DEVOTED CHOICE GIVEBACK 006 TN (PPO)

DEVOTED CHOICE GIVEBACK 006 TN (PPO) is a PPO plan offered by Devoted Health, Inc. available for enrollment in 2025 to people living in Tri-Cities. This plan received an overall rating of 3.5 out of 5 stars in 2026.

It's important to know that DEVOTED CHOICE GIVEBACK 006 TN (PPO) 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 CHOICE GIVEBACK 006 TN (PPO).

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.

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:

Drug Coverage

The DEVOTED CHOICE GIVEBACK 006 TN (PPO) Medicare plan features an annual drug deductible of $605. Under this plan, Tier 1 preferred generic drugs are highly affordable with no copay for standard pharmacy or standard mail-order services. For Tier 2 generic medications, standard pharmacy copays range from $3 to $9 depending on the supply, while standard mail-order copays offer savings at $7.50 for a 3-month supply. Higher-tier medications transition to coinsurance costs, with Tier 3 preferred brand drugs requiring a 22% coinsurance for both standard retail and mail-order options. Tier 4 non-preferred drugs and Tier 5 specialty drugs both carry a 25% coinsurance rate, with specialty tier coverage limited to a 1-month supply. This plan provides a structured cost-sharing model that balances no-cost generics with percentage-based costs for brand-name and specialty prescriptions.

Additional Benefits

The DEVOTED CHOICE GIVEBACK 006 TN (PPO) plan offers comprehensive medical coverage with predictable cost-sharing, including no copay and no coinsurance for primary care visits and preventive services. For specialist visits, members pay a $45 copay, while inpatient hospital stays require a $475 daily copay for the first four days and no copay for days five through ninety. Outpatient hospital services feature no coinsurance and copays ranging from no copay up to $575. This plan also includes valuable supplemental benefits, such as dental and vision care with no copay for most routine services, alongside a $200 annual allowance for eyewear and a $250 annual maximum for dental services. Additionally, members can access over-the-counter items with no copay up to $105 every three months, while hearing aid copays range from $599 to $899. Skilled nursing facility care is also covered with no copay for the first twenty days and a $218 daily copay for days twenty-one through one hundred.