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Devoted BE WELL PLUS Arizona (HMO C-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Devoted BE WELL PLUS Arizona (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 BE WELL PLUS Arizona (HMO C-SNP) in 2025, please refer to our full plan details page.
Devoted BE WELL PLUS Arizona (HMO C-SNP) is a HMO C-SNP plan offered by Devoted Health, Inc. available for enrollment in 2025 to people living in Maricopa and Pinal Counties. This plan received an overall rating of 4 out of 5 stars in 2025.
It's important to know that Devoted BE WELL PLUS Arizona (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 BE WELL PLUS Arizona (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 BE WELL PLUS Arizona (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 BE WELL PLUS Arizona (HMO C-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $4.50. 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 $5900.00 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 BE WELL PLUS Arizona (HMO C-SNP) plan has a $590 deductible for prescription drugs. After the deductible is met, you pay a copay for your prescriptions, with the exact amount depending on the drug tier and pharmacy. Once your total drug costs reach $2,000, you enter the catastrophic coverage phase, where you will pay nothing for Part D covered drugs. Those who qualify for the low-income subsidy will pay $4.50.
Additional Benefits
The Devoted BE WELL PLUS Arizona (HMO C-SNP) plan offers comprehensive coverage, including inpatient and outpatient hospital services, with varying copays. You'll find no copays for preventive services, and coverage for hearing and vision services, and dental services. This plan also covers emergency services, ambulance services, and home health services, with copays or coinsurance depending on the specific service. Additional benefits include coverage for home infusion, dialysis, medical equipment, and diagnostic services.
Inpatient Hospital See details
Inpatient Hospital services are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, with prior authorization required. For Inpatient Hospital-Acute, you will pay a $335 copay for days 1-7 and no copay for days 8-90; for Inpatient Hospital Psychiatric, you will pay a $335 copay for days 1-6 and no copay for days 7-90.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services, with a copay between $0 and $435, and observation services with a copay of $335. Ambulatory Surgical Center (ASC) Services have no copay, while outpatient substance abuse services, including individual and group sessions, have a copay of $40. Outpatient blood services are also covered.
Partial Hospitalization See details
Partial Hospitalization is covered by the Devoted BE WELL PLUS Arizona (HMO C-SNP) plan, and requires prior authorization. The copay for this benefit is $70.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Devoted BE WELL PLUS Arizona (HMO C-SNP) 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 BE WELL PLUS Arizona (HMO C-SNP) plan. Emergency Services has a $125 copay, and Urgently Needed Services has a copay between $0 and $45. Worldwide Emergency Transportation has a $350 copay and 20% coinsurance, and Worldwide Emergency Coverage and Worldwide Urgent Coverage have a $125 copay.
Primary Care See details
The Devoted BE WELL PLUS Arizona (HMO C-SNP) plan covers primary care physician services, occupational therapy, physician specialist services, podiatry services, physical therapy, speech-language pathology services, additional telehealth benefits, and opioid treatment program services. Chiropractic services have a $20 copay, and routine chiropractic care is not covered. Mental health specialty services, psychiatric services, and other health care professional services have a copay between $0 and $40.
Preventive Services See details
Preventive Services include coverage for services such as Medicare-covered preventive services, annual physical exams, health education, personal emergency response systems, medical nutrition therapy, weight management programs, alternative therapies, nutritional/dietary benefits, fitness benefits, home and bathroom safety devices and modifications, kidney disease education services, glaucoma screenings, diabetes self-management training, barium enemas, digital rectal exams, and EKGs following a Welcome Visit, with no copay or coinsurance. However, in-home safety assessments, 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 exams are covered with a $40 copay, and routine hearing exams are limited to one per year. Prescription hearing aids (all types) are covered with a copay between $199 and $499 for two per year, but prescription hearing aids - inner ear, outer ear, and over the ear are not covered, and OTC hearing aids are not covered.
Vision Services See details
Vision services include coverage for eye exams with a $40 copay, and eyewear with a combined maximum benefit of $1,000 every year. Contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades are also covered.
Dental Services See details
The Devoted BE WELL PLUS Arizona (HMO C-SNP) plan covers Medicare Dental Services with a $40 copay and also covers other dental services, including oral exams, dental x-rays, and other diagnostic and preventive services. Orthodontic services have a maximum benefit of $1,000 per year, and the plan does not cover maxillofacial prosthetics, implant services, or orthodontics.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including insulin, Medicare Part B Chemotherapy/Radiation Drugs, and Other Medicare Part B Drugs. Medicare Part B Insulin Drugs have a $35 copay and 20% coinsurance, while Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have between 0% and 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered by the Devoted BE WELL PLUS Arizona (HMO C-SNP) plan. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with 0-50% coinsurance and Prosthetics/Medical Supplies with no copay, and 0-20% coinsurance. 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 BE WELL PLUS Arizona (HMO C-SNP) plan. Diagnostic Procedures/Tests have a copay between $0 and $95, Lab Services have no copay, Diagnostic Radiological Services have a copay up to $275, Therapeutic Radiological Services have 20% coinsurance, and Outpatient X-Ray Services have no copay.
Home Health Services See details
Home Health Services are covered by the Devoted BE WELL PLUS Arizona (HMO C-SNP) plan, with no copay or coinsurance, but prior authorization is required. 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 BE WELL PLUS Arizona (HMO C-SNP) 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 BE WELL PLUS Arizona (HMO C-SNP) plan, but require prior authorization. For days 1-20, there is no copay, and for days 21-100, the copay is $214.
Other Services See details
Other Services includes coverage for Diabetic Shoes and $0 Preventive Services. Acupuncture, Over-the-Counter (OTC) Items, Meal Benefit, 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 are not covered.
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