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DEVOTED CHOICE MA ONLY 014 FL (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for DEVOTED CHOICE MA ONLY 014 FL (PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on DEVOTED CHOICE MA ONLY 014 FL (PPO) in 2026, please refer to our full plan details page.
DEVOTED CHOICE MA ONLY 014 FL (PPO) is a PPO plan offered by Devoted Health, Inc. available for enrollment in 2025 to people living in Escambia, Santa Rosa Counties. This plan received an overall rating of 4.5 out of 5 stars in 2026.
It's important to know that DEVOTED CHOICE MA ONLY 014 FL (PPO) is a Medicare Advantage (MA) Plan without drug coverage. That means that this plan covers medical services but doesn't cover prescription drugs. If you are looking for a plan with prescription drug coverage, please search for other MA and PDP plans offered in your area.
Key Plan Facts
Below are a few key facts and commonly-asked questions about DEVOTED CHOICE MA ONLY 014 FL (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 MA ONLY 014 FL (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. Additionally, this plan comes with a Part B Premium reduction of $184.70. You must continue to pay paying your reduced Part B Premium.
Deductibles
This plan does not have a health deductible. Your insurance coverage on covered health services will start immediately.
Drugs are not covered by this plan, so a prescription drug deductible is not applicable.
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
Prescription drugs are not covered by DEVOTED CHOICE MA ONLY 014 FL (PPO).
Additional Benefits
The DEVOTED CHOICE MA ONLY 014 FL (PPO) plan offers comprehensive coverage for essential medical services with predictable cost-sharing and no coinsurance on many key benefits. Members enjoy no copay and no coinsurance for primary care visits, preventive care, annual physicals, and home health services. For more specialized care, specialist visits require a $45 copay, while inpatient hospital stays have a $425 copay for days 1 through 4 followed by no copay for days 5 through 90. Supplemental benefits further enhance this plan, featuring dental coverage up to a $1,000 annual limit with no copay for preventive services, and up to $400 yearly for eyewear with no copay. Routine eye exams are highly affordable with copays ranging from no copay up to $20, and hearing aids are covered with copays between $599 and $899. Additionally, diagnostic lab services, cardiac rehabilitation, and the first 20 days of skilled nursing facility care are all covered with no copay.
Inpatient Hospital See details
Inpatient hospital care under DEVOTED CHOICE MA ONLY 014 FL (PPO) is partially covered with no coinsurance, requiring a $425 copay for days 1 through 4 and no copay for days 5 through 90 per stay. Non-Medicare-covered stays, hospital upgrades, and additional psychiatric days are not covered, though unlimited additional acute hospital days are included.
Outpatient Services See details
DEVOTED CHOICE MA ONLY 014 FL (PPO) covers outpatient services with no coinsurance, including ambulatory surgical center and outpatient blood services with no copay. Outpatient hospital services require a copay of $0 to $475, observation services carry a $425 copay per stay, and outpatient substance abuse sessions have a $45 copay, with prior authorization required for most services.
Partial Hospitalization See details
DEVOTED CHOICE MA ONLY 014 FL (PPO) covers partial hospitalization services with a $70.00 copay and no coinsurance. Prior authorization is required before you can receive these services.
Ambulance and Transportation Services See details
Ambulance services are covered by DEVOTED CHOICE MA ONLY 014 FL (PPO) with prior authorization, requiring a copay of $0 to $330 with no coinsurance for ground transport, and a 20% coinsurance with no copay for air transport. Routine transportation services to health-related locations are not covered under this plan.
Emergency Services See details
DEVOTED CHOICE MA ONLY 014 FL (PPO) covers emergency services with a $115 copay and no coinsurance (waived if admitted to the hospital within 24 hours), and urgently needed services with a $0 to $40 copay and no coinsurance. Worldwide emergency and urgent care are covered up to a $25,000 maximum with a $115 copay and no coinsurance, while worldwide emergency transportation requires a $330 copay and 20% coinsurance.
Primary Care See details
DEVOTED CHOICE MA ONLY 014 FL (PPO) covers primary care physician services with no copay and no coinsurance, while specialist visits, mental health, and psychiatric services require a $45 copay and no coinsurance. Physical and occupational therapies feature copays ranging from $35 to $50 with no coinsurance, whereas podiatry is not covered, and chiropractic services are partially covered with routine and other chiropractic care excluded.
Preventive Services See details
Preventive services are partially covered by DEVOTED CHOICE MA ONLY 014 FL (PPO) with no copay and no coinsurance for covered options like annual physicals, fitness benefits, and health education. However, the plan does not cover in-home safety assessments, personal emergency response systems (PERS), medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, chemotherapy wigs, therapeutic massage, adult day health, home palliative care, in-home support, caregiver support, additional smoking cessation, disease management, telemonitoring, remote access technologies, or counseling services.
Hearing Services See details
DEVOTED CHOICE MA ONLY 014 FL (PPO) provides coverage for hearing services, featuring a $45 copay and no coinsurance for one routine annual hearing exam, plus unlimited fitting evaluations. Prescription hearing aids are partially covered with no coinsurance and copays ranging from $599 to $899 for up to two devices per year, though inner ear, outer ear, over the ear, and OTC hearing aids are not covered.
Vision Services See details
Vision services are partially covered by DEVOTED CHOICE MA ONLY 014 FL (PPO) because other eye exam services are not covered. Routine eye exams are covered with a $0 to $20 copay and no coinsurance, while eyewear is covered with no copay or coinsurance up to a combined maximum of $400 per year.
Dental Services See details
DEVOTED CHOICE MA ONLY 014 FL (PPO) offers partially covered dental services with a $1,000 annual maximum benefit for both in- and out-of-network care. Preventive and select comprehensive services have no copay and no coinsurance, while other covered services require no copay and 0% to 50% coinsurance, and Medicare-covered dental has a $45 copay and no coinsurance. However, implant services, orthodontics, and maxillofacial prosthetics are not covered.
Home Infusion bundled Services See details
DEVOTED CHOICE MA ONLY 014 FL (PPO) covers home infusion bundled services with no copay, though prior authorization is required. Under this benefit, covered Medicare Part B chemotherapy, radiation, and other drugs require no coinsurance to 20% coinsurance, while covered Part B insulin has a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered under the DEVOTED CHOICE MA ONLY 014 FL (PPO) plan with no copay and a 20% coinsurance. Prior authorization is required to receive these covered services.
Medical Equipment See details
DEVOTED CHOICE MA ONLY 014 FL (PPO) partially covers medical equipment with no copays, excluding diabetic therapeutic shoes and inserts which are not covered. Covered durable medical equipment requires a 15% coinsurance, while coinsurance ranges from no coinsurance up to 15% for diabetic supplies and up to 20% for prosthetic devices and medical supplies.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by DEVOTED CHOICE MA ONLY 014 FL (PPO) with prior authorization required. Diagnostic services have no coinsurance, featuring lab services with no copay and other tests with a copay between $0 and $95, while radiological services include X-rays with no copay, diagnostic radiology with copays starting at $0, and therapeutic radiology with a minimum 20% coinsurance.
Home Health Services See details
Home Health Services are covered under the DEVOTED CHOICE MA ONLY 014 FL (PPO) plan with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by DEVOTED CHOICE MA ONLY 014 FL (PPO) with no copay and no coinsurance, although prior authorization is required. While some services are covered, cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) rehabilitation services are not covered.
Skilled Nursing Facility (SNF) See details
DEVOTED CHOICE MA ONLY 014 FL (PPO) covers Skilled Nursing Facility (SNF) care with no coinsurance and no prior three-day hospital stay requirement. There is no copay for days 1 through 20 and a $218 daily copay for days 21 through 100, though prior authorization is required and additional days are not covered.
Other Services See details
DEVOTED CHOICE MA ONLY 014 FL (PPO) provides partial coverage for other services, offering additional preventive services not covered by Medicare with no copay and no coinsurance. Acupuncture, over-the-counter (OTC) items, and meal benefits are not covered under this plan.
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