Medicare Advantage Plans in Fort Bend, TX

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H7993-006-000-2025
H7993-019-000-2025

Want help enrolling? Give us a call.

1-800-990-0723 (TTY 711)

Devoted GIVEBACK Greater Houston (HMO)

Summary of Benefits (PDF)
Updated September 12, 2024

Devoted EXTRA Greater Houston (HMO)

Summary of Benefits (PDF)
Updated September 12, 2024

Monthly premium

$0

$0

Part B premium reduction

$174.70 per month back in your Social Security check

None

Annual out-of-pocket maximum

$7,200*

$4,900*

Food & Home Card

Pre-loaded card for purchase of food, over-the-counter, utilities, and mortgage or rent.**

Not covered

$87 per month

Dental & Eyewear

$250 per year for dental and eyewear coverage, for use at any dentist or eyewear retailer

$1,000 per year for dental and eyewear coverage, for use at any dentist or eyewear retailer

Primary care provider (PCP) visits

$0 copay*

$0 copay*

Specialist visits

Cost shares for Balance Exams with a Specialist may differ. See your Summary of Benefits for details.

$45 copay*


A referral from your PCP may be required to see a specialist. 

$30 copay*


A referral from your PCP may be required to see a specialist. 

Inpatient hospital stays

In-network*:
Days 1 - 5
$425 copay per day

Day 6+
$0 copay per day

In-network*:
Days 1 - 5
$325 copay per day

Day 6+
$0 copay per day

Pharmacy (Part D) Deductible

$590 for Tiers 3-5 only


If you receive Extra Help from Medicare, your deductible is $0.


The deductible does not apply to covered Part D insulins and most adult Part D vaccines.

$590 for Tiers 3-5 only


If you receive Extra Help from Medicare, your deductible is $0.


The deductible does not apply to covered Part D insulins and most adult Part D vaccines.

30-Day Supply Retail Pharmacy

For Part D prescriptions. If you get Extra Help from Medicare, your costs may be lower.

  • Tier 1: $0 per prescription
  • Tier 2: $1 per prescription
  • Tier 3: 20% of the total cost
  • Tier 4: 25% of the total cost
  • Tier 5: 25% of the total cost

  • Tier 1: $0 per prescription
  • Tier 2: $0 per prescription
  • Tier 3: 25% of the total cost
  • Tier 4: 25% of the total cost
  • Tier 5: 25% of the total cost

*When you use an in-network provider or pharmacy.

Next Steps

Now that you know what our plans are all about, you can:

And if you have any questions, call us at (1-800-990-0723) (TTY 711) You can also see and compare more plan options at www.Medicare.gov.