Skip to content

We have 3 plans in Miami-Dade County.

Viewing
Miami-Dade Essentials HMO
Miami-Dade HMO
Miami-Dade Prime HMO

Want help enrolling? Give us a call.

Miami-Dade Essentials HMO

Full Plan Information (PDF)

Miami-Dade HMO

Full Plan Information (PDF)

Miami-Dade Prime HMO

Full Plan Information (PDF)

Monthly Premium

$0
And your Part B premium is reduced by up to $95 per month.

$0
You must continue to pay your Part B premium.

$28.50
If you get Extra Help from Medicare, it may lower your Devoted premium. You must continue to pay your Part B premium.

Pharmacy (Part D) Deductible

$0

$0

$435 for Tiers 3-5 only
If you get full Extra Help (LIS 1-3), you won’t have a deductible. If you get partial Extra Help (LIS 4), you’ll have an $89 deductible.

Part B Giveback

This amount goes back into your Social Security check each month.

Up to $95 per month

None

None

30-Day Supply Retail Pharmacy

If you get Extra Help from Medicare, your costs may be lower.

  • Tier 1: $0 copay*
  • Tier 2: $0 copay*
  • Tier 3: $30 copay*
  • Tier 4: $85 copay*
  • Tier 5: 33% of drug cost*
  • Tier 1: $0 copay*
  • Tier 2: $0 copay*
  • Tier 3: $0 copay*
  • Tier 4: $35 copay*
  • Tier 5: 33% of drug cost*
  • Tier 1: $0 copay*
  • Tier 2: $0 copay*
  • Tier 3: 25% of drug cost*
  • Tier 4: 25% of drug cost*
  • Tier 5: 25% of drug cost*

90-Day Supply Mail-order Pharmacy

If you get Extra Help from Medicare, your costs may be lower.

  • Tier 1: $0 copay*
  • Tier 2: $0 copay*
  • Tier 3: $60 copay*
  • Tier 4: $255 copay*
  • Tier 5: Not available through mail
  • Tier 1: $0 copay*
  • Tier 2: $0 copay*
  • Tier 3: $0 copay*
  • Tier 4: $105 copay*
  • Tier 5: Not available through mail
  • Tier 1: $0 copay*
  • Tier 2: $0 copay*
  • Tier 3: 25% of drug cost*
  • Tier 4: 25% of drug cost*
  • Tier 5: Not available through mail

Erectile Dysfunction Drugs

Sildenafil (generic Viagra) is covered as a Tier 2 medication for up to 6 pills a month.

$0 copay*

$0 copay*

$0 copay*

Annual Out-of-Pocket Maximum

This is the most you'd pay in a year for covered medical services. Once you reach it, your plan pays all the costs.

$3,400*
What you pay out-of-pocket for Part D prescription drugs does not apply to this amount.

$1,500*
What you pay out-of-pocket for Part D prescription drugs does not apply to this amount.

$3,400*
What you pay out-of-pocket for Part D prescription drugs does not apply to this amount.

Primary Care Provider (PCP) Visits

$0 copay*

$0 copay*

$0 copay*

Specialist Visits

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

$10 copay*

$0 copay*

$0 copay*

Inpatient Hospital Stays

  • Days 1-2: $0 copay*
  • Days 3-7: $125 copay per day*
  • Day 8+: $0 copay*

$0 copay per stay*

$0 copay per stay*

Urgent Care

Urgently needed services are provided to treat a non-emergency, unforeseen medical illness, injury or condition that requires immediate care.

$15 copay

$0 copay

$0 copay

Emergency Room Visit

If you are admitted to the hospital within 24 hours, you do not have to pay your share of the cost for the emergency care.

$90 copay

$50 copay

$25 copay

Outpatient Surgery

  • $50 copay at an ambulatory surgery center*
  • $75 copay at an outpatient hospital setting*
  • $15 copay at an ambulatory surgery center*
  • $50 copay in an outpatient hospital setting*

$0 copay*

Labs

  • $0 copay in an office or free-standing location*
  • $25 copay at an outpatient hospital setting*
  • $0 copay in an office or free-standing location*
  • $15 copay at an outpatient hospital setting*

$0 copay*

X-rays

  • $0 copay in an office or free-standing location*
  • $25 copay at an outpatient hospital setting*
  • $0 copay in an office or free-standing location*
  • $15 copay at an outpatient hospital setting*

$0 copay*

Diagnostic Tests and Procedures

  • $0 copay in an office or free-standing location*
  • $25 copay at an outpatient hospital setting*
  • $0 copay in an office or free-standing location*
  • $15 copay at an outpatient hospital setting*

$0 copay*

Dental Services

  • $0 copay for dental services*
  • As much as $750 per year for dental services*
  • $0 copay for preventative dental services*
  • As much as $1,000 per year for comprehensive dental services*
  • $0 copay for preventative dental services*
  • As much as $1,000 per year for comprehensive dental services*

Vision Benefit

  • $0 copay for routine eye exams* (1 visit per year)
  • Up to $150 each year for eyeglasses or contacts. Fitting for contact lenses covered at no additional cost.*
  • $0 copay for routine eye exams* (1 visit per year)
  • Up to $300 each year for eyeglasses or contacts. Fitting for contact lenses covered at no additional cost.*
  • $0 copay for routine eye exams* (1 visit per year)
  • Up to $350 each year for eyeglasses or contacts. Fitting for contact lenses covered at no additional cost.*

Hearing Aid Benefit

$1,000 a year*
($500 per ear)

$1,500 a year*
($750 per ear)

$1,500 a year*
($750 per ear)

Over-the-counter Benefit

For items like toothpaste, vitamins, blood pressure cuffs, and more

$25 per month*

$75 per month*

$100 per month*

Rides to and from Your Doctor

$0 copay*
Unlimited rides

$0 copay*
Unlimited rides

$0 copay*
Unlimited rides

Fitness Benefit

  • $0 SilverSneakers Membership*
  • $150 a year in Wellness Bucks for classes, programs, and wearable devices like an Apple Watch*
  • $0 SilverSneakers Membership*
  • $150 a year in Wellness Bucks for classes, programs, and wearable devices like an Apple Watch*
  • $0 SilverSneakers Membership*
  • $150 a year in Wellness Bucks for classes, programs, and wearable devices like an Apple Watch*

Acupuncture

You must use an in-network provider.

$0 copay*
Up to 12 visits per year

$0 copay*
Up to 12 visits per year

$0 copay*
Up to 12 visits per year

Personal Emergency Response System (PERS)

A device that lets you call for emergency help by pressing a button.

$0 copay*

$0 copay*

$0 copay*

*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)