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Wellcare Dual Access (HMO-POS D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Wellcare Dual Access (HMO-POS D-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Wellcare Dual Access (HMO-POS D-SNP) in 2026, please refer to our full plan details page.
Wellcare Dual Access (HMO-POS D-SNP) is a HMO-POS D-SNP plan offered by Centene Corporation available for enrollment in 2025 to people living in Select counties in Nevada. This plan received an overall rating of 3.5 out of 5 stars in 2026.
It's important to know that Wellcare Dual Access (HMO-POS D-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
Wellcare Dual Access (HMO-POS D-SNP)is a Special Needs Type (SNP) plan. This means you can only enroll in this plan if you meet specific criteria. See our full plan details page for more information.
Key Plan Facts
Below are a few key facts and commonly-asked questions about Wellcare Dual Access (HMO-POS D-SNP).
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.
For Wellcare Dual Access (HMO-POS D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $9.50. This is the amount you must pay every month.
This plan does not come with a Part B Premium reduction. You must continue to pay your Part B premium.
Deductibles
This plan does not have a health deductible. Your insurance coverage on covered health services will start immediately.
This plan has a $615.00 drug deductible. You will need to pay this amount towards covered prescriptions before your insurance coverage for prescription medications kicks in.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $9250.00 for out-of-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $0.00 for in-network covered services, the plan will pay 100% of in-network covered costs for the rest of the year.
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:
Doctor Visits:
Specialist Visits:
Emergency Room:
Urgent Care:
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Drug Coverage
The Wellcare Dual Access (HMO-POS D-SNP) plan features an annual prescription drug deductible of $615. For Tier 1 preferred generics and Tier 2 generics, copays start as low as $18 and $19 respectively for a one-month supply at a preferred pharmacy. Notably, you can receive a three-month supply of these generic medications with no copay when utilizing preferred mail order services. For Tier 3 preferred brands and Tier 5 specialty drugs, you will pay a 25% coinsurance, while Tier 4 non-preferred drugs require copays starting at $100. Tier 6 select care drugs offer the greatest savings, featuring no copay at preferred pharmacies and through preferred mail order. Standard pharmacies and standard mail order options are also available across all tiers, though they generally feature slightly higher costs.
Additional Benefits
The Wellcare Dual Access (HMO-POS D-SNP) plan offers comprehensive medical coverage, with many outpatient, primary care, specialist, and diagnostic services requiring no copay and a 20% coinsurance. For inpatient hospital stays, members pay a set copayment, such as $2,160 per stay for acute care, with no coinsurance. Emergency care is available with a $115 copay, which is waived if admitted, while skilled nursing facility stays feature no copay for the first 20 days. This plan also includes valuable supplemental benefits, featuring preventive dental care, home health services, and fitness programs with no copay and no coinsurance. Vision and hearing benefits help lower out-of-pocket costs by providing no-copay routine exams alongside allowance limits, including up to $1,000 per ear annually for hearing aids and a $400 annual limit for eyewear. Additionally, members can access up to 36 one-way routine transportation trips and select over-the-counter items with no copay or coinsurance.
Inpatient Hospital See details
Wellcare Dual Access (HMO-POS D-SNP) covers inpatient hospital services with no coinsurance, requiring a $2,160 copayment per stay for acute care and a $2,080 copayment per stay for psychiatric care. Prior authorization is required for these services, and additional days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Wellcare Dual Access (HMO-POS D-SNP) covers outpatient services with no copays, though a 20% coinsurance applies to outpatient hospital, ambulatory surgical center, outpatient substance abuse, and blood services. Prior authorization is required for ambulatory surgical center, outpatient hospital, and outpatient substance abuse services.
Partial Hospitalization See details
Wellcare Dual Access (HMO-POS D-SNP) covers partial hospitalization services with no copay and a 20% coinsurance. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Wellcare Dual Access (HMO-POS D-SNP) covers ground and air ambulance services with a 20% coinsurance and no copay, subject to prior authorization. Transportation services are partially covered with no copay or coinsurance for up to 36 one-way trips per year to plan-approved locations, though transportation to any health-related location is not covered.
Emergency Services See details
Wellcare Dual Access (HMO-POS D-SNP) covers emergency services with a $115 copay and urgently needed services with a $40 copay, both featuring no coinsurance and copays waived if admitted to the hospital within 24 hours. Worldwide emergency and urgent services are also covered up to a $50,000 maximum benefit with a $115 copay and no coinsurance, though worldwide emergency transportation is not covered.
Primary Care See details
Wellcare Dual Access (HMO-POS D-SNP) covers primary care, specialist, outpatient therapy, psychiatric, and opioid treatment services with no copay and 20% coinsurance. Additional telehealth benefits are available with a $0 to $40 copay and 20% coinsurance, while podiatry and chiropractic services are not covered.
Preventive Services See details
Wellcare Dual Access (HMO-POS D-SNP) covers annual physical exams, fitness benefits, alternative therapies, and remote access technologies with no copay and no coinsurance. Kidney disease education and other preventive services like glaucoma screenings and diabetes self-management are covered with no copay and a 20% coinsurance. Additional preventive services are partially covered, excluding health education, in-home safety assessments, medical nutrition therapy, medication reconciliation, re-admission prevention, chemotherapy wigs, weight management, therapeutic massage, adult day health, nutritional benefits, palliative care, in-home support, caregiver support, tobacco cessation, disease management, telemonitoring, home safety modifications, and counseling.
Hearing Services See details
Wellcare Dual Access (HMO-POS D-SNP) covers hearing services, including annual routine hearing exams with a 20% coinsurance and no copay, and fitting evaluations with no copay or coinsurance. Prescription hearing aids are covered with no copay or coinsurance up to $1,000 per ear every year, although OTC, inner ear, outer ear, and over-the-ear hearing aids are not covered.
Vision Services See details
Wellcare Dual Access (HMO-POS D-SNP) covers one routine eye exam per year with no copay and a 20% coinsurance, while other eye exam services are not covered. Eyewear is covered up to a $400 annual maximum with no copays, requiring a 20% coinsurance for contact lenses and no coinsurance for eyeglasses, frames, lenses, and upgrades.
Dental Services See details
Wellcare Dual Access (HMO-POS D-SNP) partially covers dental services, offering Medicare-covered dental with no copay and a 20% coinsurance, and other preventive and comprehensive dental services with no copay and no coinsurance. Prior authorization is required for most services, and maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Wellcare Dual Access (HMO-POS D-SNP) covers home infusion bundled services with no copay and no coinsurance, subject to prior authorization. Medicare Part B chemotherapy, radiation, and other Part B drugs require no copay and a coinsurance between no coinsurance and 20%, while Part B insulin is covered with a $35 copay and no coinsurance.
Dialysis Services See details
Dialysis Services are covered under the Wellcare Dual Access (HMO-POS D-SNP) plan with no copay and a 20% coinsurance.
Medical Equipment See details
Medical equipment is covered under the Wellcare Dual Access (HMO-POS D-SNP) plan with no copay and a 20% coinsurance for durable medical equipment, prosthetics, medical supplies, and diabetic services. Prior authorization is required for these benefits, and diabetic supplies are limited to specified manufacturers.
Diagnostic and Radiological Services See details
Wellcare Dual Access (HMO-POS D-SNP) covers diagnostic and radiological services, including lab work, diagnostic tests, therapeutic radiology, and outpatient X-rays, with no copay and a 20% coinsurance. Prior authorization is required for all of these covered services.
Home Health Services See details
Wellcare Dual Access (HMO-POS D-SNP) covers Home Health Services with no copay and no coinsurance. Prior authorization is required to receive these covered services.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered under Wellcare Dual Access (HMO-POS D-SNP) with no copay, meaning some services are covered. However, standard cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered and require a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
Wellcare Dual Access (HMO-POS D-SNP) covers Skilled Nursing Facility (SNF) services with no coinsurance, featuring no copay for days 1 to 20 and days 71 to 100, and a $218 copay for days 21 to 70. Prior authorization is required, and additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Wellcare Dual Access (HMO-POS D-SNP) covers select other services with no copay and no coinsurance, including over-the-counter items and chronic illness meal benefits, though a referral is required for meals. Acupuncture and other additional services are not covered under this plan.
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