Medicare Advantage Plan H2845-005-0 in Okmulgee County, OK DEVOTED CHOICE 005 OK (PPO) • 2026
DEVOTED CHOICE 005 OK (PPO), CMS Plan-ID H2845-005-0, is a 2026 Medicare Advantage Plan (Part C), with prescription drug coverage, by Devoted Health. The plan uses a Preferred Provider Organization (PPO) provider network structure.
Based on the most recent CMS data, plan enrollments topped 214 members, with 0 in Okmulgee County, Oklahoma.
DEVOTED CHOICE 005 OK Overview
Plan Overview for H2845-005-0 |
|
|---|---|
| CMS Plan ID: |
H2845-005-0
|
| Plan Type: | PPO |
| Plan Year: | 2026 |
| Monthly Premium: |
$0.00
Plus your Medicare Part B premium. |
| Medical Deductible: | $0.00 |
| Maximum Out-of-Pocket: | $4900.00 (In-Network) |
| Part B Give Back: | Not offered |
| Prescription Drug Coverage: | Enhanced, $375.00 deductible |
| Additional Benefits: | Dental, Vision, Hearing |
| Service Area: | Okmulgee County, OK |
| Enrollment (Nationwide): | 214 beneficiaries |
| Enrollment (CMS – Local) | 0 beneficiaries in Okmulgee County |
| Provided By: | Devoted Health |
To learn more about your plan options, costs, and enrollment periods without agent assistance, try our helpful Medicare Resources below (click to open).
Frequently Asked Questions About DEVOTED CHOICE 005 OK (PPO)
Here are some of the most frequently asked questions people have about Plan ID H2845-005-0:
How much does DEVOTED CHOICE 005 OK cost per month?
DEVOTED CHOICE 005 OK has a $0.00 monthly premium for 2026. You must also continue to pay any Medicare Part B premium you owe.
How much could I pay out of pocket with DEVOTED CHOICE 005 OK?
The in-network maximum out-of-pocket (MOOP) limit for DEVOTED CHOICE 005 OK is $4900.00 in 2026. After you reach this limit, the plan pays covered in-network Part A and Part B costs for the remainder of the year.
Does Plan ID H2845-005-0 cover prescription drugs?
Yes. Plan ID H2845-005-0 includes Medicare Part D prescription drug coverage, with a $375.00 deductible for 2026.
What is the CMS Star Rating for DEVOTED CHOICE 005 OK?
Contract H2845, which includes this plan, has a ★0.0 out of 5 CMS Star Rating for 2026.
What type of network does Plan ID H2845-005-0 have?
Plan ID H2845-005-0 uses a Preferred Provider Organization (PPO) provider network.
How many people are enrolled in DEVOTED CHOICE 005 OK?
The most recent CMS enrollment data shows approximately 214 beneficiaries enrolled in this plan.
Which insurance company offers Plan ID H2845-005-0?
Plan ID H2845-005-0 is offered by Devoted Health.
Covered Services & Costs
Office Visits
This plan lists in-network cost sharing for primary care and specialist visits, along with related office-based services.
| Covered Service | In-Network Cost |
|---|---|
| Primary: | In-network: $0 copay | Out-of-network: $5 copay |
| Specialist: | In-network: $35 copay | Out-of-network: $35 copay |
Preventive and Wellness Services
Preventive and wellness benefits may include routine exams, telehealth, fitness programs, health education, and other in-network services.
| Covered Service | In-Network Cost |
|---|---|
| Annual wellness exam: | In-network: $0 copay |
| Telehealth benefit: | In-network: $0-$45 copay |
| Routine chiropractic: | Not covered |
| Fitness benefits: | In-network: $0 copay | Out-of-network: $0 copay, 0% coinsurance |
| Health education: | In-network: $0 copay | Out-of-network: $0 copay, 0% coinsurance |
| Counseling services: | Not covered |
| Over-the-counter drug benefits: | In-network: $0 copay | Out-of-network: $0 copay, 0% coinsurance |
| Health transportation (non-emergency): | Not covered |
Diagnostic, Lab, and Imaging Services
Diagnostic coverage includes in-network cost sharing for lab tests, x-rays, radiology, and other diagnostic procedures used to evaluate health conditions.
| Covered Service | In-Network Cost |
|---|---|
| Diagnostic radiology services: | In-network: $0-$300 copay | Out-of-network: $0-$300 copay |
| Lab services: | In-network: $0-$20 copay | Out-of-network: $0-$20 copay, 20% coinsurance |
| Outpatient x-rays: | In-network: $0-$75 copay | Out-of-network: $0-$75 copay |
| Diagnostic tests and procedures: | In-network: $0-$95 copay | Out-of-network: $0-$95 copay |
Emergency and Urgent Care Services
Emergency and inpatient coverage includes cost sharing for urgent care, emergency room visits, ambulance transportation, hospital stays, and skilled nursing facility care.
| Covered Service | In-Network Cost |
|---|---|
| Emergency room care: | $130 copay |
| Worldwide emergency care: | $130 copay |
| Urgent care: | $0-$45 copay |
| Inpatient hospital care: | In-network: | Tier 1 | $295 per day for days 1-6 | $0 per day for days 7-90 | $0 per stay | Out-of-network: | $295 per day for days 1-6 | $0 per day for days 7-90 | $0 per stay |
| Skilled Nursing Facility: | In-network: | Tier 1 | $0 per day for days 1-20 | $218 per day for days 21-100 | Out-of-network: | 35% per stay |
| Ground ambulance: | In-network: $0-$315 copay | Out-of-network: $0-$315 copay |
Mental Health Services
Mental health coverage includes in-network cost sharing for outpatient individual and group therapy, as well as inpatient psychiatric hospital care.
| Covered Service | In-Network Cost |
|---|---|
| Outpatient individual therapy: | In-network: $35 copay | Out-of-network: $35 copay |
| Outpatient group therapy: | In-network: $35 copay | Out-of-network: $35 copay |
| Inpatient psychiatric hospital care: | In-network: | Tier 1 | $295 per day for days 1-6 | $0 per day for days 7-90 | $0 per stay | Out-of-network: | $295 per day for days 1-6 | $0 per day for days 7-90 | $0 per stay |
Rehabilitation Services
Rehabilitation coverage includes in-network cost sharing for physical therapy, speech and language therapy, and occupational therapy services.
| Covered Service | In-Network Cost |
|---|---|
| Physical therapy and speech and language therapy: | In-network: $35-$50 copay | Out-of-network: $35-$50 copay |
| Occupational therapy: | In-network: $35-$50 copay | Out-of-network: $35-$50 copay |
Medical Equipment and Supplies
Medical equipment coverage includes in-network cost sharing for diabetes supplies, durable medical equipment, prosthetics, and related supplies.
| Covered Service | In-Network Cost |
|---|---|
| Diabetes supplies: | In-network: 0%-25% coinsurance | Out-of-network: 25%-35% coinsurance |
| Durable medical equipment: | In-network: 20%-25% coinsurance | Out-of-network: 35% coinsurance |
| Prosthetics: | In-network: 0%-20% coinsurance | Out-of-network: 0%-40% coinsurance |
Medicare Part B Drugs
Medicare Part B drug coverage includes in-network cost sharing for chemotherapy and other medications covered under Medicare Part B.
| Covered Service | In-Network Cost |
|---|---|
| Chemotherapy: | In-network: 0%-20% coinsurance | Out-of-network: 40% coinsurance |
| Other Part B drugs (Medicare-covered): | In-network: 0%-20% coinsurance | Out-of-network: 0%-40% coinsurance |
Dental Services
Dental coverage includes in-network cost sharing for preventive care, exams, x-rays, cleanings, and comprehensive dental procedures.
| Covered Service | In-Network Cost |
|---|---|
| Oral exam: | In-network: $0 copay | Out-of-network: $0 copay, 0% coinsurance |
| Dental x-rays: | In-network: $0 copay | Out-of-network: $0 copay, 0% coinsurance |
| Cleaning: | In-network: $0 copay | Out-of-network: $0 copay, 0% coinsurance |
| Periodontics: | In-network: $0 copay | Out-of-network: $0 copay, 0% coinsurance |
| Endodontics: | In-network: 0%-50% coinsurance | Out-of-network: 0%-50% coinsurance |
| Restorative services: | In-network: 0%-50% coinsurance | Out-of-network: 0%-50% coinsurance |
| Implant services: | Not covered |
| Orthodontics: | Not covered |
| Oral/Maxillofacial surgery: | In-network: $0 copay | Out-of-network: $0 copay, 0% coinsurance |
Vision Services
Vision coverage includes in-network cost sharing for routine eye exams, contact lenses, eyeglass frames and lenses, and related eyewear services.
| Covered Service | In-Network Cost |
|---|---|
| Routine eye exam: | In-network: $0 copay | Out-of-network: $0 copay, 0% coinsurance |
| Contact lenses: | In-network: $0 copay | Out-of-network: $0 copay, 0% coinsurance |
| Eyeglass frames only: | In-network: $0 copay | Out-of-network: $0 copay, 0% coinsurance |
| Eyeglass lenses only: | In-network: $0 copay | Out-of-network: $0 copay, 0% coinsurance |
| Eyeglasses (frames & lenses): | In-network: $0 copay | Out-of-network: $0 copay, 0% coinsurance |
| Upgrades: | In-network: $0 copay | Out-of-network: $0 copay, 0% coinsurance |
Hearing Services
Hearing coverage includes in-network cost sharing for hearing exams, fittings and evaluations, prescription hearing aids, and over-the-counter hearing aids.
| Covered Service | In-Network Cost |
|---|---|
| Hearing exam: | In-network: $0 copay | Out-of-network: $0 copay, 0% coinsurance |
| Fitting/evaluation: | In-network: $0 copay | Out-of-network: $0 copay, 0% coinsurance |
| Prescription hearing aids: | In-network: $399-$699 copay | Out-of-network: $399-$699 copay |
| OTC hearing aids: | Not covered |
Additional and Special Needs Services
Additional benefits may include in-network services for adult day health, palliative care, personal emergency response systems, weight management, alternative therapies, and home safety needs.
| Covered Service | In-Network Cost |
|---|---|
| Adult day health services: | Not covered |
| Home-based palliative care: | Not covered |
| Personal emergency response system: | Not covered |
| Weight management programs: | In-network: $0 copay | Out-of-network: $0 copay, 0% coinsurance |
| Wigs for chemotherapy-related hair loss: | Not covered |
| Alternative therapies: | In-network: $0 copay | Out-of-network: $0 copay, 0% coinsurance |
| Massage therapy: | Not covered |
| Home/bathroom safety devices: | In-network: $0 copay | Out-of-network: 35% coinsurance |
DEVOTED CHOICE 005 OK covers 100% of certain preventive services as a required Part B benefit.
Prescription Drug Coverage
Part D Coverage Level (Benefit Design)
DEVOTED CHOICE 005 OK includes an enhanced benefit Medicare Part D plan (PDP). Enhanced plans have a higher actuarial value than basic plans. Actuarial value simply refers to the percentage of cost that's covered by the plan.
Plan Premium
The following table outlines the prescription drug plan premium details of this plan.
| Part D Premium Component | Amount |
|---|---|
| Basic Part D Premium: | $-30.20 |
| Supplemental Part D Premium: | $30.20 |
| Total Part D Premium: | $0.00 |
| Low Income Premium Subsidy: | $28.24 |
| Low Income Premium Subsidy CMS Pays: | $0.00 |
| Low Income Subsidy Premium: | $0.00 |
For more information about the Low Income Subsidy, refer to the Social Security Extra Help page.
Plan Deductible
The Medicare Part D annual deductible with this plan is $375.00. This is the amount you must pay at the pharmacy before Devoted Health begins paying its share.
Out-of-Pocket Costs
In addition to the plan's monthly premium and deductible, DEVOTED CHOICE 005 OK has out-of-pocket costs that you must pay when you pick up your prescriptions. The following table shows you those costs.
| Drug Tier | Retail | Mail Order |
|---|---|---|
| Preferred Generic | $0.00 copay | Coming soon |
| Generic | $0.00 copay | Coming soon |
| Preferred Brand | 19% coinsurance | Coming soon |
| Non-Preferred Drug | 25% coinsurance | Coming soon |
| Specialty Tier | 28% coinsurance | Coming soon |
| *Deductible does not apply. | ||
CMS Medicare Star Ratings
Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates Medicare Advantage PPOs across nine broad categories using a 5-star rating system. These star ratings provide insight into the quality of care and service you can expect from this Devoted Health plan.
| CMS Measure | Star Rating |
|---|---|
| 2026 Overall Rating | |
| Staying Healthy: Screenings, Tests, Vaccines | Plan too new to be measured |
| Managing Chronic (Long Term) Conditions | Plan too new to be measured |
| Member Experience with Health Plan | Plan too new to be measured |
| Complaints and Changes in Plans Performance | Plan too new to be measured |
| Health Plan Customer Service | Plan too new to be measured |
| Drug Plan Customer Service | Plan too new to be measured |
| Complaints and Changes in the Drug Plan | Plan too new to be measured |
| Member Experience with the Drug Plan | Plan too new to be measured |
| Drug Safety and Accuracy of Drug Pricing | Plan too new to be measured |
Contact Devoted Health
Call 833-748-3201 (TTY 711) to speak with a licensed HealthCompare insurance agent (M-F 8AM-10PM, Sat 9AM-8PM EST) and learn more about this plan and other plans on this site. You may also Enroll Online .
| Contact Type | Details |
|---|---|
| Website: | Devoted Health Plan Page |
| New Members: | 1-844-978-2770 |
| Existing Members: | 1-800-338-6833 |
| Plan Address: | Devoted Health | PO Box 211037 | Eagan, MN 55121 |
Medicare Plan Decision Resources
Medicare Plan Data Sources and Methodology
| Data Source | Publisher | CMS Version |
|---|---|---|
| Landscape Source Files | Centers for Medicare & Medicaid Services | 202608 |
| Medicare Part C & D Performance | Centers for Medicare & Medicaid Services | 2026 |
| Plan Benefits Package | Centers for Medicare & Medicaid Services | 2026 |
| Monthly Enrollment by Contract/Plan/State/County | Centers for Medicare & Medicaid Services | 2026-08 |
| Publisher | Reference | Last Accessed |
|---|---|---|
| Devoted Health (official source) | http://www.devoted.com | October 13, 2025 |
| CMS.gov | Medicare Advantage Plan Fact Sheet | 25 May, 2025 |
| Medicare.gov | Joining a plan | 25 May, 2025 |
| Medicare.gov | Your coverage options | 25 May, 2025 |
Medicare.org independently compiles and interprets Medicare plan information using data published by the Centers for Medicare & Medicaid Services (CMS), official plan information, and other authoritative Medicare sources. The sources used for this plan are documented below.
Medicare.org is an independent Medicare information and enrollment resource and is not affiliated with or endorsed by the U.S. Government or the federal Medicare program. Enrollment assistance is provided through HealthCompare, an Allstate company.
Medicare plan data and editorial content curated and maintained by David W. Bynon, Editorial Steward, using a standardized, data-driven methodology for Medicare plan interpretation and publication.