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Wellpoint Full Dual Advantage (HMO-POS D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Wellpoint Full Dual Advantage (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 Wellpoint Full Dual Advantage (HMO-POS D-SNP) in 2026, please refer to our full plan details page.
This summary reflects 2026 plan information. Where this plan continues in 2027, the full plan details page links to its 2027 benefits and costs.
Wellpoint Full Dual Advantage (HMO-POS D-SNP) is a HMO-POS D-SNP plan offered by Wellpoint Iowa, Inc. available for the 2026 plan year to people living in Iowa. This plan received an overall rating of 3 out of 5 stars in 2026.
It's important to know that Wellpoint Full Dual Advantage (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:
Wellpoint Full Dual Advantage (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 Wellpoint Full Dual Advantage (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 Wellpoint Full Dual Advantage (HMO-POS D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $29.00. 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
Health deductible: information not available.
This plan has a $615.00 drug deductible that applies only to drugs in certain tiers. You pay this amount toward covered prescriptions in those tiers before the plan's cost sharing begins; drugs in the other tiers are not subject to the deductible. See the full plan details page for the tier table.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $9250.00 for in-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your out-of-pocket costs reach $9250.00 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:
Sign up for Wellpoint Full Dual Advantage (HMO-POS D-SNP)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. Call-center hours (ET): Mon-Fri 8am-10pm; Sat 9am-8pm; Sun closed.
Drug Coverage
The Wellpoint Full Dual Advantage (HMO-POS D-SNP) plan features an annual drug deductible of $615. Under this plan, members enjoy no copay for Tier 1 preferred generic drugs and Tier 6 select care drugs filled for one-month, two-month, or three-month supplies at standard pharmacies or through standard mail order. This structure offers significant savings on many common and essential medications. For other tiers, including Tier 2 generic, Tier 3 preferred brand, and Tier 4 non-preferred drugs, members pay a 25% coinsurance for all supply durations. Tier 5 specialty drugs also require a 25% coinsurance for a one-month supply through standard retail or mail-order channels. This simple cost-sharing model helps you easily understand and budget for your brand-name and specialty prescription needs.
Additional Benefits
The Wellpoint Full Dual Advantage (HMO-POS D-SNP) offers robust healthcare coverage with many services featuring no copay. Essential benefits like inpatient hospital stays, skilled nursing facility care, and home health services are covered with no copay and no coinsurance. For other medical needs, such as specialist visits, diagnostic tests, and outpatient care, you will generally pay no copay alongside a 20% coinsurance. This plan also includes valuable supplemental benefits to help manage your overall health and wellness costs. You can access dental services with a $4,000 annual maximum and hearing aids with up to $3,000 for prescription devices, both featuring no copay and no coinsurance. Additionally, the plan provides a $105 monthly over-the-counter allowance, 24 one-way transportation trips, and vision coverage with an annual eyewear limit of $325.
Inpatient Hospital See details
Wellpoint Full Dual Advantage (HMO-POS D-SNP) partially covers inpatient acute and psychiatric hospital services with no copay and no coinsurance, although prior authorization is required. Additional hospital days, non-Medicare-covered stays, and upgrades are not covered under these benefits.
Outpatient Services See details
Wellpoint Full Dual Advantage (HMO-POS D-SNP) covers outpatient services with no copay, though a 20% coinsurance and prior authorization are required for outpatient hospital, observation, ambulatory surgical center, and substance abuse services. Outpatient blood services are fully covered with no copay and no coinsurance.
Partial Hospitalization See details
Wellpoint Full Dual Advantage (HMO-POS D-SNP) covers partial hospitalization services with a $60.00 copay and no coinsurance. Prior authorization is required to access this covered benefit.
Ambulance and Transportation Services See details
Wellpoint Full Dual Advantage (HMO-POS D-SNP) covers ground and air ambulance services with a 20% coinsurance and no copay. Transportation services are partially covered, providing up to 24 one-way trips per year to plan-approved locations with no copay and no coinsurance, though transportation to any health-related location is not covered.
Emergency Services See details
Wellpoint Full Dual Advantage (HMO-POS D-SNP) covers emergency services with a $115 copay and no coinsurance, and urgently needed services with a $20 copay and no coinsurance. Worldwide emergency, urgent care, and transportation services are also covered with no copay or coinsurance, up to a $100,000 maximum benefit limit.
Primary Care See details
Wellpoint Full Dual Advantage (HMO-POS D-SNP) covers primary care, specialist visits, physical therapy, and mental health services with no copay and 20% coinsurance, while additional telehealth services feature no copay and no coinsurance. Although chiropractic services are technically covered, routine and other chiropractic care are not covered in practice.
Preventive Services See details
Wellpoint Full Dual Advantage (HMO-POS D-SNP) covers preventive services with no copay and no coinsurance for annual physicals, kidney disease education, memory fitness, and remote access technologies, though benefits like health education, personal emergency response systems, and in-home safety assessments are not covered. Other preventive services, including glaucoma screenings, diabetes self-management training, digital rectal exams, and post-welcome visit EKGs, are covered with no copay and a 20% coinsurance.
Hearing Services See details
Hearing services are covered by Wellpoint Full Dual Advantage (HMO-POS D-SNP) with no deductible, offering fitting evaluations and OTC hearing aids up to $300 annually with no copay or coinsurance, and routine exams with no copay and a 20% coinsurance. Prescription hearing aids are partially covered with no copay or coinsurance up to $3,000 annually, but inner ear, outer ear, and over the ear prescription hearing aids are not covered.
Vision Services See details
Vision services are partially covered by Wellpoint Full Dual Advantage (HMO-POS D-SNP), which does not cover other eye exam services or eyewear upgrades. Routine eye exams are covered once per year with no copay and 20% coinsurance, while eyewear has an annual $325 limit with no copay and no coinsurance for eyeglasses, and no copay with 20% coinsurance for contact lenses.
Dental Services See details
Dental services are partially covered by Wellpoint Full Dual Advantage (HMO-POS D-SNP), featuring an annual maximum benefit of $4,000 for preventive and comprehensive services with no copay and no coinsurance. Medicare-covered dental services require a 20% coinsurance and no copay, and while most major dental treatments are covered, implant and orthodontic services are not covered.
Home Infusion bundled Services See details
Wellpoint Full Dual Advantage (HMO-POS D-SNP) covers home infusion bundled services with no copay, though prior authorization is required. Covered Medicare Part B insulin drugs require a $35 copay and no coinsurance, while Part B chemotherapy, radiation, and other drugs feature no copay and 0% to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered under the Wellpoint Full Dual Advantage (HMO-POS D-SNP) plan with no copay and a 20% coinsurance.
Medical Equipment See details
Wellpoint Full Dual Advantage (HMO-POS D-SNP) covers durable medical equipment with no copay and 0% to 20% coinsurance, while prosthetics and medical supplies are covered with no copay and 20% coinsurance. Diabetic equipment, including supplies and therapeutic shoes or inserts, is covered with no copay and no coinsurance.
Diagnostic and Radiological Services See details
Wellpoint Full Dual Advantage (HMO-POS D-SNP) covers diagnostic and radiological services, including lab work, diagnostic tests, therapeutic radiology, and outpatient X-rays, with a 20% coinsurance and no copayment. Prior authorization is required for all of these covered services.
Home Health Services See details
Home health services are covered by Wellpoint Full Dual Advantage (HMO-POS D-SNP) with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac rehabilitation services under Wellpoint Full Dual Advantage (HMO-POS D-SNP) require prior authorization and feature no copay with a 20% coinsurance. While some services are covered, individual cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for peripheral artery disease (PAD) rehabilitation services are not covered.
Skilled Nursing Facility (SNF) See details
Wellpoint Full Dual Advantage (HMO-POS D-SNP) covers Skilled Nursing Facility (SNF) services with no copay and no coinsurance, although prior authorization is required. The plan allows for admission without a prior three-day inpatient hospital stay, but does not cover additional days beyond the standard Medicare-covered limit.
Other Services See details
Wellpoint Full Dual Advantage (HMO-POS D-SNP) partially covers other services with no copay and no coinsurance, providing a $105 monthly over-the-counter allowance, chronic illness meals, and community resource support. Acupuncture is not covered under this benefit.
Plan Providers
Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross and Blue Shield, Aspire Health Plan, Dean Health Plan, Devoted Health, Florida Blue Medicare, Freedom Health, Health Care Service Corporation, HealthSpringSM, HealthSun, Healthy Blue, Humana, Molina Healthcare, Mutual of Omaha, Medica Central Health Plan, Optimum HealthCare, Premera Blue Cross, SCAN Health Plan, Simply, UnitedHealthcare(R), Wellcare, WellPoint.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. Call-center hours (ET): Mon-Fri 8am-10pm; Sat 9am-8pm; Sun closed.
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Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
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