Wellcare Simple Value (HMO)

Wellcare Simple Value (HMO) is a HMO plan offered by Centene Corporation available for enrollment in 2025 to people living in Select Counties in Arizona. This plan received an overall rating of 3.5 out of 5 stars in 2026.

It's important to know that Wellcare Simple Value (HMO) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.

Key Plan Facts

Below are a few key facts and commonly-asked questions about Wellcare Simple Value (HMO).

Plan Costs:

The cost of a Medicare Advantage Plan is made up of four main parts.

• First, the monthly premium — the amount you pay every month.
• Second, the deductible — the amount you pay out of pocket for covered services before the plan starts paying.
• Third, the copayments and coinsurance — the amounts you pay out of pocket for covered services, usually after meeting the deductible (if applicable). Copays are fixed dollar amounts; coinsurance is a percentage of the cost.
• Fourth, the Out-of-Pocket Maximum — the maximum amount you could have to pay out of pocket in a year. This may be different for in-network and out-of-network services.

You can see below for the coinsurance and specific copayments for in the Additional Benefits section below, or refer to our Plan Details page for more details.

Common Services:

Drug Coverage

The Wellcare Simple Value (HMO) medicare plan offers an enhanced alternative drug benefit with an annual prescription drug deductible of $615.00. After meeting this deductible, you will pay no copay for Tier 1 preferred generic drugs at preferred pharmacies and no copay for Tier 5 specialty drugs at both preferred and standard locations. For other medications, standard generics and non-preferred drugs carry a 25% coinsurance, while preferred brand drugs require up to 34% coinsurance depending on your pharmacy choice. Once your yearly out-of-pocket drug costs reach $2,100.00, you enter the catastrophic coverage phase and pay nothing for Medicare Part D covered drugs. Individuals who qualify for the Low-Income Subsidy, also known as Extra Help, will also benefit from a reduced Part D premium of nothing. This plan provides structured cost-sharing options to help you budget for your essential prescription medications.

Additional Benefits

The Wellcare Simple Value (HMO) plan offers comprehensive coverage with predictable costs, featuring no coinsurance for inpatient hospital stays, outpatient services, and emergency care. Members pay daily copays for the first few days of acute hospital stays and skilled nursing facility care, while specialist consultations, diagnostic lab tests, and routine home health services require no copays. Emergency room visits require a $150 copay, and urgent care costs a $20 copay, ensuring affordable access to immediate medical attention. For supplemental health needs, this plan provides dental, vision, and hearing services with no copays or coinsurance, including a $1,500 dental maximum and a $200 annual vision allowance. Essential medical equipment, dialysis, and therapeutic radiology are covered with a standard 20% coinsurance and no copay. Additionally, members can take advantage of acupuncture, over-the-counter items, and up to 12 one-way transportation trips to plan-approved locations with no copays.