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Medicare Advantage Plans in Maricopa County, AZ

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H8173-001-000-2025
H6586-001-000-2025
H8173-019-000-2025

Want help enrolling? Give us a call.

Devoted CORE Arizona (HMO)

Summary of Benefits (PDF)
Updated September 12, 2024

Devoted CHOICE Arizona (PPO)

Summary of Benefits (PDF)
Updated September 12, 2024

Devoted GIVEBACK Arizona (HMO)

Summary of Benefits (PDF)
Updated September 12, 2024

Monthly premium

$0

$0

$0

Part B premium reduction

None

None

$162.60 per month back in your Social Security check

Annual out-of-pocket maximum

$5,900*

$5,900*, in-network


$8,950, in- and out-of-network

$9,350*

Food & Home Card

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

$20 per month

Not covered

Not covered

Dental & Eyewear

$500 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

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

Primary care provider (PCP) visits

$0 copay*

$0 copay*, in-network


$25 copay, out-of-network

$0 copay*

Specialist visits

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

$45 copay*

$40 copay*, in-network


$40 copay, out-of-network

$55 copay*

Inpatient hospital stays

In-network*:
Days 1 - 7
$230 copay per day

Day 8+
$0 copay per day

In-network*:
Days 1 - 7
$335 copay per day

Day 8+
$0 copay per day

Out-of-network:
Days 1 - 7
$335 copay per day

Day 8+
$0 copay per day

In-network*:
Days 1 - 4
$445 copay per day

Day 5+
$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.

$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: $5 per prescription
  • Tier 3: 25% 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: $10 per prescription
  • Tier 3: 25% 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: $5 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.