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DEVOTED DUAL FULL 040 TX (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for DEVOTED DUAL FULL 040 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 040 TX (HMO D-SNP) in 2026, please refer to our full plan details page.
DEVOTED DUAL FULL 040 TX (HMO D-SNP) is a HMO D-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 DUAL FULL 040 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 040 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 040 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 040 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 040 TX (HMO D-SNP) Medicare plan features an annual drug deductible of $615. For prescription drugs in Tiers 1 through 4, which include preferred generic, generic, preferred brand, and non-preferred drugs, you will pay a 25% coinsurance at standard pharmacies and standard mail order. Tier 5 specialty drugs also require a 25% coinsurance for a 1-month supply at standard pharmacies and standard mail order. Beneficiaries can save on Tier 6 select care drugs, which feature no copay for 1-month, 2-month, and 3-month supplies at standard pharmacies and standard mail order. This D-SNP plan offers structured prescription drug coverage to help you manage your healthcare costs.
Additional Benefits
The DEVOTED DUAL FULL 040 TX (HMO D-SNP) plan offers comprehensive coverage with no copay and no coinsurance for primary care visits, preventive services, and home health care. For inpatient hospital stays, you will pay no coinsurance but will face a copay of $2,230 per stay for acute care and $2,080 per stay for psychiatric care. Emergency services are available with a $115 copay, which is waived if you are admitted, while outpatient services generally feature no copayments and coinsurance of up to 20 percent. Specialist visits, diagnostics, and medical equipment require no copay but may carry a coinsurance of up to 20 percent. This plan also features strong supplemental benefits, including up to $3,000 annually for dental care and a $400 annual limit for eyewear with no copays, deductibles, or coinsurance, alongside a $50 quarterly allowance for over-the-counter items. Routine hearing exams have no copay and 20 percent coinsurance, while covered hearing aids require a copay between $399 and $699.
Inpatient Hospital See details
DEVOTED DUAL FULL 040 TX (HMO D-SNP) covers inpatient hospital services with no coinsurance, requiring a $2,230 copay per stay for acute care and a $2,080 copay per stay for psychiatric care. Prior authorization is required, and while unlimited additional acute days are covered, upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Outpatient services are covered under the DEVOTED DUAL FULL 040 TX (HMO D-SNP) plan with no copays, though coinsurance of up to 20% applies to outpatient hospital, ambulatory surgical center, substance abuse, and blood services. Prior authorization is required for most of these outpatient services, and substance abuse treatments also require a referral.
Partial Hospitalization See details
DEVOTED DUAL FULL 040 TX (HMO D-SNP) covers partial hospitalization services with no copay and a 20% coinsurance. Prior authorization is required to receive this benefit.
Ambulance and Transportation Services See details
DEVOTED DUAL FULL 040 TX (HMO D-SNP) covers ambulance services with no copay, requiring no coinsurance to 20% coinsurance for ground transport and 20% coinsurance for air transport, with prior authorization required. Transportation services are not covered under this plan.
Emergency Services See details
DEVOTED DUAL FULL 040 TX (HMO D-SNP) covers emergency services with a $115 copay (waived if admitted within 24 hours) and no coinsurance, and urgently needed services with no copay and a 0% to 20% coinsurance up to $40. Worldwide emergency, urgent, and transportation services are also covered up to a $25,000 limit with no copay and no coinsurance.
Primary Care See details
DEVOTED DUAL FULL 040 TX (HMO D-SNP) offers primary care physician services with no copay and no coinsurance, while specialist visits, mental health, and physical therapy services require no copay and a 20% coinsurance. Podiatry and routine chiropractic services are not covered, but telehealth options are available with no copay and 0% to 20% coinsurance.
Preventive Services See details
Preventive Services are partially covered by DEVOTED DUAL FULL 040 TX (HMO D-SNP) with no copay and no coinsurance for covered services like annual physicals, fitness benefits, and nutritional counseling. Excluded sub-services that are not covered include in-home safety assessments, personal emergency response systems (PERS), medical nutrition therapy, post-discharge medication reconciliation, readmission prevention, wigs, therapeutic massage, adult day health, home-based palliative care, in-home support, caregiver support, additional smoking cessation, enhanced disease management, telemonitoring, remote access technologies, and counseling.
Hearing Services See details
DEVOTED DUAL FULL 040 TX (HMO D-SNP) covers hearing exams with no copay and a 20% coinsurance for routine annual exams, which require prior authorization. Prescription hearing aids are partially covered with no coinsurance and a copayment of $399 to $699 for up to two aids per year, though OTC, inner ear, outer ear, and over the ear hearing aids are not covered.
Vision Services See details
DEVOTED DUAL FULL 040 TX (HMO D-SNP) provides partially covered vision services, offering one routine eye exam per year with no copay, no deductible, and 0% to 20% coinsurance (prior authorization required), while other eye exam services are not covered. Eyewear is covered with no copay, no deductible, and no coinsurance, up to a $400 annual maximum benefit for contact lenses, eyeglasses, frames, lenses, and upgrades.
Dental Services See details
DEVOTED DUAL FULL 040 TX (HMO D-SNP) partially covers dental services, offering up to $3,000 annually for preventive and comprehensive care with no copay and no coinsurance, while Medicare-covered dental services require no copay and a 20% coinsurance. This plan does not cover 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 040 TX (HMO D-SNP) with no copay, though prior authorization is required. Associated Medicare Part B chemotherapy, radiation, and other drugs feature no copay and coinsurance ranging from no coinsurance to 20%, while Part B insulin is covered with a $35 copay and coinsurance ranging from no coinsurance to 20%.
Dialysis Services See details
Dialysis Services are covered under the DEVOTED DUAL FULL 040 TX (HMO D-SNP) plan with no copay and a 20% coinsurance. Prior authorization is required for these services.
Medical Equipment See details
DEVOTED DUAL FULL 040 TX (HMO D-SNP) covers medical equipment, including durable medical equipment (DME), prosthetics, and diabetic supplies, with no copay. Coinsurance for these covered items ranges from 0% (no coinsurance) to 20%, and prior authorization is required.
Diagnostic and Radiological Services See details
DEVOTED DUAL FULL 040 TX (HMO D-SNP) covers diagnostic and radiological services with prior authorization required and no copays. While diagnostic procedures and tests have no coinsurance, a 20% coinsurance applies to lab services, diagnostic and therapeutic radiological services, and outpatient X-rays.
Home Health Services See details
DEVOTED DUAL FULL 040 TX (HMO D-SNP) covers home health services with no copay and no coinsurance, though prior authorization is required for these services.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the DEVOTED DUAL FULL 040 TX (HMO D-SNP) plan because cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered. While there is no copay, these services require a 20% coinsurance and prior authorization.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are partially covered by DEVOTED DUAL FULL 040 TX (HMO D-SNP) with no coinsurance, requiring no copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required, and additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Other Services under DEVOTED DUAL FULL 040 TX (HMO D-SNP) are partially covered, featuring no copay and no coinsurance for additional preventive services and over-the-counter (OTC) items with a $50 maximum benefit every three months. Acupuncture, meal benefits, and highly integrated dual eligible SNP services are not covered.
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