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Devoted CORE Arizona (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Devoted CORE Arizona (HMO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Devoted CORE Arizona (HMO) in 2025, please refer to our full plan details page.
Devoted CORE Arizona (HMO) is a HMO plan offered by Devoted Health, Inc. available for enrollment in 2025 to people living in Yavapai and Coconino Counties. This plan received an overall rating of 4 out of 5 stars in 2025.
It's important to know that Devoted CORE Arizona (HMO) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Key Plan Facts
Below are a few key facts and commonly-asked questions about Devoted CORE Arizona (HMO).
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 CORE Arizona (HMO), 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 $590.00 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 $6750.00 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 CORE Arizona (HMO) plan has an Enhanced Alternative drug benefit. The plan has a deductible of $590.00. In the initial coverage phase, after you meet your deductible, you will pay either a 25% coinsurance or no copay, depending on the drug tier and pharmacy. Once your total drug costs reach $2000.00, you enter the catastrophic coverage phase where you pay nothing for Part D covered drugs.
Additional Benefits
The Devoted CORE Arizona (HMO) plan offers a wide range of benefits with varying costs. Hospital stays have a copay, while outpatient services often have no copay. Emergency, primary care, preventive, hearing, vision, and dental services are covered, with copays applying to some services like specialist visits, hearing exams, and eye exams. The plan also includes coverage for home infusion, dialysis, medical equipment, and diagnostic services, but these may involve coinsurance. Skilled nursing facility stays have a copay, while home health services have no copay. This plan offers a comprehensive suite of benefits with cost-sharing elements like copays and coinsurance, and includes some services that require prior authorization.
Inpatient Hospital See details
Inpatient Hospital services are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric. For days 1-5 of Inpatient Hospital-Acute or Inpatient Hospital Psychiatric, there is a $450 copay, and for days 6-90, there is no copay. Non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute, as well as Additional Days and Non-Medicare-covered stays for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient services are covered by the Devoted CORE Arizona (HMO) plan, with no copay for outpatient hospital services, a $450 copay for observation services, and no copay for ambulatory surgical center services. Outpatient substance abuse services have a $40 copay for both individual and group sessions, and outpatient blood services are covered.
Partial Hospitalization See details
Partial Hospitalization is covered under the Devoted CORE Arizona (HMO) plan, but requires prior authorization. You will have a $105 copay for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Devoted CORE Arizona (HMO) plan. Ground ambulance services have a copay between $0 and $350, while air ambulance services have a 20% coinsurance; transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by the Devoted CORE Arizona (HMO) plan. Emergency Services have a $125 copay, while Urgently Needed Services have a copay between $0 and $45. Worldwide Emergency Transportation has a $350 copay and 20% coinsurance, while Worldwide Emergency Coverage and Worldwide Urgent Coverage have a $125 copay.
Primary Care See details
The Devoted CORE Arizona (HMO) plan covers Primary Care Physician Services with no copay, Chiropractic Services with a $20 copay, Occupational Therapy Services with a copay between $40 and $45, and Physician Specialist Services with a copay between $0 and $45. Mental Health Specialty Services, Other Health Care Professional, Psychiatric Services, and Opioid Treatment Program Services have a $40 copay for individual and group sessions. Physical Therapy and Speech-Language Pathology Services have a copay between $40 and $65, and Additional Telehealth Benefits have a copay between $0 and $45. Podiatry Services are not covered.
Preventive Services See details
Preventive Services are covered under the Devoted CORE Arizona (HMO) plan, including Medicare-covered preventive services, annual physical exams, health education, Personal Emergency Response System (PERS), weight management programs, alternative therapies, nutritional/dietary benefits, fitness benefits, home and bathroom safety devices and modifications, Kidney Disease Education Services, glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKG following Welcome Visit. In-home safety assessment, medical nutrition therapy, post discharge in-home medication reconciliation, re-admission prevention, wigs for hair loss related to chemotherapy, therapeutic massage, adult day health services, home-based palliative care, in-home support services, support for caregivers of enrollees, additional sessions of smoking and tobacco cessation counseling, enhanced disease management, telemonitoring services, remote access technologies, and counseling services are not covered.
Hearing Services See details
Hearing Services, including routine hearing exams and fitting/evaluation for hearing aids, are covered by the Devoted CORE Arizona (HMO) plan. Routine hearing exams have a $40 copay for each visit, and the plan covers one routine hearing exam every year. Prescription hearing aids (all types) are covered, with a limit of two per year. However, prescription hearing aids for the inner ear, outer ear, and over the ear, as well as OTC hearing aids, are not covered.
Vision Services See details
The Devoted CORE Arizona (HMO) plan covers vision services, including eye exams with a $40 copay. Eyewear is covered up to a combined maximum of $750 every year, and contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades are also covered.
Dental Services See details
The Devoted CORE Arizona (HMO) plan covers Medicare dental services with a $45 copay and other dental services with a $750 annual maximum. The plan also covers oral exams, dental x-rays, other diagnostic services, cleaning, fluoride treatments, other preventative services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), and oral and maxillofacial surgery. Maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, and prior authorization is required. For Medicare Part B Insulin Drugs, there is a $35 copay and 20% coinsurance; for Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, the coinsurance is between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the Devoted CORE Arizona (HMO) plan. You will pay a coinsurance of 20% for this service.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with 0-25% coinsurance and no copay, Prosthetic Devices with 0-20% coinsurance and no copay, and Medical Supplies with 20% coinsurance and no copay; however, Durable Medical Equipment for use outside the home, Diabetic Supplies, and Diabetic Therapeutic Shoes/Inserts are not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered by the Devoted CORE Arizona (HMO) plan, with copays and coinsurance applying to some services. Diagnostic Procedures/Tests have a copay between $0 and $95, while Lab Services have no copay. Diagnostic Radiological Services have a copay up to $300, and Therapeutic Radiological Services have a coinsurance of at least 20%. Outpatient X-Ray Services have no copay.
Home Health Services See details
Home Health Services are covered by the Devoted CORE Arizona (HMO) plan with no copay and no coinsurance, but additional hours of care and personal care services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the Devoted CORE Arizona (HMO) plan. The plan does not cover Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, or Additional Cardiac Rehabilitation Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Devoted CORE Arizona (HMO) plan, but require prior authorization. For days 1-20, there is a $10 copay, and for days 21-100, the copay is $214. Additional days beyond Medicare-covered and non-Medicare-covered stays are not covered.
Other Services See details
The "Other Services" benefit for Devoted CORE Arizona (HMO) does not cover acupuncture, over-the-counter items, meal benefits, Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, and Self-Directed Personal Assistance Services. Some services are covered, including Other 2, which covers preventive services with no copay.
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