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DEVOTED CHOICE 007 TN (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for DEVOTED CHOICE 007 TN (PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on DEVOTED CHOICE 007 TN (PPO) in 2026, please refer to our full plan details page.
DEVOTED CHOICE 007 TN (PPO) is a PPO plan offered by Devoted Health, Inc. available for enrollment in 2025 to people living in Chattanooga and Knoxville. This plan received an overall rating of 3.5 out of 5 stars in 2026.
It's important to know that DEVOTED CHOICE 007 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 007 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.
For DEVOTED CHOICE 007 TN (PPO), 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 $375.00 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 combined Maximum Out-Of-Pocket cost of $8950.00 (in-network or out-of-network combined). You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $8950.00 for covered services, the plan will pay 100% of covered costs for the rest of the year.
The plan may have separate out-pocket-maximums for in-network and out-of-network services. See our full plan details page for more information.
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 CHOICE 007 TN (PPO) Medicare plan has an annual drug deductible of $375. Tier 1 preferred generic drugs feature no copay for any supply length at standard pharmacies and standard mail order. Tier 2 generic drugs require a low copay ranging from $5 for a 1-month supply up to $15 at standard pharmacies, or up to $12.50 for a 3-month supply via standard mail order. Higher-tier medications under this plan are subject to coinsurance rather than flat copays. Tier 3 preferred brand drugs require a 24% coinsurance, and Tier 4 non-preferred drugs require a 25% coinsurance. Tier 5 specialty drugs are covered with a 28% coinsurance for a 1-month supply.
Additional Benefits
The DEVOTED CHOICE 007 TN (PPO) plan offers robust medical coverage with no copay and no coinsurance for primary care visits, preventive services, and home health care. For inpatient hospital stays, members pay no coinsurance and a $295 daily copay for the first five days, with no copay for days six through ninety. Emergency room visits carry a $130 copay, which is waived if admitted, while specialist visits and outpatient services feature low to moderate copays and no coinsurance. This plan also includes valuable dental, vision, hearing, and over-the-counter benefits to help keep your out-of-pocket costs low. Dental care is covered up to $2,500 annually with no copay for preventive services, and vision coverage provides a $200 annual allowance for eyewear with no copay or deductible. Additionally, members receive a $60 quarterly allowance for over-the-counter items and can access prescription hearing aids with copays ranging from $399 to $699 and no coinsurance.
Inpatient Hospital See details
DEVOTED CHOICE 007 TN (PPO) covers inpatient acute and psychiatric hospital stays with no coinsurance, requiring a $295 daily copay for days 1 through 5 and no copay for days 6 through 90. This benefit is partially covered, as upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Outpatient services under DEVOTED CHOICE 007 TN (PPO) are covered with no coinsurance, including ambulatory surgical center and outpatient blood services which also require no copay. Outpatient hospital services require a copay of $0 to $395, observation services carry a $295 copay per stay, and outpatient substance abuse sessions have a $35 copay, all with no coinsurance.
Partial Hospitalization See details
DEVOTED CHOICE 007 TN (PPO) covers partial hospitalization services with an $85.00 copay and no coinsurance, though prior authorization is required.
Ambulance and Transportation Services See details
DEVOTED CHOICE 007 TN (PPO) covers ground ambulance services with no coinsurance and a copay ranging from no copay to $300, and air ambulance services with a 20% coinsurance and no copay. Prior authorization is required for ambulance services, costs are not waived if you are admitted to the hospital, and additional transportation services are not covered.
Emergency Services See details
DEVOTED CHOICE 007 TN (PPO) covers emergency services with a $130 copay (waived if admitted to the hospital within 24 hours) and no coinsurance, and urgently needed services with a copay ranging from no copay to $45 and no coinsurance. Worldwide emergency and urgent care are also covered up to a $25,000 maximum benefit with a $130 copay and no coinsurance, while worldwide emergency transportation requires a $300 copay and 20% coinsurance.
Primary Care See details
DEVOTED CHOICE 007 TN (PPO) covers primary care physician services with no copay and no coinsurance, while specialist, therapy, and mental health services carry copays ranging from $0 to $50 with no coinsurance. Chiropractic services are partially covered, as routine and other chiropractic services are not covered, whereas podiatry services are not covered by the plan.
Preventive Services See details
DEVOTED CHOICE 007 TN (PPO) covers preventive services, including annual physical exams, kidney disease education, and routine screenings, with no copay and no coinsurance. Additional preventive benefits are partially covered with no copay and no coinsurance for services like fitness programs, weight management, and alternative therapies, while sub-services such as therapeutic massage, in-home support, and personal emergency response systems are not covered.
Hearing Services See details
Hearing services under DEVOTED CHOICE 007 TN (PPO) are partially covered with no deductible, offering routine hearing exams for a $35 copay and no coinsurance. Prescription hearing aids are covered with no coinsurance and copayments ranging from $399 to $699, though OTC hearing aids and inner ear, outer ear, and over-the-ear prescription hearing aids are not covered.
Vision Services See details
DEVOTED CHOICE 007 TN (PPO) provides partially covered vision services, featuring one annual routine eye exam with a $0 to $35 copay and no coinsurance, while other eye exam services are not covered. Eyewear is covered with no copay, no coinsurance, and no deductible, offering a combined maximum benefit of $200 per year for contacts, eyeglasses, lenses, frames, and upgrades.
Dental Services See details
DEVOTED CHOICE 007 TN (PPO) dental services are covered up to a $2,500 annual limit for both in- and out-of-network care, offering no copay and no coinsurance for preventive services, periodontics, and oral surgery. Restorative, endodontic, and prosthodontic services feature no copay and 0% to 50% coinsurance, while Medicare-covered dental requires a $35 copay and no coinsurance. Maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
DEVOTED CHOICE 007 TN (PPO) covers Home Infusion bundled Services with no copay, subject to prior authorization. Under this benefit, Medicare Part B chemotherapy, radiation, and other drugs require no copay and between no coinsurance and 20% coinsurance, while Medicare Part B insulin is covered with a $35 copay and between no coinsurance and 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered by DEVOTED CHOICE 007 TN (PPO) with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
DEVOTED CHOICE 007 TN (PPO) covers medical equipment with no copays, featuring 20% to 50% coinsurance for durable medical equipment and no coinsurance to 20% coinsurance for prosthetics and medical supplies. Diabetic equipment is partially covered with no copays and no coinsurance to 50% coinsurance for supplies, while diabetic therapeutic shoes and inserts are not covered.
Diagnostic and Radiological Services See details
DEVOTED CHOICE 007 TN (PPO) covers diagnostic and radiological services, with prior authorization required for both. Diagnostic lab services and outpatient X-rays have no copay, diagnostic procedures and tests carry a $0 to $95 copay with no coinsurance, and diagnostic radiological services start at a $0 copay. Therapeutic radiological services require a minimum 20% coinsurance, and coinsurance also applies to outpatient X-ray services.
Home Health Services See details
Home Health Services are covered by DEVOTED CHOICE 007 TN (PPO) with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac rehabilitation services are covered by DEVOTED CHOICE 007 TN (PPO) with no coinsurance and require prior authorization. However, several key sub-services, including cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation, are not covered under this plan.
Skilled Nursing Facility (SNF) See details
DEVOTED CHOICE 007 TN (PPO) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring prior authorization and allowing admission without a prior three-day hospital stay. There is no copay for days 1 through 20, a $218 daily copay for days 21 through 100, and additional days beyond the standard Medicare benefit are not covered.
Other Services See details
DEVOTED CHOICE 007 TN (PPO) partially covers other services, offering over-the-counter (OTC) items and additional preventive services with no copay and no coinsurance. Acupuncture and meal benefits are not covered, and the OTC benefit has a maximum allowance of $60 every three months.
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