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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) prescription drug plan features an annual 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. You can also save on these tiers by using preferred mail order, which offers no copay for a three-month supply. Tier 3 preferred brands and Tier 5 specialty drugs require a 25% coinsurance, while Tier 4 non-preferred drugs carry a copay starting at $100. For Tier 6 select care drugs, there is no copay when using a preferred pharmacy or a preferred mail order service for multi-month supplies. Standard pharmacy options are also available across all tiers with slightly higher copays or equal coinsurance rates.
Additional Benefits
The Wellcare Dual Access (HMO-POS D-SNP) plan offers comprehensive medical coverage, with many key outpatient and specialist services requiring no copay and a 20% coinsurance. Inpatient hospital stays require a copay of $2,080 per admission, while emergency room visits incur a $115 copay and urgent care visits have a $40 copay. Routine preventive care, home health services, and up to 24 annual one-way transportation trips are fully covered with no copay and no coinsurance. Supplemental benefits are a major highlight of this plan, featuring preventive and comprehensive dental services with no copay or coinsurance up to a generous $4,000 yearly maximum. Members also enjoy routine hearing and vision benefits, which include no copay or coinsurance for prescription hearing aids up to $1,000 annually and no copay for eyeglasses up to $300 per year. Over-the-counter items and home infusion services are also fully covered with no copay or coinsurance to help manage daily health needs.
Inpatient Hospital See details
Wellcare Dual Access (HMO-POS D-SNP) covers inpatient acute and psychiatric hospital stays with a copayment of $2,080 per admission or stay and no coinsurance, with prior authorization required. This benefit is partially covered because 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, including outpatient hospital, ambulatory surgical center, substance abuse, and blood services, with no copay and a 20% coinsurance. Prior authorization is required for outpatient hospital, ambulatory surgical center, and substance abuse treatments.
Partial Hospitalization See details
Partial hospitalization is covered by Wellcare Dual Access (HMO-POS D-SNP) with no copay and a 20% coinsurance. Prior authorization is required for these services.
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, while plan-approved transportation services are covered with no copay or coinsurance for up to 24 one-way trips per year. Both benefits require prior authorization, and transportation to non-approved health-related locations is not covered.
Emergency Services See details
Wellcare Dual Access (HMO-POS D-SNP) covers emergency services with a $115 copay and no coinsurance (waived if admitted within 24 hours) and urgently needed services with a $40 copay and no coinsurance, both of which count toward the plan-level deductible. Worldwide emergency and urgent services are partially 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, therapy, mental health, psychiatric, and opioid treatment services with no copay and 20% coinsurance. Additional telehealth benefits are available with a copay of $0.00 to $40.00 and 20% coinsurance, while podiatry and chiropractic services are not covered.
Preventive Services See details
Wellcare Dual Access (HMO-POS D-SNP) covers preventive services, offering annual physicals, fitness benefits, and alternative therapies with no copay and no coinsurance, while kidney education and other screenings have no copay and 20% coinsurance. Additional preventive benefits are partially covered, as health education, in-home safety assessments, PERS, medical nutrition therapy, medication reconciliation, re-admission prevention, wigs, weight management, therapeutic massage, adult day health, nutritional benefits, palliative care, in-home support, caregiver support, smoking cessation, disease management, telemonitoring, home modifications, and counseling are not covered.
Hearing Services See details
Wellcare Dual Access (HMO-POS D-SNP) covers hearing services with no deductible, offering routine exams with no copay and 20% coinsurance, and fitting evaluations with no copay or coinsurance. For prescription hearing aids, which feature no copay or coinsurance up to a $1,000 annual maximum, some services are covered but inner ear, outer ear, and over the ear devices, as well as OTC hearing aids, are not covered.
Vision Services See details
Wellcare Dual Access (HMO-POS D-SNP) vision services are partially covered, excluding other eye exam services, and require prior authorization with no deductibles. Routine eye exams are covered once annually with no copay and a 20% coinsurance, while eyewear is covered up to $300 yearly with no copay for eyeglasses and upgrades, and no copay with a 20% coinsurance for contact lenses.
Dental Services See details
Wellcare Dual Access (HMO-POS D-SNP) provides partially covered dental services, featuring no copay and 20% coinsurance for Medicare-covered dental, and no copay and no coinsurance for preventive and comprehensive dental services up to a $4,000 yearly maximum. While most covered services require prior authorization, maxillofacial prosthetics, implant services, and orthodontics are not covered under this plan.
Home Infusion bundled Services See details
Home infusion bundled services are covered by Wellcare Dual Access (HMO-POS D-SNP) with no copay, while associated Medicare Part B insulin has a $35 copay and no coinsurance. Other covered Part B drugs, including chemotherapy and radiation, require a coinsurance ranging from 0% to 20%.
Dialysis Services See details
Dialysis services are covered by Wellcare Dual Access (HMO-POS D-SNP) with no copay and a 20% coinsurance.
Medical Equipment See details
Wellcare Dual Access (HMO-POS D-SNP) covers medical equipment, including durable medical equipment, prosthetics, medical supplies, and diabetic equipment, with no copay and a 20% coinsurance. Prior authorization is required for these benefits, and diabetic supplies are limited to specified manufacturers.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Wellcare Dual Access (HMO-POS D-SNP) with no copay and a 20% coinsurance for all diagnostic procedures, lab services, X-rays, and radiological therapies. Prior authorization is required for these covered services.
Home Health Services See details
Home health services are covered under the Wellcare Dual Access (HMO-POS D-SNP) plan with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Wellcare Dual Access (HMO-POS D-SNP) covers Cardiac Rehabilitation Services with no copay, though specific services including cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation are not covered and require a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is covered by Wellcare Dual Access (HMO-POS D-SNP) with no coinsurance, offering no copay for days 1–20 and days 71–100, but requiring a $218 daily copay for days 21–70. 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) partially covers other services, offering over-the-counter (OTC) items with no copay and no coinsurance through reimbursement, including nicotine replacement therapy and naloxone. Acupuncture, meal benefits, and highly integrated services for dual-eligible SNPs are not covered under this benefit.
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