Medicare Advantage · HMO
Devoted Health
Plan year 2026

DEVOTED C-SNP PREMIUM 016 PA (HMO C-SNP) H6852-016

Monthly premium
$32.70
+ your Part B premium
Max out-of-pocket
$7,800
in-network annual cap
Primary care
$0
per visit copay
Specialist
$35
per visit
Eligibility required for this 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.
Extra benefits for members who qualify
  • Food and produce benefit
  • General supports for living
These benefits are not available to every member. Even if you have a listed chronic condition, the plan must confirm that you meet its coverage criteria. See the Evidence of Coverage for complete rules.

Your costs at a glanceIn-network, for the 2026 plan year

Rx deductible
$615
Inpatient hospital
Days 1-7: $375/day, Days 8-90: $0/day
no limit on covered hospital days
Inpatient mental health
Days 1-5: $375/day, Days 6-90: $0/day
Outpatient surgery
$475
Emergency room
$115
Urgent care
$40

What's included, and what it's actually worth5 benefits included. Tap any card for the detail

Dental

$2,000/yr preventive dental allowance
Details$2,000/yr preventive dental allowance
This is a supplemental benefit with plan-specific limits. See plan documents for details.

OTC allowance

$50/quarter OTC allowance
Prepaid card$50/quarter OTC allowance

Hearing

$399–$699copay per hearing aid
Details$399–$699 copay per hearing aid
This is a supplemental benefit with plan-specific limits. See plan documents for details.

Vision

$300/yr eyewear allowance
Eyewear allowance$300/yr eyewear allowance
This is a supplemental benefit with plan-specific limits. See plan documents for details.
See more details about this plan
Doctor Visits: PCP$0 copay
In-network$0 copay per visit
Doctor Visits: Specialist$35 copay
In-network$35 copay per visit
Inpatient Hospital$375/day, days 1–7
In-networkDays 1-7: $375/day, Days 8-90: $0/day
Benefit limitNone — additional covered days are unlimited
Outpatient Surgery$475 copay
In-network$475 copay per procedure
Mental HealthDays 1-5: $375/day, Days 6-90: $0/day
Inpatient psychiatricDays 1-5: $375/day, Days 6-90: $0/day
MealsMeal benefit

Your coverageCheck your coverageFrom the doctors and prescriptions you added

Your plan's drug tiers30-day retail · after any applicable deductible

Tier 1
$18
Preferred Generic
Tier 2
$20
Generic
Tier 3
23%
Preferred Brand· after deductible
Tier 4
26%
Non-Pref Brand· after deductible
Tier 5
25%
Specialty· after deductible
Tier 6
$0
Tier 6· after deductible

Our take

Where this plan shines

See your primary doctor for $0.

Things to know before you enroll

This plan’s out-of-pocket maximum is above the national median.
Network restriction — you’ll need to use in-network providers except in emergencies.
Limited coverage while traveling outside the plan’s service area.
Questions? Talk to a licensed agent at1-866-764-3312 (TTY: 711)

Plan documents

Plan questions

Common questions about DEVOTED C-SNP PREMIUM 016 PA (HMO C-SNP)

What does DEVOTED C-SNP PREMIUM 016 PA (HMO C-SNP) cover?

DEVOTED C-SNP PREMIUM 016 PA (HMO C-SNP) 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 ($2,000/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 Advantage

How much does DEVOTED C-SNP PREMIUM 016 PA (HMO C-SNP) cost in 2026?

The published 2026 monthly plan premium for DEVOTED C-SNP PREMIUM 016 PA (HMO C-SNP) is $32.70. 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 $7,800; it does not include Part D drug spending. Published visit costs include primary care $0 and specialist visits $35. These figures are plan data, not a personal yearly-cost estimate.

Understand Medicare drug-cost limits

Can I use my current doctors with DEVOTED C-SNP PREMIUM 016 PA (HMO C-SNP)?

CMS lists DEVOTED C-SNP PREMIUM 016 PA (HMO C-SNP) as a HMO 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 doctors

What chronic conditions qualify for DEVOTED C-SNP PREMIUM 016 PA (HMO C-SNP)?

DEVOTED C-SNP PREMIUM 016 PA (HMO C-SNP) 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 Plans

How does DEVOTED C-SNP PREMIUM 016 PA (HMO C-SNP) coordinate care for my chronic condition?

DEVOTED C-SNP PREMIUM 016 PA (HMO C-SNP) 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 ($2,000/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 PREMIUM 016 PA (HMO C-SNP)?

DEVOTED C-SNP PREMIUM 016 PA (HMO C-SNP) 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 periods

More plan options

Browse the full 2026 Chronic Condition Special Needs Plan directory. This plan is offered in Pennsylvania. Plan availability can vary by county.

Helpful next steps

DEVOTED C-SNP PREMIUM 016 PA H6852-016 (HMO C-SNP) — 2026