DEVOTED CHOICE GIVEBACK 004 NC (PPO)
Medicare Advantage PPO with drug coverage · Devoted Health
Plan IDH9700-004-0
$0monthly premium, 2026
$8,000in-network out-of-pocket max
$605drug deductible
–plan too new to be measured
Costs
- Part C premium
- $0
- Part D premium
- $0 (basic −$30.40, supplemental $30.40)
- Total monthly premium
- $0
- Out-of-pocket maximum
- $8,000.00
- Drug deductible
- $605
- Extra Help premium subsidy
- $36.17
Plan details
- Plan type
- PPO
- Drug coverage
- Yes (enhanced alternative)
- Organization
- Devoted Health, Inc. · DEVOTED HEALTH PLAN OF NORTH CAROLINA INC
- Region
- North Carolina and Virginia
Where this plan is available
North Carolina: Alamance, Caswell, Davidson, Davie, Forsyth, Guilford, Person, Randolph, Rockingham, Stokes, Yadkin
Other plans under contract H9700
| Plan | Monthly premium | Out-of-pocket max | Drug deductible | Star rating |
|---|---|---|---|---|
| DEVOTED CHOICE 001 NC (PPO)Devoted Health · H9700-001-0 · PPO | $0 | $5,400 | $370 | Plan Too New To Be Measured |
| DEVOTED CHOICE GIVEBACK 002 NC (PPO)Devoted Health · H9700-002-0 · PPO | $0 | $8,000 | $605 | Plan Too New To Be Measured |
| DEVOTED CHOICE 003 NC (PPO)Devoted Health · H9700-003-0 · PPO | $0 | $4,500 | $370 | Plan Too New To Be Measured |
| DEVOTED CHOICE 005 NC (PPO)Devoted Health · H9700-005-0 · PPO | $0 | $5,300 | $370 | Plan Too New To Be Measured |
| DEVOTED CHOICE GIVEBACK 006 NC (PPO)Devoted Health · H9700-006-0 · PPO | $0 | $8,000 | $605 | Plan Too New To Be Measured |
| DEVOTED CHOICE MA ONLY 007 NC (PPO)Devoted Health · H9700-007-0 · PPO | $0 | $9,250 | no drug coverage | Plan Too New To Be Measured |
| DEVOTED CHOICE 008 NC (PPO)Devoted Health · H9700-008-0 · PPO | $0 | $5,900 | $270 | Plan Too New To Be Measured |
| DEVOTED CHOICE GIVEBACK 009 NC (PPO)Devoted Health · H9700-009-0 · PPO | $0 | $9,250 | $605 | Plan Too New To Be Measured |
Questions and answers
What is the monthly premium for DEVOTED CHOICE GIVEBACK 004 NC (PPO)?
For 2026 the plan premium is $0 a month in addition to the Medicare Part B premium.
What is the maximum out-of-pocket for DEVOTED CHOICE GIVEBACK 004 NC (PPO)?
The in-network maximum out-of-pocket limit is $8,000.00.
What is the drug deductible?
The annual Part D deductible is $605.
What is the star rating of DEVOTED CHOICE GIVEBACK 004 NC (PPO)?
No overall rating: plan too new to be measured.
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