DEVOTED C-SNP CHOICE PREMIUM 015 GA (PPO C-SNP) H5453-015
- Food and produce benefit
- General supports for living
Your costs at a glanceIn-network, for the 2026 plan year
What's included, and what it's actually worth5 benefits included. Tap any card for the detail
Dental
$2,500/yr preventive dental allowance
OTC allowance
$50/quarter OTC allowance
Hearing
$399–$699copay per hearing aid
Vision
$300/yr eyewear allowance
See more details about this plan
Doctor Visits: PCP$0 copay
Doctor Visits: Specialist$40 copay
Inpatient Hospital$450/day, days 1–5
Outpatient Surgery$550 copay
Mental HealthDays 1-4: $450/day, Days 5-90: $0/day
Your coverageCheck your coverageFrom the doctors and prescriptions you added
Your plan's drug tiers30-day retail · after any applicable deductible
Our take
Where this plan shines
Things to know before you enroll
Plan documents
Plan questions
Common questions about DEVOTED C-SNP CHOICE PREMIUM 015 GA (PPO C-SNP) (Local PPO)
What does DEVOTED C-SNP CHOICE PREMIUM 015 GA (PPO C-SNP) (Local PPO) cover?
DEVOTED C-SNP CHOICE PREMIUM 015 GA (PPO C-SNP) (Local PPO) is a Chronic Condition Special Needs Plan, a Medicare Advantage plan for people whose qualifying condition the plan verifies, including cardiovascular disorders and diabetes. The plan record also identifies Part D prescription drug coverage. Its published drug benefit lists 6 formulary tiers. Published supplemental benefits include dental ($2,500/yr preventive dental allowance), vision ($300/yr eyewear allowance), hearing ($399–$699 copay per hearing aid), and over-the-counter (OTC) ($50/quarter OTC allowance). Review the plan documents for covered services, limits, and rules. Coverage can change each plan year.
Learn about Medicare AdvantageHow much does DEVOTED C-SNP CHOICE PREMIUM 015 GA (PPO C-SNP) (Local PPO) cost in 2026?
The published 2026 monthly plan premium for DEVOTED C-SNP CHOICE PREMIUM 015 GA (PPO C-SNP) (Local PPO) is $25.40. The standard Part B premium is $202.90/month in 2026 for most people; assistance may pay it for some members. The listed Part D deductible is $615. The in-network medical out-of-pocket maximum is $7,400; it does not include Part D drug spending. Published visit costs include primary care $0 and specialist visits $40. These figures are plan data, not a personal yearly-cost estimate.
Understand Medicare drug-cost limitsCan I use my current doctors with DEVOTED C-SNP CHOICE PREMIUM 015 GA (PPO C-SNP) (Local PPO)?
CMS lists DEVOTED C-SNP CHOICE PREMIUM 015 GA (PPO C-SNP) (Local PPO) as a Local PPO plan. A network label alone does not confirm that a specific doctor participates. Use the doctor lookup tool, then confirm with the doctor's office and the plan before receiving care. Provider networks and member costs can change. Emergency care and travel coverage can follow different network rules.
Check your doctorsWhat chronic conditions qualify for DEVOTED C-SNP CHOICE PREMIUM 015 GA (PPO C-SNP) (Local PPO)?
DEVOTED C-SNP CHOICE PREMIUM 015 GA (PPO C-SNP) (Local PPO) is listed in the current plan record as a C-SNP. The plan must verify that you have one of its qualifying chronic or disabling conditions, such as Cardio DIS CHF and Diabetes. If the plan uses a pre-enrollment assessment, provider verification is due by the end of your first month of enrollment. If verification is still missing, the plan must notify you and may disenroll you at the end of your second month. Your coverage continues if verification arrives before then. Review the official plan documents for the exact criteria.
Learn about Special Needs PlansHow does DEVOTED C-SNP CHOICE PREMIUM 015 GA (PPO C-SNP) (Local PPO) coordinate care for my chronic condition?
DEVOTED C-SNP CHOICE PREMIUM 015 GA (PPO C-SNP) (Local PPO) is identified in the current plan record as a Chronic Condition Special Needs Plan for qualifying conditions that include Cardio DIS CHF and Diabetes. The record also lists dental ($2,500/yr preventive dental allowance), vision ($300/yr eyewear allowance), and hearing ($399–$699 copay per hearing aid). The data on this page does not describe a personal care plan or promise a specific care coordinator. Review the Evidence of Coverage and ask the plan how its model of care, provider communication, and medication support apply to your verified condition.
When can I enroll in DEVOTED C-SNP CHOICE PREMIUM 015 GA (PPO C-SNP) (Local PPO)?
DEVOTED C-SNP CHOICE PREMIUM 015 GA (PPO C-SNP) (Local PPO) is a 2026 Medicare Advantage plan. The Annual Enrollment Period runs from October 15 through December 7, with changes taking effect January 1. The Medicare Advantage Open Enrollment Period runs from January 1 through March 31 for people already enrolled in Medicare Advantage. Because this is a C-SNP, the plan must also verify its eligibility requirements. A qualifying circumstance may create a Special Enrollment Period, but eligibility alone does not guarantee a year-round right to enroll. Confirm the enrollment window and effective date that apply to you before changing coverage.
Review Medicare enrollment periodsMore plan options
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