DEVOTED DUAL CHOICE FULL 004 UT (PPO D-SNP) in Salt Lake County, Utah — 2026 plan details
Last updated Jul 18, 2026
Reviewed by Jason Burns, Editorial Steward
Published by Senior Direct Answers · Licensed under Citation License 1.0
DEVOTED DUAL CHOICE FULL 004 UT (PPO D-SNP) (H4473-004) is a $34-premium Medicare Advantage PPO D-SNP from Devoted Health, Inc. available in Salt Lake County, Utah in 2026, with a —-star overall rating, a $9,250 in-network out-of-pocket maximum, and a $615 annual Part D drug deductible.
Plan facts (CMS CY2026 Landscape file)
| Organization | Devoted Health, Inc. |
|---|---|
| Plan name | DEVOTED DUAL CHOICE FULL 004 UT (PPO D-SNP) |
| Contract ID | H4473 |
| Plan ID | 004 |
| Segment ID | 0 |
| Contract year | 2026 |
| Contract category | SNP |
| Plan type | PPO D-SNP |
| SNP | Yes — Dual-Eligible |
| Monthly consolidated premium | $34.40 |
| Part C premium | $0.00 |
| Part D basic premium | $34.40 |
| Part D total premium | $34.40 |
| Annual Part D deductible | $615.00 |
| Maximum out-of-pocket (in-network) | $9250.00 |
| Overall star rating | — |
How this plan is structured
- $34 consolidated premium. A $0 or near-$0 consolidated premium does not remove the Part B premium — the standard 2026 Part B premium is $202.90 per month and still applies. See the 2026 Medicare Part B premium.
- PPO D-SNP plan type. Plan-type rules determine in-network use and referrals. See how Medicare Advantage HMO and PPO plans differ.
- $9,250 in-network out-of-pocket maximum. The MOOP is the annual cap on what a member pays in-network for covered Part A and Part B services. See how the Medicare Advantage MOOP works.
- Service area = Salt Lake County. Medicare Advantage plans are sold by service area; moving out of the plan's service area triggers a Special Enrollment Period to switch plans. See how moving changes your Medicare options.
How it compares in Salt Lake County
The CMS CY2026 Landscape file lists 48 Medicare Advantage plans in Salt Lake County, Utah, of which 0 carry a 5.0-star overall rating and 26 have a $0 consolidated monthly premium. Consolidated premiums range from $0.00 to $135.00 per month, and in-network out-of-pocket maximums range from $3500.00 to $9250.00.
For the full county plan directory, see all Medicare plans in Salt Lake County, Utah.
How to verify your doctors take this plan
Network participation changes throughout the year; we hold no provider-network data, so verify directly with these three sources before you decide:
- Open the plan's official Medicare.gov page and use its provider-directory link: Medicare.gov Plan Finder — H4473-004.
- Call the plan (Devoted Health, Inc.) using the member-services number listed on that plan page and ask whether each doctor, hospital, and pharmacy is in-network for 2026.
- Get free, unbiased help from your State Health Insurance Assistance Program (SHIP) — see free unbiased Medicare help from SHIP.
What H4473-004 means
CMS assigns every Medicare Advantage and Part D offering a plan identifier made of three parts. In H4473-004, the leading H marks the contract type (H = Medicare Advantage / Part C contract), the four digits 4473 are the contract number issued to the organization, and the three-digit 004 is the plan benefit package under that contract. The segment ID 0 identifies the service-area segment within the plan (0 = the default single segment).
Frequently asked questions
Is DEVOTED DUAL CHOICE FULL 004 UT (PPO D-SNP) an HMO or PPO?
DEVOTED DUAL CHOICE FULL 004 UT (PPO D-SNP) is a PPO D-SNP Medicare Advantage plan.
Does DEVOTED DUAL CHOICE FULL 004 UT (PPO D-SNP) include prescription drug coverage?
Yes — DEVOTED DUAL CHOICE FULL 004 UT (PPO D-SNP) is a Medicare Advantage plan with prescription drug coverage (MA-PD) and a $615.00 annual Part D drug deductible for 2026.
What is the maximum out-of-pocket cost for DEVOTED DUAL CHOICE FULL 004 UT (PPO D-SNP)?
The 2026 in-network maximum out-of-pocket limit for DEVOTED DUAL CHOICE FULL 004 UT (PPO D-SNP) is $9250.00, per the CMS CY2026 Landscape file.
What counties offer DEVOTED DUAL CHOICE FULL 004 UT (PPO D-SNP) (H4473-004)?
DEVOTED DUAL CHOICE FULL 004 UT (PPO D-SNP) (H4473-004) is offered in six Utah counties: Davis County, Morgan County, Salt Lake County, Summit County, Tooele County, and Wasatch County.
Sources
- CMS, Plan Year 2026 Medicare Advantage & Part D Landscape source file (March 2026) — retrieved 2026-07-18. Overall star rating year: 2026.
- Medicare.gov Plan Finder — compare plans and enroll.