Devoted BEWELL PLUS Arizona (C-SNP HMO) 2023 Maricopa County, Arizona Medicare Advantage Special Needs Plan
Devoted BEWELL PLUS Arizona is a C-SNP Medicare Advantage Special Needs Plan (HMO), from Devoted Health, that's available in Maricopa County, Arizona. It offers all of the same basic benefits as Original MedicareOriginal Medicare is private fee-for-service health insurance for people on Medicare. It has two parts. Part A is hospital coverage. Part B is medical coverage., plus some additional benefits that Medicare Part AMedicare Part A is hospital coverage for Medicare beneficiaries. It covers inpatient care in hospitals and skilled nursing facilities. It also covers limited home healthcare services and hospice care. and Part B do not cover, but out-of-pocket costsOut-of-Pocket Costs for Medicare are the remaining costs that are not covered by the beneficiary's health insurance plan. These costs can come from the beneficiary's monthly premiums, deductibles, coinsurance, and copayments. are different.
This plan is rated 4.0 (Good) stars by CMS.
Key Takeaways
- This is a private, Medicare-approved, special needs plan for individuals with specific severe or disabling chronic conditions.
- In addition to the specific chronic condition(s) above, you must have Medicare Part A and Part B, and you must live in the Maricopa County service area to qualify.
- Devoted BEWELL PLUS Arizona uses a HMO healthcare provider network to deliver healthcare services. Plus, it provides prescription drug coverage through a Medicare Part DMedicare Part D plans are an option Medicare beneficiaries can use to get prescription drug coverage. Part D plans provide cost-sharing on covered medications in four different phases: deductible, initial coverage, coverage gap, and catastrophic. Each... plan that's bundled in with other plan benefits.
- The annual Part D deductible is $505.00. You pay this amount before cost-sharing begins.
- This Devoted Health C-SNP plan includes all of the same benefits as Original Medicare, but the out-of-pocket costs (deductibles and copays) may be different. Carefully review the "Health Plan Costs & Benefits" section below for details.
| Plan Basics | |
|---|---|
| Plan ID: | H8173-014-0 |
| Plan Type: | C-SNP |
| Network Type: | HMO |
| Plan Year: | 2023 |
| Premium: | $37.50/mo Plus your Part B premium. |
| Health Plan Deductible: | $0.00 |
| Out-of-Pocket Maximum: | $3,200 In-networkDoctors, hospitals, pharmacies, and other healthcare providers that agree to health plan members' services and supplies at a set price are in-network providers. With some health plans, your care is only covered if you get... |
| Drug Plan Benefit: | Enhanced $505.00 deductible |
| Rx Gap Coverage: | Yes |
| Supplemental Benefits: | None |
| Availability: | Maricopa County, AZ |
| Insured By: | Devoted Health |
Health Plan Costs & Benefits
Devoted BEWELL PLUS Arizona is a Health Maintenance Organization (HMO) plan. HMO plan members usually receive health care services through the plan’s local network of providers. Referrals are almost always required to see a specialist and other providers. However, Devoted BEWELL PLUS Arizona does allow out-of-network care for emergencies and out-of-area dialysis.
PremiumsA premium is an amount that an insurance policyholder must pay for coverage. Premiums are typically paid on a monthly basis. In the federal Medicare program, there are four different types of premiums. , deductiblesA deductible is an amount a beneficiary must pay for their health care expenses before the health insurance policy begins to pay its share., and copays vary widely from plan to plan. It is very important to compare costs and apply them to your personal financial and healthcare needs.
Monthly Premium
Devoted BEWELL PLUS Arizona's total monthly premium in Maricopa County is $37.50. This includes your prescription coverage, as well. Plus, you must continue to pay your monthly Medicare Part B premiumThe Medicare Part B premium is the monthly charge paid by beneficiaries for their outpatient medical care, services, and supplies. A beneficiary's premium may be uplifted by an IRMAA surcharge if their income is above....
Annual Deductible
Devoted BEWELL PLUS Arizona's annual health plan deductible is $0.00. This does not include the deductible for the prescription drug plan (if any), which is detailed below.
Maximum Out-of-Pocket Limit
The Maximum Out-of-Pocket (MOOP) with this Devoted Health plan is $3,200 in-network. Unlike Original Medicare, Medicare Advantage plansMedicare Advantage (MA), also known as Medicare Part C, are health plans from private insurance companies that are available to people eligible for Original Medicare (Medicare Part A and Medicare Part B). must set an annual Maximum Out-of-Pocket (MOOP) limit on inpatient and outpatient healthcare services. Once you reach this amount of spending on your copaymentsA copayment, also known as a copay, is a set dollar amount you are required to pay for a medical service., all of your Medicare Part A and Part B services will be covered at no additional charge for the remainder of the year. MOOP does not include monthly premiums, prescriptions, or other extra benefits.
Health Plan Out-of-Pocket Costs
The following table is a summary of the most common out-of-pocket costs you will incur if you join this Devoted Health plan:
| Healthcare Service | Member Cost |
|---|---|
| Health plan deductible | $0 |
| Maximum out-of-pocket enrollee responsibility (does not include prescription drugs) | $3,200 In-network |
| Doctor Visits | |
| Specialist | $0-15 copay per visit (referral required) |
| Wellness programs (e.g., fitness, nursing hotline) | Covered |
| Preventive care | $0 copay |
| Mental Health Services | |
| Outpatient individual therapy visit | $0-15 copay (authorization required) |
| Outpatient group therapy visit with a psychiatrist | $0-15 copay (authorization required) |
| Inpatient hospital - psychiatric | $175 per day for days 1 through 7 $0 per day for days 8 through 90 (authorization required) |
| Outpatient individual therapy visit with a psychiatrist | $0-15 copay (authorization required) |
| Rehabilitation Services | |
| Occupational therapy visit | $10-20 copay (referral required) |
| Medical Equipment / Supplies | |
| Durable medical equipmentDurable medical equipment (DME) is equipment that is designed to last and can be used repeatedly. It is suitable for home use and includes wheelchairs, oxygen equipment, and hospital beds. (e.g., wheelchairs, oxygen) | 0-20% coinsuranceCoinsurance is a percentage of the total you are required to pay for a medical service. per item (authorization required) |
| Diabetes supplies | $0 copay (authorization required) |
| Diagnostic Procedures / Lab Services / Imaging | |
| Diagnostic radiology services (e.g., MRI) | $0-100 copay (referral required, authorization required) |
| Outpatient x-rays | $0-15 copay (referral required, authorization required) |
| Lab services | $0 copay (authorization required) |
| Medicare Part BMedicare Part B is medical coverage for people with Original Medicare benefits. It covers doctor visits, preventative care, tests, durable medical equipment, and supplies. Medicare Part B pays 80 percent of most medically necessary healthcare services. Drugs | |
| Other Part B drugs | 0-20% coinsurance (authorization required) |
| Foot Care (podiatry Services) | |
| Routine foot care | $0 copay |
| Hearing | |
| Hearing aids | $399-699 copay (limits may apply) |
| Fitting/evaluation | $0 copay |
| Preventive Dental | |
| Oral exam | $0 copay (limits may apply) |
| Cleaning | $0 copay (limits may apply) |
| Fluoride treatment | $0 copay (limits may apply) |
| Comprehensive Dental | |
| Diagnostic services | $0 copay (referral required, authorization required, limits may apply) |
| Extractions | $0 copay (referral required, authorization required, limits may apply) |
| Endodontics | $0 copay (referral required, authorization required, limits may apply) |
| Prosthodontics, other oral/maxillofacial surgery, other services | $0 copay (referral required, authorization required, limits may apply) |
| Periodontics | $0 copay (referral required, authorization required, limits may apply) |
| Restorative services | $0 copay (referral required, authorization required, limits may apply) |
| Vision | |
| Routine eye exam | $0 copay (limits may apply) |
| Eyeglass frames | $0 copay (limits may apply) |
| Contact lenses | $0 copay (limits may apply) |
| Upgrades | $0 copay (limits may apply) |
| Other | Not covered |
| Eyeglasses (frames and lenses) | $0 copay (limits may apply) |
| Emergency Care / Urgent Care | |
| Urgent care | $0-15 copay per visit (always covered) |
| Ground ambulance | $225 copay |
| Inpatient hospital coverage | $175 per day for days 1 through 7 $0 per day for days 8 through 90 |
| Outpatient hospital coverage | $0-175 copay per visit |
| Skilled Nursing Facility | $0 per day for days 1 through 20 $184 per day for days 21 through 40 $0 per day for days 41 through 100 |
| Optional supplemental benefits | No |
Feel free to download our Devoted BEWELL PLUS Arizona Summary of Benefits information.
Prescription Drug Plan Costs & Benefits
Devoted BEWELL PLUS Arizona includes an enhanced benefit Medicare Part D plan (PDP). Enhanced plans have a higher actuarial value than basic plans. Actuarial value simply refers to the percentage of cost that's covered by the plan.
Enhanced plans generally have higher monthly premiums than basic benefit plans but offer more benefits. For example, many enhanced PDPs do not have an annual deductible, may offer additional coverage during the coverage gap (aka, "donut hole"), and may have a broader list of supported drugs, known as a formularyA formulary is a list of prescription drugs covered by a prescription drug plan or another insurance plan offering prescription drug benefits. Medications not on a plan's formulary are generally not covered.. Some enhanced PDPs even cover excluded drugs. It's important to remember that benefits vary from plan to plan.
Prescription Drug Plan Premium
Although the prescription drug plan (Part D) premium is bundled with the total plan cost, some plans have supplemental costs and/or offer low-income subsidySocial Security's Low-Income Subsidy (LIS) program helps Medicare beneficiaries pay for their Medicare Part D prescription drugs by paying some of the costs. Also known as "Extra Help", beneficiaries who qualify for LIS receive premium... (LIS) assistance. The following table outlines the prescription drug plan premium details of this plan.
| Basic Part D Premium: | $37.50 |
| Supplemental Part D Premium: | $0.00 |
| Total Part D Premium: | $37.50 |
| Part D Premium with Full LIS Assistance: | $0.00 |
| Part D Premium with 75% LIS Assistance: | $9.40 |
| Part D Premium with 50% LIS Assistance: | $18.70 |
| Part D Premium with 25% LIS Assistance: | $28.10 |
For more information about the Low-Income Subsidy (aka, "Extra Help") program, refer to the Social Security Extra Help page.
Prescription Drug Plan Deductible
The Medicare Part D annual deductible with this plan is $505.00. This is the amount you must pay at the pharmacy before Devoted Health begins paying its share.
Prescription Drug Plan Out-of-Pocket Costs
In addition to the plan's monthly premium and deductible, Devoted BEWELL PLUS Arizona has copayments (a fixed dollar amount) and/or coinsurances (a percentage amount) that you must pay when you pick up your prescriptions. The following table shows you those costs.
| Tier | Preferred | Standard |
|---|---|---|
| 1 (Preferred Generic) | N/A | 25% |
| 2 (Generic) | N/A | 25% |
| 3 (Preferred Brand) | N/A | 25% |
| 4 (Non-Preferred Drug) | N/A | 25% |
| 5 (Specialty Tier) | N/A | 25% |
Our Review & 2023 CMS Rating Marks
Each year the Centers for Medicare & Medicaid ServicesThe Centers for Medicare & Medicaid Services (CMS) is the U.S. Federal agency that runs the Medicare, Medicaid, and Children’s Health Insurance Programs. (CMS) rates Medicare Advantage C-SNP's in nine broad categories. MedicareWireMedicareWire is a Medicare insurance consulting agency. We founded MedicareWire after seeing and hearing how confusing and frustrating it is to find, understand, and choose a plan. Our services are free to the consumer. does not recommend joining a plan with an overall rating of less than 3.0. (3 stars)
This Medicare Advantage C-SNP plan is way better than average. Here's how we can make this claimA request for payment that you submit to Medicare or other health insurance when you get items and services that you think are covered.. The member experience with this Devoted Health plan is average. Complaints and changes in performance with this plan are average. The plan shines at customer service with an overall excellent mark on this important metric.
| CMS Measure | Star Rating |
|---|---|
| 2023 Overall Rating | |
| Staying Healthy: Screenings, Tests, Vaccines | Plan too new to be measured |
| Managing Chronic (Long Term) Conditions | Plan too new to be measured |
| Member Experience with Health Plan | |
| Complaints and Changes in Plans Performance | |
| Health Plan Customer Service | |
| Drug Plan Customer Service | |
| Complaints and Changes in the Drug Plan | |
| Member Experience with the Drug Plan | |
| Drug Safety and Accuracy of Drug Pricing |
How to Qualify to Enroll in
Devoted BEWELL PLUS Arizona
To be eligible to enroll in Devoted BEWELL PLUS Arizona, you must meet these requirements:
- You are eligible for Medicare;
- You live in Maricopa County (the plan’s service area); and
- You have been diagnosed with one or more severe or disabling chronic conditions.
A disabiling chronic condition (disease) is one that lasts one or more years and requires ongoing medical attention and/or limits activities of daily living. They include:
- Autoimmune disorders
- End-stage renal diseaseEnd-Stage Renal Disease (ESRD), also known as kidney failure, is a condition that causes you to need dialysis or a kidney transplant. People with ESRD are eligible for Medicare coverage regardless of age.
- Cancer
- Cardiovascular disorders
- Hematologic disorders
- HIV/AIDS
- Chronic heart failure
- Chronic lung disorders
- Neurologic disorders
- Dementia
- Diabetes
- End-stage liver disease
- Neurologic disorders
- Stroke
- Mental health conditions
Additional C-SNP Plan Options
Here are some additional Medicare SNP plans in Maricopa County (C-SNPs) that might be worth reviewing:
- SCAN Balance
- Wellcare Specialty No Premium
- Cigna Achieve Medicare
- Super Plus
- Alignment Health Heart & Diabetes
Contact Devoted Health
| Plan Website: | http://www.Devoted.com |
|---|---|
| Formulay Information: | http://www.Devoted.com |
| Pharmacy Information: | Devoted Health Pharmacy Page |
| Prospective Members: | (800)376-5889 |
| TTY Users: | (711)- |
If you qualify for Medicare but have not yet enrolled or verified your enrollment status, you can do so on the Social Security Administration website. You can learn more about the Medicare Advantage program on www.medicare.gov.
Citations & References
- Devoted Health, http://www.Devoted.com, Last Accessed October 13, 2022
- MedicaidMedicaid is a public health insurance program that provides health care coverage to low-income families and individuals in the United States..gov, "Medicaid & CHIP in Arizona", Last Accessed October 15, 2022
- CMS.gov, "Chronic Condition Special Needs Plans (C-SNPs)", Last Accessed April 11, 2022
- CMS.gov, Landscape Source Files, Last Accessed October 26, 2021
- CMS.gov, Medicare Part C & D Performance, Last Accessed October 6, 2021
- CMS.gov, Plan Benefits Package, Last Accessed October 4, 2021
The Medicare Special Needs Plans in Maricopa County, Arizona for 2023 information on this page was last updated on .