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DEVOTED C-SNP 046 TX (HMO C-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for DEVOTED C-SNP 046 TX (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 046 TX (HMO C-SNP) in 2026, please refer to our full plan details page.
DEVOTED C-SNP 046 TX (HMO C-SNP) is a HMO C-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 C-SNP 046 TX (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 046 TX (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 046 TX (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 046 TX (HMO C-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $0.00. 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 $480.00 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 $4450.00 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 046 TX (HMO C-SNP) Medicare prescription drug plan features an annual drug deductible of $480. For medications in Tier 1 (Preferred Generic) and Tier 2 (Generic), members enjoy no copay for 1-month, 2-month, and 3-month supplies at standard pharmacies and through standard mail order. This makes managing everyday generic prescriptions highly affordable under this plan. For brand-name and specialty medications, costs are calculated as a percentage of the drug cost. Tier 3 (Preferred Brand) drugs require a 25% coinsurance, while Tier 4 (Non-Preferred Drug) prescriptions carry a 43% coinsurance for standard pharmacy and mail-order fills. Specialty Tier 5 drugs have a 27% coinsurance for a 1-month supply.
Additional Benefits
The DEVOTED C-SNP 046 TX (HMO C-SNP) plan provides comprehensive healthcare coverage with predictable out-of-pocket costs. Members enjoy no copay for primary care provider visits, while specialist visits require a copay ranging from $25 to $50. Inpatient hospital stays require a $325 daily copay for the first five days and no copay for days six through ninety, while home health services are fully covered with no copay or coinsurance. This plan also features robust supplemental benefits, including preventive dental care with no copay and comprehensive dental coverage up to a $3,000 annual limit. Routine vision exams have a copay of up to $25, and members receive a $400 annual allowance for eyewear with no copay. Additionally, the plan covers routine hearing exams for a $25 copay and provides a $50 quarterly allowance for over-the-counter items with no copay.
Inpatient Hospital See details
Inpatient hospital services are covered by DEVOTED C-SNP 046 TX (HMO C-SNP) with no coinsurance, requiring a copay of $325 per day for days 1 through 5 and no copay for days 6 through 90. This partially covered benefit requires prior authorization and excludes upgrades, non-Medicare-covered stays, and additional psychiatric days.
Outpatient Services See details
DEVOTED C-SNP 046 TX (HMO C-SNP) covers outpatient services with no coinsurance, offering ambulatory surgical center and outpatient blood services with no copay. Outpatient hospital services have a copay of $0 to $425, observation services require a $325 copay per stay, and outpatient substance abuse sessions have a $25 copay.
Partial Hospitalization See details
DEVOTED C-SNP 046 TX (HMO C-SNP) covers partial hospitalization services with a $55.00 copay and no coinsurance. Prior authorization is required to access this benefit.
Ambulance and Transportation Services See details
Ambulance services are covered by DEVOTED C-SNP 046 TX (HMO C-SNP) with prior authorization, featuring a ground ambulance copay ranging from no copay to $315 along with coinsurance, and air ambulance services requiring a 20% coinsurance along with a copay. Transportation services are not covered.
Emergency Services See details
DEVOTED C-SNP 046 TX (HMO C-SNP) covers emergency services with a $130 copay, which is waived if admitted to the hospital within 24 hours, and no coinsurance. Urgently needed services feature a copay ranging from no copay to $45 with no coinsurance, while worldwide emergency benefits are covered up to a $25,000 limit with a $130 copay (no coinsurance) for emergency or urgent care and a $315 copay plus 20% coinsurance for emergency transportation.
Primary Care See details
Primary care benefits under DEVOTED C-SNP 046 TX (HMO C-SNP) are partially covered, featuring no copay and no coinsurance for primary care provider visits, and copays ranging from $25 to $50 with no coinsurance for specialists, therapy, and mental health. Routine and other chiropractic services are not covered, while telehealth services are available with copays from $0 to $45 and no coinsurance.
Preventive Services See details
Preventive services under DEVOTED C-SNP 046 TX (HMO C-SNP) are partially covered with no copay and no coinsurance for services like annual physical exams, fitness benefits, and nutritional therapy. However, several sub-services are not covered, including personal emergency response systems (PERS), in-home safety assessments, therapeutic massage, and counseling.
Hearing Services See details
DEVOTED C-SNP 046 TX (HMO C-SNP) covers routine hearing exams with a $25 copay, no coinsurance, and no deductible, plus unlimited hearing aid evaluations. Prescription hearing aids are partially covered with no coinsurance and a copay of $199 to $499, but OTC hearing aids and inner ear, outer ear, and over the ear prescription models are not covered.
Vision Services See details
Vision services are partially covered by DEVOTED C-SNP 046 TX (HMO C-SNP), with other eye exam services not covered. Routine eye exams feature a $0 to $25 copay and no coinsurance, while eyewear is covered with no copay, no coinsurance, and a $400 annual limit.
Dental Services See details
DEVOTED C-SNP 046 TX (HMO C-SNP) dental services are partially covered up to a $3,000 annual limit, with a $25 copay and no coinsurance for Medicare-covered dental, and no copay with 0% to 50% coinsurance for most other services. While preventive services have no copay and no coinsurance, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered under DEVOTED C-SNP 046 TX (HMO C-SNP) with no copay, though prior authorization is required. Associated Medicare Part B chemotherapy, radiation, and other Part B drugs carry no copay and no coinsurance to 20% coinsurance, while Part B insulin requires a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered under the DEVOTED C-SNP 046 TX (HMO C-SNP) plan with no copay and a 20% coinsurance. Prior authorization is required to receive these services.
Medical Equipment See details
DEVOTED C-SNP 046 TX (HMO C-SNP) partially covers medical equipment with no copays, featuring 20% to 50% coinsurance for durable medical equipment, and no coinsurance to 20% or 50% coinsurance for prosthetics, medical supplies, and diabetic supplies. Diabetic therapeutic shoes and inserts are not covered under this plan, and prior authorization is required for covered equipment.
Diagnostic and Radiological Services See details
DEVOTED C-SNP 046 TX (HMO C-SNP) covers diagnostic and radiological services with prior authorization required. Diagnostic procedures have no coinsurance and a copay of $0 to $95, lab services have no copay or coinsurance, and outpatient X-rays have no copay but require coinsurance. Therapeutic radiology requires a copay and a minimum 20% coinsurance, while diagnostic radiology has a copay starting at $0.
Home Health Services See details
DEVOTED C-SNP 046 TX (HMO C-SNP) covers home health services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by DEVOTED C-SNP 046 TX (HMO C-SNP) with no coinsurance and a $25 copay; however, only some services are covered in practice as cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered.
Skilled Nursing Facility (SNF) See details
DEVOTED C-SNP 046 TX (HMO C-SNP) covers skilled nursing facility (SNF) care with no coinsurance, offering no copay for days 1 to 20 and a $218 daily copay for days 21 to 100. Prior authorization is required, no prior three-day hospital stay is needed, and additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Other services are partially covered by DEVOTED C-SNP 046 TX (HMO C-SNP), offering no copay and no coinsurance for over-the-counter (OTC) items up to $50 every three months, diabetic shoes, and additional preventive services. Acupuncture and meal benefits are not covered.
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1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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