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Wellcare Dual Reserve (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Wellcare Dual Reserve (HMO 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 Reserve (HMO D-SNP) in 2025, please refer to our full plan details page.
Wellcare Dual Reserve (HMO D-SNP) is a HMO D-SNP plan offered by Centene Corporation available for enrollment in 2025 to people living in Select counties in FL. This plan received an overall rating of 3.5 out of 5 stars in 2025.
It's important to know that Wellcare Dual Reserve (HMO 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 Reserve (HMO 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 Reserve (HMO 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 Reserve (HMO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $20.30. 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 $590.00 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 $1500.00 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 Reserve (HMO D-SNP) plan has a $590 deductible for prescription drugs. After the deductible, you will pay the costs for your drugs in each tier until your total drug costs reach $2000. If you qualify for the low-income subsidy (LIS), your Part D premium is $20.30. Once your yearly out-of-pocket drug costs reach $2000, you will pay nothing for your Part D covered drugs.
Additional Benefits
The Wellcare Dual Reserve (HMO D-SNP) plan offers comprehensive coverage with no copays for many services. This includes inpatient hospital stays for the first 90 days, primary care, preventive services, hearing exams, vision services, dental, and home health services. Other services like outpatient services, ambulance, emergency services, and diagnostic services have varying copays or coinsurance amounts.
Inpatient Hospital See details
Inpatient Hospital benefits, including acute and psychiatric care, are covered by the Wellcare Dual Reserve (HMO D-SNP) plan with no copay for days 1-90. Additional days, non-Medicare-covered stays, and upgrades for acute and psychiatric care are not covered.
Outpatient Services See details
Outpatient Services, including outpatient hospital services, observation services, ambulatory surgical center services, outpatient substance abuse services, and outpatient blood services, are covered. Outpatient hospital services have a copay between $0 and $50, while observation services have a copay between $50 and $140. Ambulatory Surgical Center Services, Individual Sessions for Outpatient Substance Abuse, Group Sessions for Outpatient Substance Abuse, and Outpatient Blood Services have no copay.
Partial Hospitalization See details
Partial Hospitalization is covered by the Wellcare Dual Reserve (HMO D-SNP) plan, but requires prior authorization and a doctor's referral. The copay for this benefit is $130.
Ambulance and Transportation Services See details
Ambulance Services are covered with a $150 copay for both ground and air ambulance services, and Transportation Services to a plan-approved health-related location are covered with no copay for up to 36 one-way trips per year, utilizing rideshare, bus/subway, or medical transport. Transportation Services to any health-related location are not covered.
Emergency Services See details
Emergency Services, including Worldwide Emergency Coverage and Worldwide Urgent Coverage, are covered with a $140 copay and no coinsurance. Urgently Needed Services are covered with no copay and no coinsurance, and Worldwide Emergency Transportation is not covered.
Primary Care See details
Wellcare Dual Reserve (HMO D-SNP) covers primary care physician services, chiropractic services, occupational therapy services, physician specialist services, mental health specialty services, other health care professional, psychiatric services, physical therapy and speech-language pathology services, additional telehealth benefits, and opioid treatment program services with no copay. This plan does not cover podiatry services.
Preventive Services See details
Preventive services, including an annual physical exam, are covered with no copay. Kidney disease education services have a 20% coinsurance, and other preventive services like Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit, are covered with no copay.
Hearing Services See details
The Wellcare Dual Reserve (HMO D-SNP) plan covers hearing exams, routine hearing exams and fitting/evaluation for hearing aids with no copay. Prescription hearing aids are covered, with a maximum plan benefit coverage of $1000 per ear every year, but inner ear, outer ear, and over the ear hearing aids are not covered.
Vision Services See details
Vision services, including eye exams and eyewear, are covered. There is no copay for eye exams and eyewear services.
Dental Services See details
Dental services are covered with no copay. Oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatment, other preventive dental services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), and oral and maxillofacial surgery are covered with no copay. Orthodontic services are covered up to a maximum of $5,000 per year, and maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs with a $35 copay, and Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs with 0% to 20% coinsurance. Prior authorization is required for these services.
Dialysis Services See details
Dialysis Services are covered by the Wellcare Dual Reserve (HMO D-SNP) plan, but a doctor referral is required. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME), with 20% coinsurance and prior authorization required, and Prosthetics/Medical Supplies, with 20% coinsurance. Diabetic Equipment is covered, with coinsurance for Medicare-covered Diabetic Supplies and a copay for Medicare-covered Diabetic Therapeutic Shoes or Inserts.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered by the Wellcare Dual Reserve (HMO D-SNP) plan. Diagnostic Procedures/Tests have no copay, while Lab Services have no copay. Diagnostic Radiological Services have a copay of up to $50, Therapeutic Radiological Services have up to 20% coinsurance, and Outpatient X-Ray Services have a $40 copay.
Home Health Services See details
Home Health Services are covered under the Wellcare Dual Reserve (HMO D-SNP) plan with no copay and no coinsurance. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the Wellcare Dual Reserve (HMO D-SNP) plan. This plan does not cover Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, or Additional Cardiac Rehabilitation Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Wellcare Dual Reserve (HMO D-SNP) plan, with prior authorization and a doctor referral required. There is no copay for days 1-20 and 31-100, but there is a $214 copay for days 21-30.
Other Services See details
The Wellcare Dual Reserve (HMO D-SNP) plan's Other Services benefit covers over-the-counter items and meal benefits with no copay, but it does not cover acupuncture, Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, or Self-Directed Personal Assistance Services. Meal benefits require a doctor's referral.
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