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DEVOTED C-SNP CHOICE PLUS 006 NE (PPO C-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for DEVOTED C-SNP CHOICE PLUS 006 NE (PPO C-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on DEVOTED C-SNP CHOICE PLUS 006 NE (PPO C-SNP) in 2026, please refer to our full plan details page.
DEVOTED C-SNP CHOICE PLUS 006 NE (PPO C-SNP) is a PPO C-SNP plan offered by Devoted Health, Inc. available for enrollment in 2026 to people living in Nebraska. The overall rating for this plan is not yet available for 2026.
It's important to know that DEVOTED C-SNP CHOICE PLUS 006 NE (PPO 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 C-SNP CHOICE PLUS 006 NE (PPO 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 C-SNP CHOICE PLUS 006 NE (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.
For DEVOTED C-SNP CHOICE PLUS 006 NE (PPO C-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $41.50. 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 has a $670.00 health deductible. This means, every calendar year, you pay this amount towards covered services before your insurance coverage kicks in.
This plan has a $615.00 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 $13900.00 (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 $13900.00 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 C-SNP CHOICE PLUS 006 NE (PPO C-SNP) Medicare plan features an annual drug deductible of $615. For prescription coverage, Tier 6 Select Care Drugs are available with no copay for 1-month, 2-month, and 3-month supplies at standard pharmacies and standard mail order. Tier 1 Preferred Generic drugs have an $18 copay for a 1-month supply, while Tier 2 Generic drugs require a $19 copay for a 1-month supply through standard fills. For higher-tier medications, costs are based on coinsurance rather than flat copays at standard pharmacies and standard mail order. Tier 3 Preferred Brand drugs carry a 25% coinsurance, and Tier 4 Non-Preferred drugs have a 31% coinsurance for up to a 3-month supply. Additionally, Tier 5 Specialty Tier drugs require a 25% coinsurance for a 1-month supply.
Additional Benefits
The DEVOTED C-SNP CHOICE PLUS 006 NE (PPO C-SNP) Medicare plan offers comprehensive medical coverage with no copay for primary care visits, home health services, and annual physicals. For specialized care, members pay no copay alongside a 30% coinsurance for specialist visits and physical therapy, while inpatient hospital stays require a copay of $2,230 per stay with no coinsurance. Emergency care is available with a $115 copay, which is waived if admitted, while outpatient services and diagnostic tests feature no copays and varying coinsurance rates. Extra benefits under this plan include dental services with no copay and no coinsurance up to a $3,000 annual limit, plus a $300 annual allowance for eyewear with no copay or coinsurance. Routine hearing and vision exams are covered with no copay and coinsurance up to 50%, while prescription hearing aids require a copay ranging from $399 to $699. Additionally, the plan offers no copay and no coinsurance for over-the-counter items up to $50 every three months.
Inpatient Hospital See details
DEVOTED C-SNP CHOICE PLUS 006 NE (PPO C-SNP) covers inpatient acute hospital stays with a $2,230 copay per stay and psychiatric stays with a $2,080 copay per stay, both with no coinsurance. Prior authorization is required for these services, and upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
DEVOTED C-SNP CHOICE PLUS 006 NE (PPO C-SNP) covers outpatient services with no copays, though prior authorization is required. Under this plan, you will pay no coinsurance to 50% coinsurance for outpatient hospital and ambulatory surgical center services, and a 30% coinsurance for outpatient substance abuse and blood services.
Partial Hospitalization See details
DEVOTED C-SNP CHOICE PLUS 006 NE (PPO C-SNP) covers partial hospitalization with no copay and a 20% coinsurance. Prior authorization is required for these services.
Ambulance and Transportation Services See details
Ambulance services are covered by DEVOTED C-SNP CHOICE PLUS 006 NE (PPO C-SNP) with no copay, requiring prior authorization and either no coinsurance to 50% coinsurance for ground transport or 50% coinsurance for air transport. Transportation services are not covered under this plan.
Emergency Services See details
DEVOTED C-SNP CHOICE PLUS 006 NE (PPO C-SNP) covers emergency services with a $115 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services require no copay and a 0% to 20% coinsurance (maximum $40 per visit), while worldwide emergency, urgent, and transportation services are covered up to $25,000 with no copay and no coinsurance.
Primary Care See details
DEVOTED C-SNP CHOICE PLUS 006 NE (PPO C-SNP) provides primary care physician services with no copay and no coinsurance, though chiropractic services are not covered. Specialist visits, physical and occupational therapy, mental health, psychiatric, podiatry, and opioid treatment services are covered with no copay and 30% coinsurance. Telehealth and other healthcare professional services are also covered with no copay and 0% to 30% coinsurance.
Preventive Services See details
Preventive services are partially covered by DEVOTED C-SNP CHOICE PLUS 006 NE (PPO C-SNP) with no copay and no coinsurance for covered benefits like annual physicals and kidney disease education. Uncovered sub-services include in-home safety assessments, personal emergency response systems (PERS), post-discharge medication reconciliation, re-admission 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 technologies, and counseling.
Hearing Services See details
DEVOTED C-SNP CHOICE PLUS 006 NE (PPO C-SNP) offers hearing services including one annual routine hearing exam with no copay and 50% coinsurance, and unlimited fitting evaluations with no copay. Prescription hearing aids are partially covered up to two per year with no coinsurance and a copay of $399 to $699, while OTC, inner ear, outer ear, and over-the-ear hearing aids are not covered.
Vision Services See details
DEVOTED C-SNP CHOICE PLUS 006 NE (PPO C-SNP) partially covers vision services, offering one routine eye exam per year with no copay and 0% to 50% coinsurance, though other eye exam services are not covered. Eyewear is covered with no copay, no coinsurance, and no deductible up to a combined annual maximum of $300 for contacts, lenses, frames, and upgrades.
Dental Services See details
Dental Services are partially covered by DEVOTED C-SNP CHOICE PLUS 006 NE (PPO C-SNP), featuring Medicare-covered services with no copay and 30% coinsurance, and other covered dental services with no copay and no coinsurance up to a $3,000 annual limit. Services not covered under this plan include other diagnostic dental, other preventive dental, maxillofacial prosthetics, implant services, and orthodontics.
Home Infusion bundled Services See details
Home infusion bundled services are covered by DEVOTED C-SNP CHOICE PLUS 006 NE (PPO C-SNP) with no copay, though prior authorization is required. Associated Medicare Part B drugs, including chemotherapy and insulin, incur a coinsurance ranging from no coinsurance to 20%, with insulin also requiring a $35 copay that counts toward the plan-level deductible.
Dialysis Services See details
Dialysis Services are covered under the DEVOTED C-SNP CHOICE PLUS 006 NE (PPO C-SNP) plan with no copay and a 20% coinsurance. Prior authorization is required for these services.
Medical Equipment See details
Medical Equipment benefits under DEVOTED C-SNP CHOICE PLUS 006 NE (PPO C-SNP) are partially covered, featuring no copay for all covered items, though diabetic therapeutic shoes and inserts are not covered. Covered durable medical equipment (DME) and diabetic supplies carry a 20% coinsurance, while prosthetic devices and medical supplies range from no coinsurance to 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by DEVOTED C-SNP CHOICE PLUS 006 NE (PPO C-SNP) with no copays, though prior authorization is required. Diagnostic procedures and tests have no coinsurance, while therapeutic radiological services carry a 20% coinsurance, and lab services, diagnostic radiological services, and outpatient X-rays require a 50% coinsurance.
Home Health Services See details
Home health services are covered under the DEVOTED C-SNP CHOICE PLUS 006 NE (PPO C-SNP) plan with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered under the DEVOTED C-SNP CHOICE PLUS 006 NE (PPO C-SNP) plan with no copay, though prior authorization is required. However, some services are not covered in practice, meaning you will face a 30% coinsurance for cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for peripheral artery disease (PAD) rehabilitation services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by DEVOTED C-SNP CHOICE PLUS 006 NE (PPO C-SNP) with no coinsurance and prior authorization required, with no prior three-day hospital stay needed. There is no copay for days 1 through 20, a $218 daily copay for days 21 through 100, and additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Other services are partially covered by DEVOTED C-SNP CHOICE PLUS 006 NE (PPO C-SNP), featuring no copay and no coinsurance for over-the-counter (OTC) items up to $50 every three months, non-Medicare covered diabetic shoes, and additional preventive services. Acupuncture and meal benefits are not covered under this plan.
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