DEVOTED C-SNP CHOICE PREMIUM 019 TN (PPO C-SNP)

DEVOTED C-SNP CHOICE PREMIUM 019 TN (PPO C-SNP) is a PPO C-SNP plan offered by Devoted Health, Inc. available for enrollment in 2026 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 C-SNP CHOICE PREMIUM 019 TN (PPO C-SNP) 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 C-SNP CHOICE PREMIUM 019 TN (PPO 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.

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 C-SNP CHOICE PREMIUM 019 TN (PPO C-SNP) plan features an annual drug deductible of $615. For Tier 1 preferred generic drugs, you will pay an $18 copay for a 1-month supply through standard pharmacies and standard mail order. Tier 2 generic drugs carry a $19 copay for a 1-month supply, while Tier 6 select care drugs are available with no copay. Higher-tier prescription medications under this plan transition to coinsurance costs rather than flat copays. Tier 3 preferred brand drugs require a 21% coinsurance, and Tier 4 non-preferred drugs cost 33% coinsurance for standard pharmacy or standard mail-order services. Tier 5 specialty drugs require a 25% coinsurance for a 1-month supply, helping you plan for your specialized medication needs.

Additional Benefits

The DEVOTED C-SNP CHOICE PREMIUM 019 TN (PPO C-SNP) plan offers comprehensive medical coverage featuring no copay and no coinsurance for primary care visits, select telehealth services, and home health care. For inpatient hospital stays, members pay a $355 daily copay for the first five days and no copay for days six through 90, with no coinsurance required. Emergency room visits carry a $150 copay, while specialist visits require a copay ranging from $30 to $50. This plan also includes valuable supplemental benefits, such as dental coverage up to a $2,000 annual limit with no copay for covered services and a $30 copay for Medicare-covered dental care. Vision benefits feature routine eye exams with no copay to a $30 copay alongside a $300 annual allowance for eyewear, while hearing aid copays range from $399 to $699. Additionally, skilled nursing facility stays have no copay for the first 20 days, and members receive a $50 quarterly allowance for over-the-counter items with no copay.