Devoted DUAL PLUS Pennsylvania (HMO D-SNP)
Pennsylvania Medicare-Medicaid Dual Eligible D-SNP Plan (2025 Plan)
Additional Coverage
HearingVisionDental
Overall Government Star Rating
(coming soon)
Plan Name
Devoted DUAL PLUS Pennsylvania (HMO D-SNP)
Plan Type
Medicare-Medicaid Dual Eligible Medicare Advantage Plan (D-SNP)
Devoted DUAL PLUS Pennsylvania (HMO D-SNP) is a Medicare-Medicaid Dual Eligible Medicare Advantage Plan (D-SNP), which is available in Pennsylvania and offered by the health insurance company Devoted Health. This plan’s network type is HMO which determines in-network doctors who accept the health plan and whether a referral is needed.
Annual Deductible
$0 or $465 In-network
Primary doctor visit
$0 copay
Specialist visit
$0 copay
ER visit
$0 or $110 copay per visit (always covered)
Ambulance
0% or 0-35% coinsurance
Devoted DUAL PLUS Pennsylvania (HMO D-SNP) has a monthly premium cost of $31 per month, with an annual deductible of $0 or $465 In-network and a maximum out of pocket cost sharing of $9,350 In-network. The most common benefit costs which people evaluate when choosing a plan are costs for a primary doctor visit, specialist doctor visit, emergency room visit, and ambulance. These costs are listed in this summary section and a full list of benefit costs for Devoted DUAL PLUS Pennsylvania (HMO D-SNP) are defined below.
Yes
Part D Prescription Drug Coverage
Devoted DUAL PLUS Pennsylvania (HMO D-SNP) is a Medicare Advantage plan which does include Medicare Part D Prescription Drug coverage. Other common benefits included with Medicare Advantage plans are coverage for dental, vision, and hearing. Devoted DUAL PLUS Pennsylvania (HMO D-SNP) includes coverage for hearing, vision, dental.
Medicare Advantage health plans can offer even more additional benefits. Devoted DUAL PLUS Pennsylvania (HMO D-SNP) includes coverage for the following additional benefits:
Other benefits
Over the counter drug benefits
Home and bathroom safety devices
Health Portion of Premium
Health Plan Max Out-of-Pocket
Nationwide Coverage included
Hearing Coverage included
Doctor Services
Tests, labs, & imaging
Diagnostic tests & procedures
Diagnostic radiology services (like MRI)
Emergency care
$0 or $110 copay per visit (always covered)
Urgent care
0% or 35% coinsurance per visit (always covered)
Hospital Services
Inpatient hospital coverage
Outpatient hospital coverage
0% or 35-40% coinsurance per visit
Skilled nursing facility
Skilled nursing facility
$0 per day for days 1 through 20
$0 or $214 per day for days 21 through 64
$0 per day for days 65 through 100
Preventive services
Ambulance
Therapy services
Occupational therapy visit
Physical therapy & speech & language therapy visit
Mental health services
Outpatient group therapy with a psychiatrist
Outpatient individual therapy with a psychiatrist
Outpatient group therapy visit
Outpatient individual therapy visit
Opioid treatment services
Opioid treatment services
Other services
Durable medical equipment (like wheelchairs & oxygen)
0% or 0-20% coinsurance per item
Prosthetics (like braces, artificial limbs)
0% or 0-20% coinsurance per item
Diabetes supplies
0% or 20% coinsurance per item
Tier drug costs for: Standard retail pharmacy drug cost for 1-month
Tiers | Initial coverage phase | Catastrophic coverage phase |
---|
Preferred Generic |
Generic drugs :
25% coinsurance Brand-name drugs :
25% coinsurance |
Generic drugs :
0% coinsurance Brand-name drugs :
0% coinsurance |
Generic |
Preferred Brand |
Non-Preferred Drug |
Specialty Tier |
Part B Drugs
Hearing
Preventive Dental
Oral exam
In-network: $0 copay
Out-of-network: $0 copay
Cleaning
In-network: $0 copay
Out-of-network: $0 copay
Fluoride treatment
In-network: $0 copay
Out-of-network: $0 copay
Dental x-rays
In-network: $0 copay
Out-of-network: $0 copay
Comprehensive dental
Restorative services
In-network: $0 copay
Out-of-network: $0 copay
Endodontics
In-network: $0 copay
Out-of-network: $0 copay
Periodontics
In-network: $0 copay
Out-of-network: $0 copay
Prosthodontics, removable
In-network: $0 copay
Out-of-network: $0 copay
Prosthodontics, fixed
In-network: $0 copay
Out-of-network: $0 copay
Maxillofacial prosthetics
Oral and maxillofacial surgery
In-network: $0 copay
Out-of-network: $0 copay
Adjunctive general services
In-network: $0 copay
Out-of-network: $0 copay
Vision
Eyeglasses (frames & lenses)
When Can I Sign Up for Medicare?
Enter your birthday month and year to learn when you can sign up for different Medicare plan options.