Devoted Health Medicare Plan Hearing Aid Benefits

140,179 Total Members

OTC Supplemental Benefits Prescription Hearing Aid Coverage
Company Plan name Plan type OTC Supplement OTC Rolls Over? Annual OTC Supplement Coverage? Covered Amount Covers OTC Aids? Coinsurance? Copay? Prior Authorization? Need Referral? Enrollees
Devoted Health Devoted CORE Greater Houston (HMO)
H7993-001-0 		HMO $95 per Quarter No $380 Yes No No Yes No No 14,704
Devoted Health Devoted PRIME Greater Houston (HMO)
H7993-002-0 		HMO $60 per Quarter No $240 Yes No No Yes No No 14,336
Devoted Health Devoted CORE Ohio (HMO)
H2697-001-0 		HMO $55 per Quarter No $220 Yes No No Yes No No 10,805
Devoted Health Devoted CORE Illinois (HMO)
H7151-001-0 		HMO $65 per Quarter No $260 Yes No No Yes No No 5,974
Devoted Health Devoted ESSENTIALS Tampa (HMO)
H1290-051-2 		HMO $60 per Quarter No $240 Yes No No Yes No No 5,678
Devoted Health Devoted CORE Arizona (HMO)
H8173-001-0 		HMO $145 per Quarter No $580 Yes No No Yes No No 4,921
Devoted Health Devoted PRIME Ohio (HMO)
H2697-002-0 		HMO $170 per Quarter No $680 Yes No No Yes No No 4,644
Devoted Health Devoted GIVEBACK Ohio (HMO)
H2697-003-0 		HMO $55 per Quarter No $220 Yes No No Yes No No 4,449
Devoted Health Devoted DUAL Tampa (HMO D-SNP)
H1290-024-0 		HMO $100 per Quarter No $400 Yes No No Yes No No 3,927
Devoted Health Devoted GIVEBACK Greater Houston (HMO)
H7993-006-0 		HMO $55 per Quarter No $220 Yes No No Yes No No 3,898
Devoted Health Devoted CORE Tampa (HMO)
H1290-036-2 		HMO $140 per Quarter No $560 Yes No No Yes No No 3,531
Devoted Health Devoted SELECT Arizona (HMO)
H8173-002-0 		HMO $0 per Month No $0 Yes No No Yes No No 2,645
Devoted Health Devoted BEWELL Arizona (HMO C-SNP)
H8173-011-0 		HMO $75 per Quarter No $300 Yes No No Yes No No 2,072
Devoted Health Devoted DUAL Ohio - 1 (HMO D-SNP)
H2697-010-0 		HMO $100 per Quarter No $400 Yes No No Yes No No 1,832
Devoted Health Devoted CORE Broward (HMO)
H1290-002-0 		HMO $145 per Quarter No $580 Yes No No Yes No No 1,808
Devoted Health Devoted BEWELL San Antonio - D (HMO C-SNP)
H7993-005-0 		HMO $270 per Quarter No $1,080 Yes No No Yes No No 1,784
Devoted Health Devoted CORE Arizona (HMO)
H8173-007-0 		HMO $75 per Quarter No $300 Yes No No Yes No No 1,728
Devoted Health Devoted DUAL Orlando (HMO D-SNP)
H1290-022-0 		HMO $100 per Quarter No $400 Yes No No Yes No No 1,666
Devoted Health Devoted CHOICE Hawaii (PPO)
H2686-001-0 		Local PPO $95 per Quarter No $380 Yes No No Yes No No 1,601
Devoted Health Devoted CORE San Antonio (HMO)
H7993-003-0 		HMO $215 per Quarter No $860 Yes No No Yes No No 1,578
Devoted Health Devoted ESSENTIALS Jacksonville (HMO)
H1290-031-0 		HMO $0 per Month No $0 Yes No No Yes No No 1,386
Devoted Health Devoted CORE Orlando (HMO)
H1290-005-0 		HMO $145 per Quarter No $580 Yes No No Yes No No 1,299
Devoted Health Devoted CORE Ohio (HMO)
H2697-004-0 		HMO $55 per Quarter No $220 Yes No No Yes No No 1,265
Devoted Health Devoted CHOICE GIVEBACK Tampa (PPO)
H9884-005-0 		Local PPO $60 per Quarter No $240 Yes No No Yes No No 1,254
Devoted Health Devoted ESSENTIALS Orlando (HMO)
H1290-018-0 		HMO $65 per Quarter No $260 Yes No No Yes No No 1,214
Devoted Health Devoted PRIME (HMO)
H1290-037-5 		HMO $250 per Quarter No $1,000 Yes No No Yes No No 1,193
Devoted Health Devoted DUAL Jacksonville (HMO D-SNP)
H1290-023-0 		HMO $100 per Quarter No $400 Yes No No Yes No No 1,185
Devoted Health Devoted CORE Colorado (HMO)
H7147-004-0 		HMO $50 per Quarter No $200 Yes No No Yes No No 1,171
Devoted Health Devoted DUAL Ohio - 2 (HMO D-SNP)
H2697-011-0 		HMO $50 per Quarter No $200 Yes No No Yes No No 1,167
Devoted Health Devoted GIVEBACK Illinois (HMO)
H7151-003-0 		HMO $0 per Month No $0 Yes No No Yes No No 1,115
Devoted Health Devoted DUAL Miami-Dade (HMO D-SNP)
H1290-019-0 		HMO $100 per Quarter No $400 Yes No No Yes No No 1,070
Devoted Health Devoted CHOICE Illinois (PPO)
H6545-001-0 		Local PPO $155 per Quarter No $620 Yes No No Yes No No 1,038
Devoted Health Devoted CORE Miami-Dade (HMO)
H1290-001-0 		HMO $145 per Quarter No $580 Yes No No Yes No No 1,028
Devoted Health Devoted CORE Jacksonville (HMO)
H1290-029-0 		HMO $140 per Quarter No $560 Yes No No Yes No No 999
Devoted Health Devoted CORE North Carolina (HMO)
H5299-001-0 		HMO $65 per Quarter No $260 Yes No No Yes No No 989
Devoted Health Devoted CORE North Florida (HMO)
H1290-027-0 		HMO $140 per Quarter No $560 Yes No No Yes No No 982
Devoted Health Devoted DUAL Broward (HMO D-SNP)
H1290-020-0 		HMO $100 per Quarter No $400 Yes No No Yes No No 942
Devoted Health Devoted CHOICE GIVEBACK Upstate (PPO)
H7028-002-0 		Local PPO $0 per Month No $0 Yes No No Yes No No 939
Devoted Health Devoted CHOICE Ohio (PPO)
H2526-001-0 		Local PPO $100 per Quarter No $400 Yes No No Yes No No 884
Devoted Health Devoted CORE Alabama (HMO)
H3080-001-0 		HMO $65 per Quarter No $260 Yes No No Yes No No 863
Devoted Health Devoted DUAL Alabama - 1 (HMO D-SNP)
H3080-003-0 		HMO $65 per Quarter No $260 Yes No No Yes No No 862
Devoted Health Devoted CHOICE PLUS Hawaii (PPO)
H2686-002-0 		Local PPO $85 per Quarter No $340 Yes No No Yes No No 853
Devoted Health Devoted CORE Palm Beach (HMO)
H1290-003-0 		HMO $140 per Quarter No $560 Yes No No Yes No No 838
Devoted Health Devoted PREMIUM (HMO)
H1290-044-3 		HMO $250 per Quarter No $1,000 Yes No No Yes No No 813
Devoted Health Devoted ESSENTIALS Palm Beach (HMO)
H1290-015-0 		HMO $55 per Quarter No $220 Yes No No Yes No No 813
Devoted Health Devoted ESSENTIALS North Florida (HMO)
H1290-035-0 		HMO $55 per Quarter No $220 Yes No No Yes No No 812
Devoted Health Devoted ESSENTIALS Broward (HMO)
H1290-014-0 		HMO $70 per Quarter No $280 Yes No No Yes No No 804
Devoted Health Devoted SELECT Arizona (HMO)
H8173-008-0 		HMO $125 per Quarter No $500 Yes No No Yes No No 773
Devoted Health Devoted PRIME San Antonio (HMO)
H7993-004-0 		HMO $195 per Quarter No $780 Yes No No Yes No No 704
Devoted Health Devoted CHOICE GIVEBACK Polk (PPO)
H9884-006-0 		Local PPO $45 per Quarter No $180 Yes No No Yes No No 633
Devoted Health Devoted GIVEBACK Ohio (HMO)
H2697-006-0 		HMO $60 per Quarter No $240 Yes No No Yes No No 624
Devoted Health Devoted CHOICE PLUS Oregon (PPO)
H7199-002-0 		Local PPO $50 per Quarter No $200 Yes No No Yes No No 617
Devoted Health Devoted DUAL Palm Beach (HMO D-SNP)
H1290-021-0 		HMO $100 per Quarter No $400 Yes No No Yes No No 605
Devoted Health Devoted CHOICE Oregon (PPO)
H7199-001-0 		Local PPO $100 per Quarter No $400 Yes No No Yes No No 573
Devoted Health Devoted ESSENTIALS Miami-Dade (HMO)
H1290-013-0 		HMO $60 per Quarter No $240 Yes No No Yes No No 572
Devoted Health Devoted CORE Colorado (HMO)
H7147-001-0 		HMO $50 per Quarter No $200 Yes No No Yes No No 548
Devoted Health Devoted LIBERTY Arizona (HMO)
H8173-005-0 		HMO $50 per Quarter No $200 Yes No No Yes No No 536
Devoted Health Devoted CHOICE Upstate (PPO)
H7028-001-0 		Local PPO $65 per Quarter No $260 Yes No No Yes No No 511
Devoted Health Devoted CORE Oregon (HMO)
H2923-001-0 		HMO $80 per Quarter No $320 Yes No No Yes No No 501
Devoted Health Devoted CHOICE GIVEBACK Austin (PPO)
H6813-001-0 		Local PPO $0 per Month No $0 Yes No No Yes No No 488
Devoted Health Devoted GIVEBACK Alabama (HMO)
H3080-002-0 		HMO $55 per Quarter No $220 Yes No No Yes No No 453
Devoted Health Devoted CORE Upstate (HMO)
H3041-001-0 		HMO $50 per Quarter No $200 Yes No No Yes No No 421
Devoted Health Devoted GIVEBACK Colorado (HMO)
H7147-005-0 		HMO $0 per Month No $0 Yes No No Yes No No 420
Devoted Health Devoted CHOICE Alabama (PPO)
H9888-001-0 		Local PPO $85 per Quarter No $340 Yes No No Yes No No 416
Devoted Health Devoted GIVEBACK El Paso (HMO)
H7993-008-0 		HMO $60 per Quarter No $240 Yes No No Yes No No 415
Devoted Health Devoted DUAL North Florida (HMO D-SNP)
H1290-033-0 		HMO $100 per Quarter No $400 Yes No No Yes No No 400
Devoted Health Devoted CHOICE Arizona (PPO)
H6586-001-0 		Local PPO $115 per Quarter No $460 Yes No No Yes No No 367
Devoted Health Devoted PRIME Ohio (HMO)
H2697-005-0 		HMO $185 per Quarter No $740 Yes No No Yes No No 359
Devoted Health Devoted CORE Pennsylvania (HMO)
H6852-001-0 		HMO $50 per Quarter No $200 Yes No No Yes No No 337
Devoted Health Devoted DUAL Alabama - 2 (HMO D-SNP)
H3080-004-0 		HMO $65 per Quarter No $260 Yes No No Yes No No 335
Devoted Health Devoted GIVEBACK Arizona (HMO)
H8173-013-0 		HMO $50 per Quarter No $200 Yes No No Yes No No 307
Devoted Health Devoted ESSENTIALS Daytona (HMO)
H1290-049-0 		HMO $0 per Month No $0 Yes No No Yes No No 305
Devoted Health Devoted CORE Tennessee (HMO)
H7605-004-0 		HMO $95 per Quarter No $380 Yes No No Yes No No 298
Devoted Health Devoted ESSENTIALS East Coast Florida (HMO)
H1290-045-0 		HMO $0 per Month No $0 Yes No No Yes No No 289
Devoted Health Devoted CHOICE Colorado (PPO)
H4808-002-0 		Local PPO $35 per Quarter No $140 Yes No No Yes No No 286
Devoted Health Devoted CHOICE (PPO)
H9884-004-0 		Local PPO $110 per Quarter No $440 Yes No No Yes No No 284
Devoted Health Devoted GIVEBACK North Carolina (HMO)
H5299-002-0 		HMO $0 per Month No $0 Yes No No Yes No No 282
Devoted Health Devoted DUAL East Coast Florida (HMO D-SNP)
H1290-039-0 		HMO $100 per Quarter No $400 Yes No No Yes No No 273
Devoted Health Devoted CORE Daytona (HMO)
H1290-050-0 		HMO $145 per Quarter No $580 Yes No No Yes No No 266
Devoted Health Devoted DUAL Colorado - 1 (HMO D-SNP)
H7147-003-0 		HMO $75 per Quarter No $300 Yes No No Yes No No 262
Devoted Health Devoted CORE East Coast Florida (HMO)
H1290-046-0 		HMO $145 per Quarter No $580 Yes No No Yes No No 261
Devoted Health Devoted CORE Tennessee (HMO)
H7605-007-0 		HMO $75 per Quarter No $300 Yes No No Yes No No 261
Devoted Health Devoted BEWELL PLUS Arizona (HMO C-SNP)
H8173-014-0 		HMO $75 per Quarter No $300 Yes No No Yes No No 243
Devoted Health Devoted CHOICE South Florida (PPO)
H9884-001-0 		Local PPO $145 per Quarter No $580 Yes No No Yes No No 240
Devoted Health Devoted CHOICE Colorado (PPO)
H4808-001-0 		Local PPO $35 per Quarter No $140 Yes No No Yes No No 203
Devoted Health Devoted GIVEBACK Tennessee (HMO)
H7605-008-0 		HMO $65 per Quarter No $260 Yes No No Yes No No 198
Devoted Health Devoted GIVEBACK Pennsylvania (HMO)
H6852-002-0 		HMO $75 per Quarter No $300 Yes No No Yes No No 193
Devoted Health Devoted CHOICE Austin (PPO)
H6813-002-0 		Local PPO $90 per Quarter No $360 Yes No No Yes No No 189
Devoted Health Devoted CHOICE Pennsylvania (PPO)
H6018-001-0 		Local PPO $65 per Quarter No $260 Yes No No Yes No No 180
Devoted Health Devoted ESSENTIALS Manatee (HMO)
H1290-032-0 		HMO $0 per Month No $0 Yes No No Yes No No 167
Devoted Health Devoted GIVEBACK Tennessee (HMO)
H7605-005-0 		HMO $0 per Month No $0 Yes No No Yes No No 157
Devoted Health Devoted CHOICE Orlando (PPO)
H9884-003-0 		Local PPO $110 per Quarter No $440 Yes No No Yes No No 156
Devoted Health Devoted DUAL Daytona (HMO D-SNP)
H1290-041-0 		HMO $100 per Quarter No $400 Yes No No Yes No No 132
Devoted Health Devoted CHOICE Arizona (PPO)
H6586-002-0 		Local PPO $50 per Quarter No $200 Yes No No Yes No No 128
Devoted Health Devoted PRIME North Carolina (HMO)
H5299-003-0 		HMO $50 per Quarter No $200 Yes No No Yes No No 126
Devoted Health Devoted CHOICE North Florida (PPO)
H9884-012-0 		Local PPO $110 per Quarter No $440 Yes No No Yes No No 122
Devoted Health Devoted CHOICE Tennessee (PPO)
H9231-001-0 		Local PPO $95 per Quarter No $380 Yes No No Yes No No 122
Devoted Health Devoted CHOICE Arizona (PPO)
H6586-003-0 		Local PPO $125 per Quarter No $500 Yes No No Yes No No 121
Devoted Health Devoted CHOICE East Coast Florida (PPO)
H9884-008-0 		Local PPO $60 per Quarter No $240 Yes No No Yes No No 115
Devoted Health Devoted RESTORE PLUS Tennessee - D (HMO C-SNP)
H7605-006-0 		HMO $75 per Quarter No $300 Yes No No Yes No No 94
Devoted Health Devoted CORE Ohio (HMO)
H2697-007-0 		HMO $55 per Quarter No $220 Yes No No Yes No No 90
Devoted Health Devoted BEWELL PLUS Arizona (HMO C-SNP)
H8173-015-0 		HMO $120 per Quarter No $480 Yes No No Yes No No 78
Devoted Health Devoted CHOICE Northwest Florida (PPO)
H9884-011-0 		Local PPO $80 per Quarter No $320 Yes No No Yes No No 72
Devoted Health Devoted GIVEBACK Tennessee (HMO)
H7605-002-0 		HMO $0 per Month No $0 Yes No No Yes No No 71
Devoted Health Devoted CORE Tennessee (HMO)
H7605-001-0 		HMO $85 per Quarter No $340 Yes No No Yes No No 68
Devoted Health Devoted CORE Manatee (HMO)
H1290-025-0 		HMO $140 per Quarter No $560 Yes No No Yes No No 67
Devoted Health Devoted CORE Alabama (HMO)
H3080-005-0 		HMO $130 per Quarter No $520 Yes No No Yes No No 60
Devoted Health Devoted DUAL Manatee (HMO D-SNP)
H1290-034-0 		HMO $100 per Quarter No $400 Yes No No Yes No No 58
Devoted Health Devoted CORE El Paso (HMO)
H7993-007-0 		HMO $100 per Quarter No $400 Yes No No Yes No No 57
Devoted Health Devoted GIVEBACK Ohio (HMO)
H2697-009-0 		HMO $60 per Quarter No $240 Yes No No Yes No No 53
Devoted Health Devoted DUAL Northwest Florida - 2 (HMO D-SNP)
H1290-043-0 		HMO $60 per Quarter No $240 Yes No No Yes No No 52
Devoted Health Devoted PRIME Tennessee (HMO)
H7605-003-0 		HMO $60 per Quarter No $240 Yes No No Yes No No 47
Devoted Health Devoted DUAL Alabama - 1 (HMO D-SNP)
H3080-006-0 		HMO $65 per Quarter No $260 Yes No No Yes No No 39
Devoted Health Devoted PRIME Ohio (HMO)
H2697-008-0 		HMO $180 per Quarter No $720 Yes No No Yes No No 38
Devoted Health Devoted DUAL Northwest Florida - 1 (HMO D-SNP)
H1290-042-0 		HMO $75 per Quarter No $300 Yes No No Yes No No 37
Devoted Health Devoted CHOICE Manatee (PPO)
H9884-007-0 		Local PPO $110 per Quarter No $440 Yes No No Yes No No 37
Devoted Health Devoted CHOICE Alabama (PPO)
H9888-002-0 		Local PPO $65 per Quarter No $260 Yes No No Yes No No 28

Plan Claims Contact Information

Organization Name: Devoted Health
Contact Name: Shannon O'kane
Title: Chief Compliance Officer
Phone: 1-800-338-6833
Email: sokane@devoted.com
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