Original Medicare vs a plan · Harris County, TX · 2027 plan year

Original Medicare vs DEVOTED GIVEBACK 006 TX (HMO)

Medicare.gov compares Medicare Advantage plans with each other. This page also shows Original Medicare, so you can see the full trade-off: premiums, copays, the yearly limit, extra benefits, and the rules about doctors and approvals.

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DEVOTED GIVEBACK 006 TX (HMO)

Plan premium
$0 a month
Yearly limit, in network
$8,300
2027 star rating
4.5 of 5
Prior authorization needed for
24 services

In most states, including Texas, you cannot count on getting Medigap later

You can buy any Medigap plan with no health questions in the 6 months that start when you are 65 or older and have Part B. After that, a Medigap company in Texas can ask about your health. It can say no, or it can charge you more. So if you join a Medicare Advantage plan now, you may not be able to get Medigap later.

One exception is the trial right. If you joined Medicare Advantage when you first got Medicare at 65, or you left a Medigap plan to try Medicare Advantage for the first time, you can switch back within 12 months. Then you can buy a Medigap plan with no health questions.

Read about Medigap rights on Medicare.gov

Your yearly cost, side by side

Move the controls to match your year. Totals include premiums, the Part B premium, copays, and drug costs.

How much care do you expect?

Ongoing specialist care

Medigap plan with Original Medicare

Plan G pays almost everything after the $292 yearly Part B deductible.

Want to check your exact drugs? Medicare.gov lets you enter each drug and shows what each plan charges for it. Enter your drugs on Medicare.gov

Medicare.gov lists $143 to $680 a month for a 65-year-old woman who does not use tobacco. We start at the lowest price. Health questions can raise the price after your first 6 months with Part B.

Original Medicare

With Medigap Plan G at $143 a month and Wellcare Value Script (PDP)

$6,761 a year

Premiums
$4,294
Medical costs
$292
Drugs
$2,175

Most you can pay in a bad year, before drugs: $4,586.

DEVOTED GIVEBACK 006 TX (HMO)

HMO from Devoted Health

$3,251 a year

Premiums
$90
Medical costs
$1,779
Drugs
$1,382

Most you can pay in a bad year, before drugs: $8,390.

With these settings, DEVOTED GIVEBACK 006 TX (HMO) costs about $3,510 less a year than Original Medicare.

Tipping point for DEVOTED GIVEBACK 006 TX (HMO): with this drug use, if your medical copays and coinsurance in this plan pass $5,289 in a year, Original Medicare with Plan G costs less. The plan caps those costs at $8,300.

These are estimates, not quotes. Check every number with Medicare (Medicare.gov or 1-800-MEDICARE) and with the plan before you choose. What you pay depends on your doctors and hospitals, your drugs and pharmacy, and the care you use. Drug costs use typical prices for generic and brand-name drugs. Original Medicare amounts are 2027 projections from the 2026 Medicare Trustees Report. CMS sets the final amounts in November.

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What you pay each time you get care

In-network costs for one visit or one stay. The Original Medicare amounts follow your Medigap choice above: Plan G.

Primary doctor visit

  • Original Medicare + Medigap Plan G

    $0

    after the $292 yearly Part B deductible

  • DEVOTED GIVEBACK 006 TX (HMO)

    $0 copay

Specialist visit

  • Original Medicare + Medigap Plan G

    $0

    after the $292 yearly Part B deductible

  • DEVOTED GIVEBACK 006 TX (HMO)

    $45

    Prior authorization

Lab tests

  • Original Medicare + Medigap Plan G

    $0

    most Medicare-covered tests

  • DEVOTED GIVEBACK 006 TX (HMO)

    $0-$45 or 20%

    Prior authorization

MRI or CT scan

  • Original Medicare + Medigap Plan G

    $0

    after the $292 yearly Part B deductible

  • DEVOTED GIVEBACK 006 TX (HMO)

    $25-$300

    Prior authorization

Emergency room

  • Original Medicare + Medigap Plan G

    $0

    after the $292 yearly Part B deductible

  • DEVOTED GIVEBACK 006 TX (HMO)

    $115

Urgent care

  • Original Medicare + Medigap Plan G

    $0

    after the $292 yearly Part B deductible

  • DEVOTED GIVEBACK 006 TX (HMO)

    $0-$40

Outpatient surgery

  • Original Medicare + Medigap Plan G

    $0

    after the $292 yearly Part B deductible

  • DEVOTED GIVEBACK 006 TX (HMO)

    $0-$425

    Prior authorization

Ground ambulance

  • Original Medicare + Medigap Plan G

    $0

    after the $292 yearly Part B deductible

  • DEVOTED GIVEBACK 006 TX (HMO)

    $0-$375

    Prior authorization

Hospital stay, 5 days

  • Original Medicare + Medigap Plan G

    $0

    Plan G pays the $1,788 Part A deductible

  • DEVOTED GIVEBACK 006 TX (HMO)

    $2,125

    for a 5-day stay

    Prior authorization
See every cost in one table
What you pay in networkOriginal Medicare + Medigap Plan GDEVOTED GIVEBACK 006 TX (HMO)
Monthly premiumPart B $209.50 + Medigap Plan G $143 + drug plan $5.30$0 (pays back $202 a month of your Part B premium) + Part B $209.50
Yearly limit on what you payYou pay the $292 Part B deductible. Plan G pays the rest.$8,300 in network
Medical deductible$292 Part B. Plan G pays the $1,788 Part A deductible.$200
Primary doctor visit$0, after the $292 yearly Part B deductible$0 copay
Specialist visit$0, after the $292 yearly Part B deductible$45 copayPrior authorization
Lab tests$0, most Medicare-covered tests$0-$45 copay, 20% coinsurancePrior authorization
MRI or CT scan$0, after the $292 yearly Part B deductible$25-$300 copayPrior authorization
X-rays$0, after the $292 yearly Part B deductible$0-$75 copayPrior authorization
Emergency room$0, after the $292 yearly Part B deductible$115 copay
Urgent care$0, after the $292 yearly Part B deductible$0-$40 copay
Outpatient hospital$0, after the $292 yearly Part B deductible$0-$525 copayPrior authorization
Surgery center$0, after the $292 yearly Part B deductible$0-$425 copayPrior authorization
Ground ambulance$0, after the $292 yearly Part B deductible$0-$375 copayPrior authorization
Hospital stay$0, Plan G pays the $1,788 Part A deductible$425 per day for days 1-5; $0 per day for days 6-90Prior authorization
Skilled nursing facility$0, Plan G pays days 21-100$0 per day for days 1-20; $221 per day for days 21-100Prior authorization
Mental health visit$0, after the $292 yearly Part B deductible$45 copayPrior authorization
Physical therapy$0, after the $292 yearly Part B deductible$45-$50 copayPrior authorization
Home health care$0, Medicare-covered home health$0 copayPrior authorization
Medical equipment$0, after the $292 yearly Part B deductible20% coinsurancePrior authorization
Part B drugs$0 after the $292 Part B deductible0%-20% coinsurancePrior authorization
Drug deductible (Part D)$700 with Wellcare Value Script (PDP)$461
Drug tiers (one month, retail)Generic: $0 copayPreferred Brand: 25% coinsuranceNon-Preferred Drug: 49% coinsuranceInjectable Drugs: 15% coinsuranceSpecialty Tier: 25% coinsuranceSelect Care Drugs: $11 copayPreferred Generic: $0 copayGeneric: $0 copayPreferred Brand: 15% coinsuranceNon-Preferred Drug: 25% coinsuranceSpecialty Tier: 26% coinsurance

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A higher drug plan premium is not, by itself, a reason to switch

With Original Medicare, you buy a separate drug plan. In Texas, 10 drug plans are for sale for 2027, from $5.30 to $199 a month. Half of them cost $104.70 a month or less.

  • Every 2027 drug plan limits what you pay for covered drugs to $2,400 a year. The drug coverage in Medicare Advantage plans has the same limit.
  • The premium is one part of your yearly cost. The calculator above adds premiums, medical costs, and drug costs, so you can see the whole year.
  • A Medicare Advantage plan can cost less in a light year. But you also take on its network and prior authorization rules, and you may not be able to get Medigap later.
  • If your income is limited, Extra Help can pay most of your drug plan premium and drug costs. Check Extra Help at SSA.gov

Doctors, referrals, and prior authorization

Cost is one side. The other side is how you get care. These rules come from the CMS plan files. Prior authorization means the plan must approve a service before you get it.

Original Medicare

  • Any doctor or hospital in the U.S. that takes Medicare
  • No referrals
  • Prior authorization only for a short list of services

DEVOTED GIVEBACK 006 TX (HMO)

HMO

  • You use doctors and hospitals in the plan network. Outside the network, the plan pays for emergencies and urgent care.
  • You need a referral to see a specialist.

Prior authorization for 24 services

Specialist visits, Diagnostic tests, MRI or CT, Radiation therapy, Outpatient hospital, Observation stay, Surgery center, Ambulance, Mental health visits, Psychiatrist visits, Physical therapy, Occupational therapy, Home health, Partial hospitalization, Cardiac rehab, Pulmonary rehab, Medical equipment, Prosthetics, Diabetic supplies, Dialysis, Substance use care, Hospital stay, Skilled nursing, Part B drugs

Extra benefits

Extra benefitOriginal MedicareDEVOTED GIVEBACK 006 TX (HMO)
DentalNoComprehensive, up to $250 a year
Eye examNoYes
Glasses or contactsNoYes, $400 allowance
Hearing aidsNoYes, copays from $599
Over-the-counter allowanceNo$800 a year
Fitness benefitNoYes
Rides to careNoNo
Meals after a hospital stayNoNo
Emergency care abroadPlan G and Plan N pay 80% after a $250 deductibleYes
Part B premium givebackNo$202 a month

What changed for 2027

DEVOTED GIVEBACK 006 TX (HMO)

Renewal Plan with SAE · 2026 plan H7993-006-0

  • In-network out-of-pocket maximum up from $7,200 to $8,300
  • Medical deductible up from $0 to $200
  • Drug deductible down from $605 to $461
  • Part B giveback up from $185 to $202
  • Diagnostic radiology (MRI, CT): $0-$300 copay to $25-$300 copay
  • Skilled nursing facility: $0 per day for days 1-20; $218 per day for days 21-100 to $0 per day for days 1-20; $221 per day for days 21-100
  • Overall star rating down from 5 to 4.5

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Sources and method

Plan data comes from the CMS 2027 Plan Benefit Package and landscape files. The data is from 2026-10-10. We checked a sample of plans field by field against Medicare.gov. Original Medicare amounts are the 2027 projections in the 2026 Medicare Trustees Report (Tables V.E1 and V.E2). CMS sets the final amounts in November. Medigap prices are the range Medicare.gov showed for ZIP 77002 on 2026-10-09. Totals use typical Medicare-allowed amounts for each service and typical drug prices.

These are estimates, not quotes, and they are for education only. Check every number with Medicare and with the plan before you choose. What you pay depends on your doctors and hospitals, your drugs and pharmacy, and the care you use. Plans can change their benefits, premiums, drug lists, and networks each year.

Pinnie is not an insurance agent or broker and does not sell Medicare plans. Pinnie is not connected with or endorsed by the U.S. government or the federal Medicare program. For all your options, visit Medicare.gov or call 1-800-MEDICARE (1-800-633-4227), TTY 1-877-486-2048.

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