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DEVOTED CHOICE 008 NC (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for DEVOTED CHOICE 008 NC (PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on DEVOTED CHOICE 008 NC (PPO) in 2026, please refer to our full plan details page.
DEVOTED CHOICE 008 NC (PPO) is a PPO plan offered by Devoted Health, Inc. available for enrollment in 2026 to people living in Northwestern/Southeastern North Carolina. The overall rating for this plan is not yet available for 2026.
It's important to know that DEVOTED CHOICE 008 NC (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 008 NC (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 008 NC (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 $270.00 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 $7900.00 (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 $7900.00 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 008 NC (PPO) Medicare plan has an annual drug deductible of $270. Under this plan, there is no copay for Tier 1 preferred generic drugs and Tier 2 generic drugs filled at standard pharmacies or through standard mail order. This $0 cost sharing applies to one-month, two-month, and three-month supplies of these generic medications. For higher-tier medications, cost sharing is based on coinsurance rather than a flat copayment. Tier 3 preferred brand drugs require a 19% coinsurance, Tier 4 non-preferred drugs carry a 25% coinsurance, and Tier 5 specialty drugs require a 27% coinsurance for a one-month supply. These coinsurance rates apply to fills at both standard pharmacies and through standard mail order.
Additional Benefits
The DEVOTED CHOICE 008 NC (PPO) plan offers robust medical coverage featuring no copay and no coinsurance for primary care visits, home health services, and annual preventive exams. For specialist visits and mental health services, patients pay a $30 copay, while inpatient hospital stays require a $325 copay for days 1 through 6 and no copay for days 7 through 90. Emergency room visits carry a $130 copay, which is waived if you are admitted to the hospital within 24 hours. This plan also includes valuable dental, vision, and hearing benefits, such as no copay for preventive dental care up to a $2,500 annual limit and a $300 annual allowance for eyewear with no copay. Skilled nursing facility stays have no copay for the first 20 days, and durable medical equipment is covered with a 20% coinsurance and no copay. Additionally, members receive a $100 over-the-counter allowance every three months to help cover everyday health needs.
Inpatient Hospital See details
DEVOTED CHOICE 008 NC (PPO) covers inpatient acute and psychiatric hospital stays with no coinsurance, requiring a $325 copay for days 1 through 6 and no copay for days 7 through 90. This benefit is partially covered because upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
DEVOTED CHOICE 008 NC (PPO) covers outpatient services with no coinsurance, featuring no copay for ambulatory surgical center and blood services. Outpatient hospital services require a $0 to $425 copay, observation services require a $325 copay per stay, and outpatient substance abuse sessions require a $30 copay, all with no coinsurance.
Partial Hospitalization See details
DEVOTED CHOICE 008 NC (PPO) covers partial hospitalization services with a $60.00 copay and no coinsurance, although prior authorization is required.
Ambulance and Transportation Services See details
DEVOTED CHOICE 008 NC (PPO) covers ambulance services with prior authorization, featuring a copay of $0 to $325 and no coinsurance for ground ambulance, and a 20% coinsurance and no copay for air ambulance. While transportation is listed as covered, some services are covered but transportation to plan-approved health-related locations and any health-related locations is not covered.
Emergency Services See details
DEVOTED CHOICE 008 NC (PPO) covers emergency services with a $130 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services range from no copay to a $45 copay with no coinsurance, while worldwide emergency services are covered up to a $25,000 limit with a $130 copay for emergency or urgent care and a $325 copay plus 20% coinsurance for emergency transportation.
Primary Care See details
DEVOTED CHOICE 008 NC (PPO) covers primary care physician services with no copay and no coinsurance, while specialist visits, mental health, psychiatric, and opioid treatment services require a $30 copay and no coinsurance. Physical, occupational, and speech therapy services have a $30 to $50 copay with no coinsurance, whereas chiropractic and podiatry services are not covered.
Preventive Services See details
Preventive Services are covered by DEVOTED CHOICE 008 NC (PPO) with no copay and no coinsurance for annual physical exams, kidney disease education, and diabetes self-management training. Additional preventive services are partially covered with no copay and no coinsurance, excluding in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, readmission prevention, chemotherapy wigs, therapeutic massage, adult day health, home-based palliative care, in-home support, caregiver support, additional smoking cessation, enhanced disease management, telemonitoring, remote access, and counseling.
Hearing Services See details
DEVOTED CHOICE 008 NC (PPO) covers hearing services, featuring a $30 copay and no coinsurance for an annual routine hearing exam, and fitting evaluations with no coinsurance. Prescription hearing aids are partially covered with no coinsurance and copays ranging from $399 to $699 for up to two aids per year, while inner ear, outer ear, over the ear, and OTC hearing aids are not covered.
Vision Services See details
DEVOTED CHOICE 008 NC (PPO) offers partially covered vision services, including one routine eye exam per year with a $0 to $30 copay and no coinsurance, though other eye exam services are not covered. Covered eyewear—including contacts, eyeglasses, lenses, frames, and upgrades—has no copay and no coinsurance, up to a combined annual maximum benefit of $300.
Dental Services See details
DEVOTED CHOICE 008 NC (PPO) partially covers dental services up to a $2,500 annual maximum, offering no copay and no coinsurance for preventive care and oral exams. Restorative, endodontic, and prosthodontic services are covered with no copay and 0% to 50% coinsurance, while Medicare-covered dental has a $30 copay and no coinsurance. Maxillofacial prosthetics, implant services, and orthodontics are not covered under this plan.
Home Infusion bundled Services See details
DEVOTED CHOICE 008 NC (PPO) covers home infusion bundled services with no copay, though prior authorization is required. Associated Medicare Part B drugs, including chemotherapy and insulin, have a coinsurance ranging from no coinsurance to 20%, with insulin drugs also carrying a $35 copay.
Dialysis Services See details
DEVOTED CHOICE 008 NC (PPO) covers Dialysis Services with no copay and a 20% coinsurance. Prior authorization is required for this benefit.
Medical Equipment See details
DEVOTED CHOICE 008 NC (PPO) partially covers medical equipment with no copays, though prior authorization is required and diabetic therapeutic shoes and inserts are not covered. Durable medical equipment requires a 20% coinsurance, while covered prosthetics, medical supplies, and diabetic supplies carry a coinsurance ranging from no coinsurance to 20%.
Diagnostic and Radiological Services See details
DEVOTED CHOICE 008 NC (PPO) covers diagnostic and radiological services, with prior authorization required for both categories. Diagnostic services feature no coinsurance, with no copay for lab services and a $0 to $95 copay for diagnostic procedures, while radiological services feature no copay for outpatient X-rays, a copay starting at $0 for diagnostic radiology, and a minimum 20% coinsurance for therapeutic radiology.
Home Health Services See details
Home Health Services are covered under the DEVOTED CHOICE 008 NC (PPO) plan with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac rehabilitation services are not covered by the DEVOTED CHOICE 008 NC (PPO) plan. None of the sub-services, including intensive cardiac, pulmonary, and supervised exercise therapy, are covered in practice.
Skilled Nursing Facility (SNF) See details
DEVOTED CHOICE 008 NC (PPO) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring prior authorization but no prior three-day inpatient hospital stay. There is no copay for days 1 through 20, followed by a $218 daily copay for days 21 through 100, while additional days beyond the Medicare-covered limit are not covered.
Other Services See details
DEVOTED CHOICE 008 NC (PPO) partially covers Other Services, which includes Over-the-Counter (OTC) items up to $100 every three months and additional preventive services with no copay and no coinsurance. Acupuncture and meal benefits are not covered under this plan.
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