Plan year 2027 · Medicare AdvantageCMS files of Sept. 22 and Oct. 1, 2026

Devoted C-SNP Plus 016 MO, 2027

H2041Contract016Plan

HMO C-SNP · special needs plan, chronic or disabling condition · 81 counties in Missouri

Run by Devoted Health Plan of Missouri Inc (contract H2041), sold as Devoted Health, owned by Devoted Health, Inc.

Renews for 2027

2026 star rating, contract H2041: not rated (too new)

Devoted C-SNP Plus 016 MO (H2041-016) costs $0 a month in 2027, down $43 from 2026, with an in-network out-of-pocket limit of $9,850 ($9,250 in 2026).

What changes from 2026 to 2027?

The changed lines are marked and come first. In-network amounts; members keep paying the Part B premium unless the plan reduces it.
What you pay or get	2026	2027	Change
Monthly premium	$43	$0	down $43
In-network out-of-pocket limit	$9,250	$9,850	up $600
Drug deductible	$615	$461	down $154
Hospital stay, in network	$2,230 a stay	$2,241 a stay	up $11for a 5-day stay
Skilled nursing facility, in network	$0 a day for days 1–20, then $218 a day for days 21–100	$0 a day for days 1–20, then $221 a day for days 21–100	up $30for a 30-day stay
Ground ambulance, in network	0% of the cost	50% of the cost	changed
Counties served	59	81	up 22
Drug tier 1, preferred generic	$18	$0	down $18
Drug tier 2, generic	$19	$0	down $19
Drug tier 3, preferred brand	25% of the cost	15% of the cost	down 10 points
Drug tier 4, non-preferred drug	31% of the cost	25% of the cost	down 6 points
Drug tier 5, specialty tier	25% of the cost	26% of the cost	up 1 point
9 lines do not change
Part B premium reduction, monthly	none	none	no change
Primary care visit	$0 copay	$0 copay	no change
Specialist visit	30% of the cost	30% of the cost	no change
Emergency room	$115 copay	$115 copay	no change
Medical deductible, in network	none	none	no change
Comprehensive dental, yearly limit	not offered	not offered	no change
Eyewear, yearly limit	$300 a year	$300 a year	no change
Hearing aids, yearly limit for both ears	not offered	not offered	no change
Over-the-counter items, yearly	$200 a year	$200 a year	no change

Source: CMS Medicare Advantage and Part D landscape files for 2027 (Sept. 22, 2026, revised Sept. 30) and 2026 (Sept. 2, 2026 revision); CMS plan benefit package files, 2027 and 2026; CMS plan crosswalk from 2026 to 2027 (Oct. 1, 2026). Plan details can change during the year; confirm on Medicare Plan Finder.

What will prescriptions cost?

Your share for a 30-day supply at a retail pharmacy, as filed with CMS; tiers whose share changes are marked
Tier	What the tier holds	2026	2027
Tier 1	Preferred Generic	$18	$0
Tier 2	Generic	$19	$0
Tier 3	Preferred Brand	25% of the cost	15% of the cost
Tier 4	Non-Preferred Drug	31% of the cost	25% of the cost
Tier 5	Specialty Tier	25% of the cost	26% of the cost

Source: CMS plan benefit package files, 2027 and 2026. Insulin is capped at $35 a month by law. A drug's tier is set by the plan's formulary.

How does it compare with plans sold where it is?

In the counties it serves, 18 chronic or disabling condition special needs plans are sold for 2027, this one included. Against the others, 17 plans have a lower out-of-pocket limit. On the premium, 17 the same.

Out-of-pocket limits of the 18 chronic or disabling condition special needs plans

$0 to under $2,0000 plans

$2,000 to under $4,0005 plans

$4,000 to under $6,0008 plans

$6,000 to under $8,0004 plans

$8,000 to $10,000 (this plan)1 plan

Source: CMS Medicare Advantage and Part D landscape files for 2027 (Sept. 22, 2026, revised Sept. 30) and 2026 (Sept. 2, 2026 revision).

Where is it sold, and what does it cost there?

The premium and the out-of-pocket limit are the same in all 81 counties: $0 a month and $9,850.

Missouri

Source: CMS Medicare Advantage and Part D landscape files for 2027 (Sept. 22, 2026, revised Sept. 30) and 2026 (Sept. 2, 2026 revision).

Who runs this plan?

Plan ID: H2041-016
Legal name of the contract: Devoted Health Plan of Missouri Inc
Sold as: Devoted Health
Parent company: Devoted Health, Inc.
Plan type: HMO C-SNP
2026 star rating of the contract: not rated (too new) overall; health plan not rated, drug plan not rated
Members, September 2026: 1,576
Plan website, as filed with CMS: www.devoted.com

Source: CMS Medicare Advantage and Part D landscape files for 2027 (Sept. 22, 2026, revised Sept. 30) and 2026 (Sept. 2, 2026 revision); CMS 2026 Star Ratings (October 2025); CMS monthly enrollment by plan and by county, September 2026 (CMS hides counts under 11). CMS publishes the 2027 Star Ratings in October 2026.

What else should you check?

Other 2027 plans in Greene, MOWhere most of its members live; premiums and limits side by side
Every Devoted Health plan for 2027Its contracts, counties and plans that end
The other 26 plans of contract H2041Same company, same contract
Is your prescription covered?Coverage share and tier for 2,259 drugs

Data, not advice. These are the plan's filed amounts, not a quote for you; confirm on Medicare Plan Finder or call the plan before you enroll.