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DEVOTED CORE 005 NM (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for DEVOTED CORE 005 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 005 NM (HMO) in 2026, please refer to our full plan details page.
DEVOTED CORE 005 NM (HMO) is a HMO plan offered by Devoted Health, Inc. available for enrollment in 2026 to people living in Southern New Mexico. The overall rating for this plan is not yet available for 2026.
It's important to know that DEVOTED CORE 005 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 005 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 005 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 $175.00 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 $4000.00 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 005 NM (HMO) Medicare plan features an annual prescription drug deductible of $175. For Tier 1 preferred generic and Tier 2 generic drugs, you will pay no copay for one-month, two-month, or three-month supplies filled at standard pharmacies or through standard mail order. For brand-name and specialty prescriptions, the plan requires coinsurance rather than flat copayments. You will pay a 19% coinsurance for Tier 3 preferred brand drugs, a 25% coinsurance for Tier 4 non-preferred drugs, and a 30% coinsurance for Tier 5 specialty drugs.
Additional Benefits
The DEVOTED CORE 005 NM (HMO) plan provides affordable access to essential medical services, featuring no copay for primary care visits and a $25 copay for specialists. Inpatient hospital stays require a $300 daily copay for days 1 through 6, followed by no copay for days 7 through 90. Emergency room visits have a $150 copay that is waived if admitted, while urgent care services range from no copay to a $45 copay. For additional wellness needs, the plan features preventive dental care and routine eyewear with no copay, alongside comprehensive dental coverage up to a $2,500 annual limit. Hearing exams require a $25 copay, while diagnostic lab services and x-rays are covered with no copay. Members also benefit from a $100 over-the-counter allowance every three months to help cover everyday health supplies.
Inpatient Hospital See details
DEVOTED CORE 005 NM (HMO) covers inpatient hospital services with no coinsurance, requiring a $300 daily copay for days 1 to 6 and no copay for days 7 to 90. This benefit is partially covered because upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered, though unlimited additional days are provided for acute care.
Outpatient Services See details
Outpatient services under DEVOTED CORE 005 NM (HMO) are covered with no coinsurance, featuring no copay for ambulatory surgical center and blood services. Copayments range from $0 to $400 for outpatient hospital services, $300 per stay for observation services, and $25 per session for outpatient substance abuse services, with prior authorization required for most services.
Partial Hospitalization See details
DEVOTED CORE 005 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
Ambulance services are covered by DEVOTED CORE 005 NM (HMO) with prior authorization, featuring a ground ambulance copay ranging from no copay to $420 with no coinsurance, and air ambulance services with a 20% coinsurance and no copay. Transportation services to health-related locations are not covered.
Emergency Services See details
DEVOTED CORE 005 NM (HMO) covers emergency services with a $150 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services are covered with no copay to a $45 copay and no coinsurance, while worldwide emergency and urgent services are covered up to a $25,000 maximum with a $150 copay and no coinsurance, and worldwide emergency transportation requires a $420 copay and 20% coinsurance.
Primary Care See details
DEVOTED CORE 005 NM (HMO) provides primary care physician services with no copay and no coinsurance, and specialist visits with a $25 copay and no coinsurance. Additional benefits like physical therapy, mental health, and telehealth services have copays ranging from $0 to $50 with no coinsurance, while podiatry and routine chiropractic care are not covered.
Preventive Services See details
Preventive services are partially covered by DEVOTED CORE 005 NM (HMO) with no copay and no coinsurance for covered benefits like annual physical exams, fitness programs, and nutritional training. Several additional services are not covered, including personal emergency response systems, therapeutic massages, in-home support, and home-based palliative care.
Hearing Services See details
DEVOTED CORE 005 NM (HMO) covers hearing exams with a $25 copay and no coinsurance, while prescription hearing aids are partially covered with a copay between $399 and $699 and no coinsurance. OTC hearing aids are not covered, and excluded prescription sub-services include inner ear, outer ear, and over-the-ear hearing aids.
Vision Services See details
DEVOTED CORE 005 NM (HMO) provides partially covered vision services, featuring one routine eye exam per year with a copay ranging from no copay to $25 and no coinsurance, though other eye exam services are not covered. Eyewear is covered with no copay and no coinsurance, offering up to a $400 annual maximum benefit for contacts, eyeglasses, lenses, frames, and upgrades.
Dental Services See details
DEVOTED CORE 005 NM (HMO) partially covers dental services up to a $2,500 annual maximum, featuring preventive services with no copay and no coinsurance, and Medicare-covered dental with a $25 copay and no coinsurance. Covered comprehensive dental options have no copay and 0% to 50% coinsurance, but maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by DEVOTED CORE 005 NM (HMO) with no copay, though prior authorization is required. Under this benefit, Medicare Part B chemotherapy, radiation, and other drugs have no copay and a 0% to 20% coinsurance, while Medicare Part B insulin drugs require a $35 copay and a 0% to 20% coinsurance.
Dialysis Services See details
DEVOTED CORE 005 NM (HMO) covers Dialysis Services with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
DEVOTED CORE 005 NM (HMO) covers medical equipment with no copays, featuring 20% to 30% coinsurance for durable medical equipment and no coinsurance to 20% coinsurance for prosthetics and medical supplies. Diabetic equipment is partially covered, offering diabetic supplies with no coinsurance to 35% coinsurance, but diabetic therapeutic shoes and inserts are not covered.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by DEVOTED CORE 005 NM (HMO) with prior authorization required. Diagnostic services have no coinsurance, featuring no copay for lab services and a $0 to $95 copay for procedures. Radiological services require a 20% coinsurance for therapeutic radiology, while diagnostic radiology has a $0 minimum copay and x-rays have no copay.
Home Health Services See details
Home health services are fully covered under the DEVOTED CORE 005 NM (HMO) plan with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac rehabilitation services are covered by DEVOTED CORE 005 NM (HMO) with no coinsurance and require prior authorization. However, some services are covered in practice as cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation are not covered and require a $25 copay.
Skilled Nursing Facility (SNF) See details
DEVOTED CORE 005 NM (HMO) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring no copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required, and while a 3-day inpatient hospital stay is not required before admission, additional days beyond the Medicare-covered limit are not covered.
Other Services See details
DEVOTED CORE 005 NM (HMO) partially covers other services, providing over-the-counter (OTC) items up to $100 every three months and additional preventive services with no copay and no coinsurance. Acupuncture, meal benefits, and other additional services are not covered under this benefit.
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