DEVOTED C-SNP CHOICE PLUS 031 TN (PPO C-SNP) Medicare Special Need Plan H7028-031 • 2027
- Monthly Premium
- $0.00Plus Part B premium.
- Medical Deductible
- Coming soon
- Maximum Out-of-Pocket
- $9850.00In-network
- Part B Giveback
- Coming soon
- Prescription Coverage
- Enhanced, $650.00 deductible
- Additional Benefits
- None
- Service Area
- See List
- Total Enrollment
- 0 beneficiaries
Introduction
CMS Plan ID H7028-031 identifies DEVOTED C-SNP CHOICE PLUS 031 TN, a Medicare Advantage Chronic Condition Special Needs Plan (C-SNP) offered by Devoted Health. Its provider network is a Preferred Provider Organization (PPO), and Medicare Part D prescription drug coverage is included. For 2027, the plan has a $0.00 monthly premium, Coming soon medical deductible, and $9850.00 in-network maximum out-of-pocket. The 2027 Part D prescription drug deductible is $650.00.
Enrollment across the plan's service areas totals 0 beneficiaries, according to CMS. Enrollment is limited to beneficiaries who live within the plan's service area: See List.
Eligibility
DEVOTED C-SNP CHOICE PLUS 031 TN is a Chronic Condition Special Needs Plan (C-SNP) designed for people with qualifying health conditions.
- Special Needs Plan Type
- Chronic Condition Special Needs Plan (C-SNP)
- Medicare Requirement
- Must have Medicare Part A and Part B
- Special Needs Requirement
- This plan is for individuals with cardiovascular disorders, chronic heart failure, and/or diabetes mellitus.
- Service Area Requirement
- Must live in the plan's service area
- Prescription Drug Coverage
- Medicare Part D prescription drug coverage is included.
Plan Benefits
DEVOTED C-SNP CHOICE PLUS 031 TN has cost-sharing, meaning there are out-of-pocket costs when receiving covered healthcare services. The tables below detail the most common in-network out-of-pocket expenses for plan H7028-031.
Compare 2027 plan benefits with 2026.
Office Visits
| Covered Service | 2027 | 2026 |
|---|---|---|
| Primary care | Coming soon | Coming soon |
| Specialist | Coming soon | Coming soon |
Preventive and Wellness Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Annual wellness exam | Coming soon | Coming soon |
| Telehealth benefit | Coming soon | Coming soon |
| Routine chiropractic | Coming soon | Coming soon |
| Fitness benefits | Coming soon | Coming soon |
| Health education | Coming soon | Coming soon |
| Counseling services | Coming soon | Coming soon |
| Over-the-counter drug benefits | Coming soon | Coming soon |
| Health transportation (non-emergency) | Coming soon | Coming soon |
Diagnostic, Lab, and Imaging Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Diagnostic radiology services | Coming soon | Coming soon |
| Lab services | Coming soon | Coming soon |
| Outpatient x-rays | Coming soon | Coming soon |
| Diagnostic tests and procedures | Coming soon | Coming soon |
Emergency and Urgent Care Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Emergency room care | Coming soon | Coming soon |
| Worldwide emergency care | Coming soon | Coming soon |
| Urgent care | Coming soon | Coming soon |
| Inpatient hospital care | Coming soon | Coming soon |
| Skilled Nursing Facility | Coming soon | Coming soon |
| Ground ambulance | Coming soon | Coming soon |
Mental Health Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Outpatient individual therapy | Coming soon | Coming soon |
| Outpatient group therapy | Coming soon | Coming soon |
| Inpatient psychiatric hospital care | Coming soon | Coming soon |
Rehabilitation Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Physical therapy and speech and language therapy | Coming soon | Coming soon |
| Occupational therapy | Coming soon | Coming soon |
Medical Equipment and Supplies
| Covered Service | 2027 | 2026 |
|---|---|---|
| Diabetes supplies | Coming soon | Coming soon |
| Durable medical equipment | Coming soon | Coming soon |
| Prosthetics | Coming soon | Coming soon |
Medicare Part B Drugs
| Covered Service | 2027 | 2026 |
|---|---|---|
| Chemotherapy | Coming soon | Coming soon |
| Other Part B drugs (Medicare-covered) | Coming soon | Coming soon |
Dental Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Oral exam | Coming soon | Coming soon |
| Dental x-rays | Coming soon | Coming soon |
| Cleaning | Coming soon | Coming soon |
| Periodontics | Coming soon | Coming soon |
| Endodontics | Coming soon | Coming soon |
| Restorative services | Coming soon | Coming soon |
| Implant services | Coming soon | Coming soon |
| Orthodontics | Coming soon | Coming soon |
| Oral/Maxillofacial surgery | Coming soon | Coming soon |
Vision Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Routine eye exam | Coming soon | Coming soon |
| Contact lenses | Coming soon | Coming soon |
| Eyeglass frames only | Coming soon | Coming soon |
| Eyeglass lenses only | Coming soon | Coming soon |
| Eyeglasses (frames & lenses) | Coming soon | Coming soon |
| Upgrades | Coming soon | Coming soon |
Hearing Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Hearing exam | Coming soon | Coming soon |
| Fitting/evaluation | Coming soon | Coming soon |
| Prescription hearing aids | Coming soon | Coming soon |
| OTC hearing aids | Coming soon | Coming soon |
Additional and Special Needs Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Adult day health services | Coming soon | Coming soon |
| Home-based palliative care | Coming soon | Coming soon |
| Personal emergency response system | Coming soon | Coming soon |
| Weight management programs | Coming soon | Coming soon |
| Wigs for chemotherapy-related hair loss | Coming soon | Coming soon |
| Alternative therapies | Coming soon | Coming soon |
| Massage therapy | Coming soon | Coming soon |
| Home/bathroom safety devices | Coming soon | Coming soon |
Certain preventive services are covered 100% by DEVOTED C-SNP CHOICE PLUS 031 TN as a Part B benefit.
Prescription Drug Coverage
DEVOTED C-SNP CHOICE PLUS 031 TN includes a Medicare Part D prescription drug plan (PDP). Plan type and coverage level are defined by CMS and may vary between basic and enhanced benefit designs.
Prescription Drug Plan Premium
The Part D prescription drug plan premium is included in the overall Medicare Advantage plan cost. Additional adjustments may apply through the Low-Income Subsidy (LIS) program, also known as Extra Help, administered by Social Security. LIS benefits are separate from Medicare Special Needs Plan coverage.
| Part D Premium Component | Amount |
|---|---|
| Basic Part D Premium: | ($16.40) |
| Supplemental Part D Premium: | $16.40 |
| Total Part D Premium: | $0.00 |
| Low-Income Premium Subsidy: | $13.65 |
| Low-Income Premium Subsidy Paid by CMS: | $0.00 |
| Low-Income Subsidy Premium: | $0.00 |
For more details, visit the Social Security Extra Help program .
Prescription Drug Plan Deductible
This plan has a $650.00 annual Part D deductible. You'll pay this deductible at the pharmacy before Devoted Health starts contributing towards your prescription costs.
Prescription Drug Plan Out-of-Pocket Costs
Beyond premiums and deductibles, DEVOTED C-SNP CHOICE PLUS 031 TN may have additional costs at pharmacies. The table below outlines out-of-pocket expenses by drug tier.
| Drug Tier | Retail | Mail Order |
|---|---|---|
| Cost data not available. | ||
| *Deductible does not apply. | ||
CMS 5-Star Performance Ratings (Contract ID: H7028)
Medicare assigns star ratings to plans based on quality and performance across multiple measures, including customer service, member experience, and health outcomes. Ratings are updated annually by the Centers for Medicare & Medicaid Services (CMS) and are shown on a 1 to 5 star scale, with 5 stars representing the highest quality.
| CMS Measure | Star Rating |
|---|---|
| 2027 Overall Rating | |
| Staying Healthy: Screenings, Tests, Vaccines | Not enough data available |
| Managing Chronic (Long Term) Conditions | |
| 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 |
Contact Information for Devoted Health
- Website
- Devoted Health Plan Page
- Providers
- Devoted Health Providers Page
- Formulary
- Devoted Health Formulary Page
- Pharmacy
- Devoted Health Pharmacy Page
- New Member Health Plan Help
- (844)978-2770
- New Member Health Plan TTY
- 711
- New Member Part D Help
- (844)978-2770
- New Member Part D TTY Users
- 711
Enrollment status and eligibility information are available through the Social Security Administration. Additional information about Medicare Advantage is available at Medicare.gov.
Plan Availability
DEVOTED C-SNP CHOICE PLUS 031 TN (H7028-031-0) is available in the following locations (click to open):
Medicare Plan Data Sources and Methodology
| Data Source | Publisher | Last Accessed |
|---|---|---|
| Landscape Source Files | Centers for Medicare & Medicaid Services | October 5, 2026 |
| Medicare Part C & D Performance | Centers for Medicare & Medicaid Services | October 5, 2026 |
| Plan Benefits Package | Centers for Medicare & Medicaid Services | October 5, 2026 |
| Monthly Enrollment by Contract/Plan/State/County | Centers for Medicare & Medicaid Services | October 5, 2026 |
Data sources and methodology documentation.
| Publisher | Reference | Last Accessed |
|---|---|---|
| Devoted Health (official source) | http://www.Devoted.com | October 4, 2026 |
| CMS.gov | Chronic Condition Special Needs Plans (C-SNPs) | April 28, 2026 |
| Medicare.gov | Understanding Medicare Advantage Plans | April 28, 2026 |
| NCOA.org | 5 Steps to Choosing the Right Medicare Plan for You | April 28, 2026 |
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