DEVOTED CHOICE MA ONLY 014 FL (PPO) Medicare Advantage Plan H9884-014 • 2026 • Escambia County, FL

DEVOTED CHOICE MA ONLY 014 FL Overview

Plan Overview for DEVOTED CHOICE MA ONLY 014 FL

This Medicare Advantage PPO plan covers Medicare Part A and Part B services and allows access to Medicare-approved providers. The monthly premium is $0.00, with lower costs when using in-network providers.

Primary care visits have a $0 copay | Out-of-network: $5 copay, specialist visits come with a $45 copay | Out-of-network: $45 copay, urgent care services carry a $0-$40 copay, and ambulance transportation is $0-$330 copay | Out-of-network: $0-$330 copay. These costs apply toward the plan’s annual maximum out-of-pocket (MOOP) limit of $9250.00. After this limit is reached, in-network services are fully covered for the remainder of the year.

This plan is listed by CMS under Plan ID H9884-014. Cost-sharing details for key services are provided below.

Cost Sharing Expenses

DEVOTED CHOICE MA ONLY 014 FL includes cost-sharing, which refers to out-of-pocket expenses for covered healthcare services. The table below outlines the most common in-network out-of-pocket costs associated with plan H9884-014.

Certain preventive services are covered 100% by DEVOTED CHOICE MA ONLY 014 FL as a Part B benefit.

Prescription Drug Coverage

This plan does not include a Medicare Part D plan for prescriptions.

CMS 5-Star Ratings

CMS evaluates Medicare Advantage (Part C) and Part D plans annually using a 5-star rating system. Ratings reflect performance in preventive care, chronic condition management, and member experience.