered, and while some chiropractic services are covered, routine and other chiropractic services are not covered.
Preventive Services See details
DEVOTED DUAL FULL 038 TX (HMO D-SNP) covers preventive services with no copay and no coinsurance, including annual physical exams, fitness benefits, and nutritional training. While many additional preventive benefits are covered, others such as in-home safety assessments, personal emergency response systems (PERS), and therapeutic massages are not covered.
Hearing Services See details
Hearing services are partially covered by DEVOTED DUAL FULL 038 TX (HMO D-SNP), offering routine exams with no deductible, no copay, and 20% coinsurance, plus prescription hearing aids with no coinsurance and copays ranging from no copay to $299. 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 DUAL FULL 038 TX (HMO D-SNP) partially covers vision services, providing one routine eye exam per year with no copay and 0% to 20% coinsurance, while other eye exam services are not covered. Eyewear is covered with no copay and no coinsurance up to a combined maximum of $400 per year for contacts, lenses, frames, and upgrades.
Dental Services See details
Dental services are partially covered by DEVOTED DUAL FULL 038 TX (HMO D-SNP), offering up to $4,000 annually for preventive and comprehensive care with no copay and no coinsurance, while Medicare-covered dental services require no copay and a 20% coinsurance. Other diagnostic dental services, other preventive dental services, maxillofacial prosthetics, implants, and orthodontics are not covered.
Home Infusion bundled Services See details
DEVOTED DUAL FULL 038 TX (HMO D-SNP) covers home infusion bundled services with no copay, though prior authorization is required. Associated Medicare Part B chemotherapy, radiation, and other drugs have no coinsurance to 20% coinsurance, while Part B insulin has a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered under the DEVOTED DUAL FULL 038 TX (HMO D-SNP) plan with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
Medical equipment is covered by DEVOTED DUAL FULL 038 TX (HMO D-SNP) with no copays, though prior authorization is required for these services. Durable medical equipment and diabetic supplies require a 20% coinsurance, while prosthetic devices and medical supplies range from no coinsurance to 20% coinsurance.
Diagnostic and Radiological Services See details
DEVOTED DUAL FULL 038 TX (HMO D-SNP) covers diagnostic and radiological services with prior authorization required and no copayments. Diagnostic procedures and tests have no coinsurance, while a 20% coinsurance applies to lab services, diagnostic and therapeutic radiological services, and outpatient X-rays.
Home Health Services See details
Home health services are covered by DEVOTED DUAL FULL 038 TX (HMO D-SNP) with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by DEVOTED DUAL FULL 038 TX (HMO D-SNP) with no copay, though prior authorization is required. While some services are covered, specific sub-services—including cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation—are not covered and carry a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by DEVOTED DUAL FULL 038 TX (HMO D-SNP) 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, a prior three-day hospital stay is not needed for admission, and additional days beyond the standard Medicare-covered 100 days are not covered.
Other Services See details
DEVOTED DUAL FULL 038 TX (HMO D-SNP) provides partial coverage for other services, offering over-the-counter (OTC) items and additional preventive services with no copay and no coinsurance. Acupuncture and meal benefits are not covered, but eligible OTC items are covered up to a maximum of $50 every three months.
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