A non-government entity
DEVOTED DUAL FULL 041 TX (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for DEVOTED DUAL FULL 041 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 041 TX (HMO D-SNP) in 2026, please refer to our full plan details page.
DEVOTED DUAL FULL 041 TX (HMO D-SNP) is a HMO D-SNP plan offered by Devoted Health, Inc. available for enrollment in 2026 to people living in San Antonio. This plan received an overall rating of 5 out of 5 stars in 2026.
It's important to know that DEVOTED DUAL FULL 041 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 041 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 041 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 041 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:
Sign up for DEVOTED DUAL FULL 041 TX (HMO D-SNP)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
Drug Coverage
The DEVOTED DUAL FULL 041 TX (HMO D-SNP) Medicare plan has an annual prescription drug deductible of $615. For standard pharmacies and standard mail order services, you will pay a 25% coinsurance for Tier 1 preferred generic, Tier 2 generic, Tier 3 preferred brand, and Tier 4 non-preferred drugs. Tier 5 specialty drugs also require a 25% coinsurance for a 1-month supply at standard pharmacies and standard mail order. For Tier 6 select care drugs, there is no copay for 1-month, 2-month, or 3-month supplies filled at standard pharmacies or standard mail order. Evaluating these coinsurance rates and deductible requirements can help you determine if this plan offers the right prescription coverage for your healthcare needs.
Additional Benefits
The DEVOTED DUAL FULL 041 TX (HMO D-SNP) plan offers robust medical coverage, featuring primary care, home health, and preventive services with no copay and no coinsurance. For inpatient hospital stays, members pay a copay of $2,230 for acute care and $2,080 for psychiatric care per stay, while outpatient services and specialist visits feature no copay and up to 20% coinsurance. Emergency room visits carry a $115 copay, which is waived if admitted, while urgent care is available with no copay and up to 20% coinsurance. In addition to basic medical care, the plan provides dental coverage up to a $3,000 annual limit and routine vision exams with an eyewear allowance of up to $400, both with no copay. Hearing aids are covered with a copay ranging from $399 to $699, and the plan offers a $50 quarterly allowance for over-the-counter items with no copay. For recovery care, skilled nursing facility stays require no copay for the first 20 days and a $218 daily copay for days 21 through 100.
Inpatient Hospital See details
DEVOTED DUAL FULL 041 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. This benefit is partially covered, as upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
DEVOTED DUAL FULL 041 TX (HMO D-SNP) outpatient services are covered with no copay, with coinsurance ranging from 0% to 20% depending on the service. This coverage includes outpatient hospital, ambulatory surgical center, outpatient substance abuse, and blood services, with no deductible for blood services and prior authorization required for most care.
Partial Hospitalization See details
DEVOTED DUAL FULL 041 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 041 TX (HMO D-SNP) covers ambulance services with no copay, requiring a 20% coinsurance for air ambulance and a 0% to 20% coinsurance for ground ambulance, both of which require prior authorization. While some transportation services are covered, transportation to plan-approved or any health-related locations is not covered under this plan.
Emergency Services See details
DEVOTED DUAL FULL 041 TX (HMO D-SNP) covers emergency services with a $115 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services are covered with no copay and a 0% to 20% coinsurance up to $40, while worldwide emergency, urgent, and transportation services are covered with no copay or coinsurance up to a $25,000 maximum.
Primary Care See details
DEVOTED DUAL FULL 041 TX (HMO D-SNP) provides primary care physician services with no copay and no coinsurance, alongside telehealth benefits featuring no copay and 0% to 20% coinsurance. Specialist visits, physical, occupational, and speech therapies, psychiatric care, and opioid treatment are covered with no copay and 20% coinsurance, while chiropractic and podiatry services are not covered.
Preventive Services See details
DEVOTED DUAL FULL 041 TX (HMO D-SNP) provides partially covered preventive services with no copay and no coinsurance for annual exams, fitness benefits, and alternative therapies. Several sub-services are not covered, including in-home safety assessments, personal emergency response systems (PERS), medical nutrition therapy, therapeutic massage, and in-home support services.
Hearing Services See details
Hearing services are covered by DEVOTED DUAL FULL 041 TX (HMO D-SNP), including routine exams with no copay and 20% coinsurance, and unlimited fitting evaluations. Prescription hearing aids are partially covered with no coinsurance and a $399 to $699 copay for up to two devices per year, though inner ear, outer ear, over the ear, and OTC hearing aids are not covered.
Vision Services See details
Vision services are partially covered by DEVOTED DUAL FULL 041 TX (HMO D-SNP) because other eye exam services are not covered. One routine eye exam is covered annually with no copay, 0% to 20% coinsurance, and no deductible, while eyewear is covered with no copay, no coinsurance, and no deductible up to a $400 annual limit.
Dental Services See details
DEVOTED DUAL FULL 041 TX (HMO D-SNP) partially covers dental services, offering Medicare-covered dental with no copay and 20% coinsurance, and other covered preventive and comprehensive dental services with no copay and no coinsurance up to a $3,000 annual limit. Specific sub-services that are not covered include other diagnostic dental, other preventive dental, maxillofacial prosthetics, implant services, and orthodontics.
Home Infusion bundled Services See details
Home infusion bundled services are covered by DEVOTED DUAL FULL 041 TX (HMO D-SNP) with no copay, though prior authorization and step therapy are required. Associated Medicare Part B chemotherapy and other drugs have no copay and coinsurance ranging from no coinsurance to 20%, while Part B insulin has a $35 copay and coinsurance ranging from no coinsurance to 20%.
Dialysis Services See details
Dialysis services are covered under the DEVOTED DUAL FULL 041 TX (HMO D-SNP) plan with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
DEVOTED DUAL FULL 041 TX (HMO D-SNP) covers medical equipment, including durable medical equipment, prosthetics, and diabetic supplies, with no copay and prior authorization required. Coinsurance for these items ranges from no coinsurance to 20%, with durable medical equipment and diabetic equipment carrying a flat 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered under DEVOTED DUAL FULL 041 TX (HMO D-SNP) with prior authorization required and no copays. There is no coinsurance for diagnostic procedures and tests, while lab services, outpatient X-rays, and diagnostic or therapeutic radiological services require a 20% coinsurance.
Home Health Services See details
DEVOTED DUAL FULL 041 TX (HMO D-SNP) covers Home Health Services 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 041 TX (HMO D-SNP) with no copay and require prior authorization. While some services are covered, standard cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered in practice and require a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered under DEVOTED DUAL FULL 041 TX (HMO D-SNP) 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, and while a prior three-day inpatient hospital stay is not needed, additional days beyond the standard 100 days are not covered.
Other Services See details
Other Services are partially covered by DEVOTED DUAL FULL 041 TX (HMO D-SNP), featuring no copay and no coinsurance for covered benefits like additional preventive services and Over-the-Counter (OTC) items up to $50 every three months. Acupuncture, meal benefits, and other additional services are not covered under this plan.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
*/SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
MedicareAdvantageRX.com is owned and operated by Dog Media Solutions LLC.
This is a promotional communication.
Every year, Medicare evaluates plans based on a 5-star rating system.
Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
Enrollment in Medicare/Medicare Advantage may be limited to certain times of the year unless you qualify for a Special Enrollment Period
We do not offer every plan available in your area. Currently, we represent 18 organizations, which offer 52,101 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
We represent Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan's contract renewal.
Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.
Please contact Medicare.gov ,1-800-MEDICARE , or your local State Health Insurance Program (SHIP) to get information on all of your options.
Medicare has neither approved nor endorsed any information on this site.
Speak with a licensed insurance agent: 1-877-649-2073 / TTY 711 | 8am - 11pm ET | 7 days a week
© 2023 Dog Media Solutions LLC. All rights reserved