DEVOTED GIVEBACK 003 IL (HMO)
The DEVOTED GIVEBACK 003 IL (HMO) is a 2026 HMO Medicare Advantage plan from Devoted Health with a $0 monthly premium and a 4-star CMS rating. It may include allowances for vision, otc / flex allowance, and part b giveback. It's available in 8 counties across 1 state.
Reviewed by the Medicare Advocates team · 2026 plan year · sourced from CMS data
Offered in 8 counties across 1 state
- Monthly premium$0
- Overall star rating4 / 5
- In-network max out-of-pocket$8,850
- Vision$100
- OTC / Flex allowance$304
- Part B giveback$2,216
2026 plan-year figures (premium, star rating, MOOP) from the CMS Landscape file; allowance amounts from CMS PBP data. Amounts vary by plan; not all plans offer all benefits.
What the DEVOTED GIVEBACK 003 IL (HMO) plan may include
- Vision: up to $100 per year in plan allowance (2026).
- OTC / Flex allowance: up to $304 per year in plan allowance (2026).
- Part B giveback: up to $2,216 per year in plan allowance (2026).
Costs & coverage detail
Annual Part D drug deductible: $605 (2026).
Doctor visits
- Specialist visit$45 copay
Emergency & urgent care
- Emergency room$115 copay
- Urgent care$0–$40 copay
Tests, labs & imaging
- Lab services$0–$65 copay
- Diagnostic tests & procedures$0–$95 copay
- X-rays$0–$75 copay
- Diagnostic radiology (CT/MRI/PET)$0–$300 copay
Outpatient hospital & surgery
- Outpatient hospital services$0–$575 copay
- Ambulatory surgical center$0–$475 copay
- Outpatient substance abuse (individual)$45 copay
Medical equipment & supplies
- Durable medical equipment (DME)20% coinsurance
Ambulance
- Ground ambulance$0–$350 copay
Vision
- Routine eye exam$0–$45 copay
Hearing
- Routine hearing exam$45 copay
- Hearing aids$599–$899 copay
Hospital stays
- Inpatient hospital$475/day, days 1–4; $0/day, days 5–90
- Skilled nursing facility (SNF)$0/day, days 1–20; $218/day, days 21–100
In-network, Medicare-covered cost sharing for the 2026 plan year (CMS PBP data). Costs vary by service and setting; see the Summary of Benefits for full detail.
Extra benefit allowances
- Eyewear allowance$100 per year
- Over-the-counter (OTC) allowance$76 per quarter
Preventive services
This plan covers $0 for all preventive services covered under Original Medicare when you use an in-network provider — including annual wellness visits, recommended screenings, and vaccines.
Common questions
- What is the DEVOTED GIVEBACK 003 IL (HMO) plan?
- It is a Medicare Advantage plan (CMS plan ID H7151-003-000) offered by Devoted Health for the 2026 plan year. Medicare Advantage plans bundle your Part A and Part B coverage, and most include extra benefits Original Medicare does not.
- What extra benefits could this plan include?
- Depending on the plan, supplemental benefits may include allowances toward vision, otc / flex allowance, part b giveback. Amounts shown are for the 2026 plan year and vary by plan and area. A licensed agent can confirm what is available to you.
- Where is this plan available?
- For 2026, this plan is offered in 8 counties across 1 state. Availability and benefits depend on your specific ZIP code.
- How do I enroll or compare plans?
- Call to speak with a licensed insurance agent who can review this plan alongside the other options in your area at no cost. There is no obligation to enroll, and enrollment may be limited to certain times of year unless you qualify for a Special Enrollment Period.
Counties served
Illinois (8 counties)
Cook, DuPage, Kane, Kankakee, Kendall, Lake, McHenry, Will
Plan documents
Official 2026 documents for this plan:
Ready when you are.
No cost. No pressure. There is no obligation to enroll.One Advocate, for as long as you’re on Medicare.