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Devoted LIBERTY CHOICE Florida (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Devoted LIBERTY CHOICE Florida (PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Devoted LIBERTY CHOICE Florida (PPO) in 2025, please refer to our full plan details page.
Devoted LIBERTY CHOICE Florida (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 3.5 out of 5 stars in 2025.
It's important to know that Devoted LIBERTY CHOICE Florida (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 LIBERTY CHOICE Florida (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 LIBERTY CHOICE Florida (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 $174.70. 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 $14000.00 (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 $14000.00 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 LIBERTY CHOICE Florida (PPO).
Additional Benefits
The Devoted LIBERTY CHOICE Florida (PPO) plan offers a variety of benefits with varying costs. Hospital stays have a $425 copay for the first 4 days, and then no copay for the next 86 days. Outpatient services have copays ranging from $0 to $525, and primary care visits have a $35-$45 copay. The plan includes coverage for hearing and vision services, with a $45 copay for hearing exams and eye exams. Dental services are also covered, with a $45 copay for Medicare dental services and a $250 maximum benefit for other dental services. The plan also covers home health services with no copay, but does not cover cardiac rehabilitation services.
Inpatient Hospital See details
Inpatient Hospital benefits, including acute and psychiatric care, are covered. For days 1-4, there is a $425 copay, and for days 5-90, there is no copay.
Outpatient Services See details
Outpatient Services, including all Outpatient Hospital Services, are covered by the Devoted LIBERTY CHOICE Florida (PPO) plan. Outpatient Hospital Services have a copay between $0 and $525, and Observation Services have a $425 copay. Ambulatory Surgical Center (ASC) Services have no copay, while Individual and Group Sessions for Outpatient Substance Abuse have a copay of $45.
Partial Hospitalization See details
Partial Hospitalization is covered by the Devoted LIBERTY CHOICE Florida (PPO) plan, with a $70 copay. Prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Devoted LIBERTY CHOICE Florida (PPO) plan. Ground ambulance services have a copay between $0 and $350, while air ambulance services have a 20% coinsurance, and transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by the Devoted LIBERTY CHOICE Florida (PPO) plan. Emergency Services has a $110 copay, while Urgently Needed Services have a copay between $0 and $45. Worldwide Emergency Coverage and Worldwide Urgent Coverage have a $110 copay, while Worldwide Emergency Transportation has a $350 copay and 20% coinsurance.
Primary Care See details
The Devoted LIBERTY CHOICE Florida (PPO) plan covers primary care physician services, chiropractic services, occupational therapy, physician specialist services, mental health specialty services, other health care professional services, psychiatric services, physical therapy and speech-language pathology services, additional telehealth benefits and opioid treatment program services. Chiropractic services excludes routine chiropractic care; occupational therapy has a $35 copay; physician specialist services have a $45 copay; individual and group mental health and psychiatric sessions have a $45 copay; physical therapy and speech-language pathology services have a $45-$50 copay; and opioid treatment program services have a $45 copay.
Preventive Services See details
Preventive services include coverage for services like health education, weight management programs, alternative therapies, and fitness benefits, while services such as in-home safety assessments, personal emergency response systems, and counseling services are not covered. Other covered services include glaucoma screenings, diabetes self-management training, barium enemas, digital rectal exams, and EKG following a welcome visit.
Hearing Services See details
Hearing services include routine hearing exams with a $45 copay, and fitting/evaluation for hearing aids, which is unlimited. Prescription hearing aids (all types) are covered with a copay between $599 and $899 for up to two hearing aids every year, while prescription hearing aids for inner ear, outer ear, and over the ear are not covered. OTC hearing aids are not covered.
Vision Services See details
Vision services include coverage for eye exams with a $45 copay. Eyewear benefits are covered, including contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades, with a combined maximum benefit of $250 every year.
Dental Services See details
Dental Services includes coverage for Medicare Dental Services with a $45 copay, and other dental services with a $250 maximum benefit. Oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatment, other preventive dental services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), and oral and maxillofacial surgery are covered. Maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, with prior authorization required. For Medicare Part B Insulin Drugs, there is a $35 copay and 20% coinsurance; for Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, there is between 0% and 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered by the Devoted LIBERTY CHOICE Florida (PPO) plan with a coinsurance between 20% and 20%.
Medical Equipment See details
Medical Equipment is covered by the Devoted LIBERTY CHOICE Florida (PPO) plan, with Durable Medical Equipment (DME) subject to a coinsurance between 17% and 18% and Prosthetic Devices covered with a coinsurance between 0% and 20%. Medical Supplies have a 20% coinsurance, and Durable Medical Equipment for use outside the home, Diabetic Supplies, and Diabetic Therapeutic Shoes/Inserts are not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, with prior authorization required. Diagnostic Procedures/Tests have a copay between $0 and $95, while Lab Services have no copay. Diagnostic Radiological Services have a maximum copay of $300, and Therapeutic Radiological Services have a coinsurance of at least 20%. Outpatient X-Ray Services have no copay.
Home Health Services See details
Home Health Services are covered by the Devoted LIBERTY CHOICE Florida (PPO) plan with no copay and no coinsurance, but authorization is required. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the Devoted LIBERTY CHOICE Florida (PPO) plan. Specifically, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Devoted LIBERTY CHOICE Florida (PPO) plan, but require prior authorization. For days 1-20 and 61-100, there is no copay, but for days 21-60, the copay is $214.
Other Services See details
Other Services are not covered, including acupuncture, over-the-counter items, meal benefits, Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, and Self-Directed Personal Assistance Services. Other 2 services are covered, including $0 preventive services.
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