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DEVOTED CORE 001 NM (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for DEVOTED CORE 001 NM (HMO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on DEVOTED CORE 001 NM (HMO) in 2026, please refer to our full plan details page.
DEVOTED CORE 001 NM (HMO) is a HMO plan offered by Devoted Health, Inc. available for enrollment in 2026 to people living in Central and Northern New Mexico. The overall rating for this plan is not yet available for 2026.
It's important to know that DEVOTED CORE 001 NM (HMO) 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 CORE 001 NM (HMO).
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 CORE 001 NM (HMO), 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 $375.00 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 Maximum Out-Of-Pocket cost of $4100.00 for out-of-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $0.00 for in-network covered services, the plan will pay 100% of in-network covered costs for the rest of the year.
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 CORE 001 NM (HMO) Medicare plan features an annual drug deductible of $375. For Tier 1 preferred generic and Tier 2 generic drugs, members pay no copay for 1-month, 2-month, or 3-month supplies filled through standard pharmacies or standard mail order. This makes managing everyday medications highly affordable under this plan. For higher-tier prescriptions, costs are determined by coinsurance rather than set copays. Tier 3 preferred brand drugs require a 19% coinsurance, Tier 4 non-preferred drugs carry a 25% coinsurance, and Tier 5 specialty drugs incur a 28% coinsurance for a 1-month supply. These coinsurance rates apply to both standard pharmacy and standard mail order options.
Additional Benefits
The DEVOTED CORE 001 NM (HMO) plan offers robust medical coverage with no copay for primary care visits and a $25 copay for specialist visits, both featuring no coinsurance. Inpatient hospital stays require a $325 daily copay for the first six days and no copay for days 7 through 90, while emergency room visits carry a $150 copay. Outpatient services generally feature no coinsurance, with copays ranging from no copay for ambulatory surgical centers up to $425 for outpatient hospital services. For ancillary care, the plan provides dental coverage up to a $2,500 annual maximum with no copay and 0% to 50% coinsurance, alongside a $400 annual limit for eyewear with no copay or coinsurance. Routine hearing exams carry a $25 copay, and skilled nursing facility stays have no copay for the first 20 days. Additionally, members benefit from a $100 quarterly allowance for over-the-counter items with no copay.
Inpatient Hospital See details
DEVOTED CORE 001 NM (HMO) covers inpatient acute and psychiatric hospital stays with no coinsurance, requiring a $325 daily copay for days 1 through 6 and no copay for days 7 through 90. Unlimited additional days are covered for acute care, but psychiatric additional days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
DEVOTED CORE 001 NM (HMO) outpatient services are covered with no coinsurance, featuring no copays for ambulatory surgical center and outpatient blood services. Outpatient hospital services have copays ranging from $0 to $425, observation services require a $325 copay per stay, and outpatient substance abuse sessions carry a $25 copay.
Partial Hospitalization See details
DEVOTED CORE 001 NM (HMO) covers partial hospitalization services with a $130.00 copay and no coinsurance. Prior authorization is required to receive this covered benefit.
Ambulance and Transportation Services See details
DEVOTED CORE 001 NM (HMO) covers prior-authorized ground ambulance services with no copay to a $350 copay and no coinsurance, and air ambulance services with a 20% coinsurance and no copay. Some transportation services are covered, but transportation to plan-approved health-related locations and any health-related locations is not covered.
Emergency Services See details
Emergency services under DEVOTED CORE 001 NM (HMO) are covered with a $150 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed care requires no copay to a $45 copay and no coinsurance, while worldwide emergency services are covered up to $25,000 with a $150 copay and no coinsurance for emergency or urgent care, and a $350 copay and 20% coinsurance for emergency transportation.
Primary Care See details
DEVOTED CORE 001 NM (HMO) covers primary care physician services with no copay and no coinsurance, and specialist visits with a $25 copay and no coinsurance. Physical, occupational, and speech therapy require a $25 to $50 copay and no coinsurance, while chiropractic and podiatry services are not covered.
Preventive Services See details
Preventive services are covered by DEVOTED CORE 001 NM (HMO) with no copay and no coinsurance for annual physical exams, kidney disease education, and glaucoma screenings. Additional preventive benefits are partially covered with no copay and no coinsurance, but do not cover in-home safety assessments, personal emergency response systems (PERS), or therapeutic massages.
Hearing Services See details
DEVOTED CORE 001 NM (HMO) hearing services are partially covered, offering routine exams for a $25 copay and no coinsurance, and up to two prescription hearing aids per year for a $399 to $699 copay and no coinsurance. OTC hearing aids, as well as inner ear, outer ear, and over-the-ear prescription hearing aid types, are not covered.
Vision Services See details
Vision services are partially covered by DEVOTED CORE 001 NM (HMO), offering one routine eye exam per year with no copay to a $25 copay and no coinsurance, while other eye exam services are not covered. Eyewear is covered with no copay, no coinsurance, and no deductible, up to a $400 annual maximum for contacts, eyeglasses, and upgrades.
Dental Services See details
Dental services are partially covered by DEVOTED CORE 001 NM (HMO), which offers Medicare-covered dental services for a $25 copay and no coinsurance, and other covered dental services for no copay and 0% to 50% coinsurance up to a $2,500 annual maximum. Maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by DEVOTED CORE 001 NM (HMO) with no copay, though prior authorization is required. Associated Medicare Part B drugs, including chemotherapy and insulin, require a coinsurance ranging from no coinsurance up to 20%, with insulin also carrying a $35 copay.
Dialysis Services See details
Dialysis Services are covered by DEVOTED CORE 001 NM (HMO) with no copay and a 20% coinsurance. Prior authorization is required for these services.
Medical Equipment See details
DEVOTED CORE 001 NM (HMO) covers medical equipment with no copays, featuring 20% to 40% coinsurance for durable medical equipment, no coinsurance to 20% coinsurance for prosthetics and medical supplies, and no coinsurance to 50% coinsurance for diabetic supplies. This benefit is partially covered because diabetic therapeutic shoes and inserts are not covered, and prior authorization is required.
Diagnostic and Radiological Services See details
DEVOTED CORE 001 NM (HMO) covers diagnostic and radiological services, featuring no copay or coinsurance for lab services, and a $0 to $95 copay with no coinsurance for diagnostic procedures. Outpatient X-rays have no copay but require a coinsurance, while therapeutic radiological services carry a minimum 20% coinsurance.
Home Health Services See details
Home Health Services are covered under the DEVOTED CORE 001 NM (HMO) plan with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by DEVOTED CORE 001 NM (HMO) with no coinsurance and a $25 copay, though prior authorization is required. While some services are covered, standard cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) services are not covered in practice.
Skilled Nursing Facility (SNF) See details
DEVOTED CORE 001 NM (HMO) covers Skilled Nursing Facility (SNF) services with no coinsurance and no required 3-day prior hospital stay, though prior authorization is required. There is no copay for days 1 through 20 and a $218 daily copay for days 21 through 100, with no coverage provided for additional days beyond the standard Medicare-covered period.
Other Services See details
DEVOTED CORE 001 NM (HMO) partially covers Other Services, providing over-the-counter (OTC) items and additional preventive services with no copay and no coinsurance. Acupuncture and meal benefits are not covered, and the OTC benefit has a maximum limit of $100 every three months.
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