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DEVOTED C-SNP 003 NM (HMO C-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for DEVOTED C-SNP 003 NM (HMO 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 003 NM (HMO C-SNP) in 2026, please refer to our full plan details page.
DEVOTED C-SNP 003 NM (HMO C-SNP) is a HMO C-SNP 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 C-SNP 003 NM (HMO 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 003 NM (HMO 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 003 NM (HMO 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 003 NM (HMO C-SNP), 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 $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 Maximum Out-Of-Pocket cost of $4400.00 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 C-SNP 003 NM (HMO C-SNP) prescription drug plan has an annual drug deductible of $615. For Tier 1 preferred generic drugs, standard pharmacy and mail-order options require an $18 copay for a 1-month supply, $36 for a 2-month supply, and $54 for a 3-month supply. Tier 2 generic drugs feature standard copays of $20 for a 1-month supply, $40 for a 2-month supply, and $60 for a 3-month supply. For higher-tier medications, Tier 3 preferred brands require 23% coinsurance, while Tier 4 non-preferred drugs require 26% coinsurance. Tier 5 specialty drugs have a 25% coinsurance for a 1-month supply. Finally, Tier 6 select care drugs are highly accessible, offering no copay for 1-month, 2-month, or 3-month supplies through standard pharmacy and mail-order channels.
Additional Benefits
The DEVOTED C-SNP 003 NM (HMO C-SNP) plan offers comprehensive medical coverage featuring no copay and no coinsurance for primary care doctor visits, preventive services, and home health care. Specialist visits, mental health services, and physical therapy require copays ranging from $30 to $50 with no coinsurance. For hospital stays, members pay no coinsurance, though inpatient acute stays carry a $405 daily copay for the first six days, after which there is no copay. This plan also includes valuable dental, vision, and hearing benefits to help reduce out-of-pocket expenses. Routine dental services have no copay up to a $3,000 annual limit, and members receive a $300 yearly eyewear allowance with no copay or coinsurance. Additionally, routine eye and hearing exams are available with a copay of up to $30, while prescription hearing aids feature copays ranging from $399 to $699 with no coinsurance.
Inpatient Hospital See details
DEVOTED C-SNP 003 NM (HMO C-SNP) covers inpatient hospital services with no coinsurance, requiring a $405 daily copay for days 1-6 of acute stays (no copay for days 7 and beyond) and days 1-5 of psychiatric stays (no copay for days 6-90). This benefit is partially covered, as room upgrades and non-Medicare-covered stays are not covered.
Outpatient Services See details
DEVOTED C-SNP 003 NM (HMO C-SNP) covers outpatient services with no coinsurance, offering ambulatory surgical center and outpatient blood services with no copay and no coinsurance. Outpatient hospital services carry a copay of $0 to $505 (with a $405 copay per stay for observation services) and no coinsurance, while outpatient substance abuse sessions require a $30 copay and no coinsurance.
Partial Hospitalization See details
DEVOTED C-SNP 003 NM (HMO C-SNP) covers partial hospitalization services with a $105.00 copay and no coinsurance. Prior authorization is required to access this benefit.
Ambulance and Transportation Services See details
DEVOTED C-SNP 003 NM (HMO C-SNP) covers ground ambulance services with a copay of $0 to $350 and no coinsurance, and air ambulance services with a 20% coinsurance and no copay, both of which require prior authorization. While some transportation services are covered, transportation to plan-approved or any health-related locations is not covered.
Emergency Services See details
DEVOTED C-SNP 003 NM (HMO C-SNP) covers emergency services with a $130 copay and no coinsurance, with the copay waived if admitted to the hospital within 24 hours. Urgently needed services feature no copay to a $45 copay and no coinsurance, while worldwide emergency services are covered up to $25,000 with a $130 copay and no coinsurance for medical care, and a $350 copay with 20% coinsurance for emergency transportation.
Primary Care See details
Primary care benefits under DEVOTED C-SNP 003 NM (HMO C-SNP) feature no copay and no coinsurance for primary care doctor visits, and a $30 copay with no coinsurance for specialist, mental health, and podiatry services. Physical, occupational, and speech therapy have a $30 to $50 copay with no coinsurance, while chiropractic services are not covered in practice as routine and other chiropractic services are excluded.
Preventive Services See details
Preventive services are covered by DEVOTED C-SNP 003 NM (HMO C-SNP) with no copay and no coinsurance, including annual physical exams, fitness programs, and kidney disease education. However, additional preventive benefits are only partially covered, excluding services such as in-home support, personal emergency response systems (PERS), and therapeutic massage.
Hearing Services See details
DEVOTED C-SNP 003 NM (HMO C-SNP) covers routine hearing exams with a $30 copay and no coinsurance, subject to prior authorization. Prescription hearing aids are partially covered with no coinsurance and a copay of $399 to $699, but inner ear, outer ear, over the ear, and OTC hearing aids are not covered.
Vision Services See details
DEVOTED C-SNP 003 NM (HMO C-SNP) offers partially covered vision services, which exclude other eye exam services but cover one routine eye exam per year with a $0 to $30 copay and no coinsurance. Eyewear is covered with no copay, no coinsurance, and no deductible, up to a $300 yearly maximum for contacts, eyeglasses, and upgrades.
Dental Services See details
DEVOTED C-SNP 003 NM (HMO C-SNP) covers dental services with a $30 copay and no coinsurance for Medicare-covered care, and no copay or coinsurance for other services up to a $3,000 annual limit. This benefit is partially covered, excluding other diagnostic and preventive services, maxillofacial prosthetics, implants, and orthodontics.
Home Infusion bundled Services See details
Home infusion bundled services are covered by DEVOTED C-SNP 003 NM (HMO C-SNP) with no copay, though prior authorization is required. Associated Medicare Part B chemotherapy, radiation, and other Part B drugs require between no coinsurance and 20% coinsurance, while Medicare Part B insulin is covered with a $35 copay and between no coinsurance and 20% coinsurance.
Dialysis Services See details
DEVOTED C-SNP 003 NM (HMO C-SNP) covers Dialysis Services with no copay and a 20% coinsurance. Prior authorization is required for these services.
Medical Equipment See details
DEVOTED C-SNP 003 NM (HMO C-SNP) covers medical equipment, prosthetics, and diabetic supplies with no copay, though coinsurance applies and prior authorization is required. Durable medical equipment carries a 20% to 50% coinsurance, while other covered supplies range from no coinsurance up to 20% or 50% coinsurance. Diabetic therapeutic shoes and inserts are not covered under this plan.
Diagnostic and Radiological Services See details
DEVOTED C-SNP 003 NM (HMO C-SNP) covers diagnostic services with no coinsurance, offering lab services with no copay and diagnostic procedures with a copay ranging from $0 to $95. Radiological services require prior authorization and feature outpatient X-rays with no copay but applicable coinsurance, diagnostic radiology with a copay starting at $0, and therapeutic radiology with a minimum 20% coinsurance.
Home Health Services See details
Home Health Services are covered by DEVOTED C-SNP 003 NM (HMO C-SNP) with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are offered by DEVOTED C-SNP 003 NM (HMO C-SNP) with no copay, no coinsurance, and prior authorization required, meaning some services are covered. However, cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered.
Skilled Nursing Facility (SNF) See details
DEVOTED C-SNP 003 NM (HMO C-SNP) 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 and a $218 daily copay for days 21 through 100, with no coverage for additional days.
Other Services See details
DEVOTED C-SNP 003 NM (HMO C-SNP) offers partially covered other services, featuring no copay and no coinsurance for over-the-counter items up to $50 every three months, diabetic shoes, and additional preventive services. Acupuncture, meal benefits, and dual-eligible SNP services are not covered under this plan.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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