Texas Medicare Advantage Plan (2024 Plan)
Monthly Premium
Your Cost
$0
by Devoted Health
Additional Coverage
HearingVisionDental
Overall Government Star Rating
4.5
out of 5 stars
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Plan Overview
Plan Name
Devoted CORE Greater Houston (HMO)
Insurance Carrier
Devoted Health
Plan Type
Medicare Advantage Plan With Part D Prescription Drug Coverage
Network Type
HMO
Devoted CORE Greater Houston (HMO) is a Medicare Advantage Plan With Part D Prescription Drug Coverage, which is available in Texas 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.
Cost Summary
Monthly Premium
$0
Annual Deductible
$0
Max Out-of-Pocket
$3,400
Primary doctor visit
$0 copay
Specialist visit
$20 copay per visit
ER visit
$135 copay per visit (always covered)
Ambulance
$250 copay
Devoted CORE Greater Houston (HMO) has a monthly premium cost of $0 per month, with an annual deductible of $0 and a maximum out of pocket cost sharing of $3,400 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 CORE Greater Houston (HMO) are defined below.
Additional Benefits and Coverage
Yes
Part D Prescription Drug Coverage
Yes
Dental
Yes
Vision
Yes
Hearing
Devoted CORE Greater Houston (HMO) 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 CORE Greater Houston (HMO) includes coverage for hearing, vision, dental.
Medicare Advantage health plans can offer even more additional benefits. Devoted CORE Greater Houston (HMO) includes coverage for the following additional benefits:
Other benefits
Fitness benefit
Limited coverage
Over the counter drug benefits
Limited coverage
In-home support services
Not covered
Home and bathroom safety devices
Limited coverage
Meals for short duration
Limited coverage
Annual physical exams
Limited coverage
Telehealth
Limited coverage
Comparing the Quality Score of Devoted CORE Greater Houston (HMO) to Other Plans in Texas
Each year the federal government evaluates the quality of Medicare Advantage and Part D Prescription Drug plans based on a 5-star scoring system. For 2024, Devoted CORE Greater Houston (HMO) received an overall government quality rating of 4.5 stars out of 5 stars.
Devoted CORE Greater Houston (HMO) performed better than Texas’s State average overall quality score of 3.8 stars.
This Plan’s 5-star Gov’t Quality Score
Texas State Average Score
Overall Government 5 Star Quality Rating
4.5
3.8
Summary rating of health plan quality
4.5
3.7
Staying healthy: screenings, tests, & vaccines
5
4.0
Managing chronic (long term) conditions
4
3.3
Member experience with health plan
4
3.5
Member complaints & changes in the health plan's performance
4
3.7
Health plan customer service
5
4.3
Summary rating of drug plan quality
4
3.6
Drug plan customer service
4
4.0
Member complaints & changes in the drug plan's performance
3
3.7
Member experience with the drug plan
5
3.7
Drug safety & accuracy of drug pricing
4
3.4
The government calculates an “Overall star rating” based on ratings for sub components including “Health plan star rating” and “Drug plan star rating”, which includes further subcomponents of each.
Devoted CORE Greater Houston (HMO) received 4.5 stars for its health plan quality score which is better than the Texas State average health plan quality score of 3.7 stars.
Devoted CORE Greater Houston (HMO) received 4 stars for its drug plan quality score which is better than the Texas State average drug plan quality score of 3.6 stars.
Plan Benefits and Coverage Details
Monthly Premium
$0
Health Portion of Premium
$0
Drug Portion of Premium
$0
Health Plan Deductible
$0
Health Plan Max Out-of-Pocket
$3,400 In-network
Nationwide Coverage included
No
Hearing Coverage included
Yes
Vision Coverage included
Yes
Dental Coverage included
Doctor Lookup Link
Plan Link
Medical Benefits
Doctor Services
Primary doctor visit
$0 copay
Specialist visit
$20 copay per visit
Tests, labs, & imaging
Diagnostic tests & procedures
$0-50 copay
Lab services
$0-25 copay
Diagnostic radiology services (like MRI)
$0-100 copay
Outpatient x-rays
$0-50 copay
Emergency care
$135 copay per visit (always covered)
Urgent care
$0-40 copay per visit (always covered)
Hospital Services
Inpatient hospital coverage
$225 per stay
Outpatient hospital coverage
$0-150 copay per visit
Skilled nursing facility
Skilled nursing facility
$0 per day for days 1 through 20
$203 per day for days 21 through 100
Preventive services
Preventive services
$0 copay
Ambulance
Ground ambulance
$250 copay
Therapy services
Occupational therapy visit
$20-40 copay
Physical therapy & speech & language therapy visit
$20-40 copay
Mental health services
Outpatient group therapy with a psychiatrist
$20 copay
Outpatient individual therapy with a psychiatrist
$20 copay
Outpatient group therapy visit
$20 copay
Outpatient individual therapy visit
$20 copay
Opioid treatment services
Opioid treatment services
Covered
Other services
Durable medical equipment (like wheelchairs & oxygen)
0-20% coinsurance per item
Prosthetics (like braces, artificial limbs)
0-20% coinsurance per item
Diabetes supplies
$0 copay
Prescription Drug Benefits
Tier drug costs for: Standard retail pharmacy drug cost for 1-month
| Tiers | Initial coverage phase | Gap coverage phase1 | Catastrophic coverage phase |
|---|---|---|---|
| Preferred Generic | $0.00 copay | $0.00 copay | $0 copay |
| Generic | $0.00 copay | $0.00 copay | $0 copay |
| Preferred Brand | $40.00 copay | $0 copay | |
| Non-Preferred Drug | $80.00 copay | $0 copay | |
| Specialty Tier | 33% | $0 copay | |
| 1 * The above cost-sharing only applies to some drugs on this tier. For all other drugs, you pay 25% for generic drugs and 25% for brand-name drugs. | |||
Part B Drugs
Chemotherapy drugs
0-20% coinsurance
Other Part B drugs
0-20% coinsurance
Extra Benefits
Hearing
Hearing exam
$20 copay
Fitting/evaluation
$0 copay
Hearing aids - All types
$399-699 copay
Preventive Dental
Oral exam
$0 copay
Cleaning
$0 copay
Fluoride treatment
$0 copay
Dental x-rays
$0 copay
Comprehensive dental
Non-routine services
$0 copay
Diagnostic services
$0 copay
Restorative services
$0 copay
Endodontics
$0 copay
Periodontics
$0 copay
Extractions
$0 copay
Prosthodontics, other oral/maxillofacial surgery, other services
$0 copay
Vision
Routine eye exam
$0 copay
Contact lenses
$0 copay
Eyeglasses (frames & lenses)
$0 copay
Eyeglass frames (only)
$0 copay
Eyeglass lenses (only)
$0 copay
Upgrades
$0 copay
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