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Wellcare Dual Access Sync (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Wellcare Dual Access Sync (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 Access Sync (HMO D-SNP) in 2026, please refer to our full plan details page.
Wellcare Dual Access Sync (HMO D-SNP) is a HMO D-SNP plan offered by Centene Corporation available for enrollment in 2026 to people living in Select counties in FL. This plan received an overall rating of 4 out of 5 stars in 2026.
It's important to know that Wellcare Dual Access Sync (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 Access Sync (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 Access Sync (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 Access Sync (HMO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $4.80. 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 Sync (HMO D-SNP) prescription drug plan features an annual drug deductible of $615. For Tier 1 preferred generic drugs, copays start at $18 at preferred pharmacies, while Tier 2 generics start at a $19 copay. Both Tier 1 and Tier 2 medications offer no copay for a three-month supply filled through preferred mail order. Tier 3 preferred brand drugs and Tier 5 specialty drugs require a 25% coinsurance, whereas Tier 4 non-preferred drugs have a copay starting at $100. Tier 6 select care drugs provide excellent value, featuring no copay at preferred pharmacies and starting at a low $2 copay for a one-month supply at standard pharmacies.
Additional Benefits
The Wellcare Dual Access Sync (HMO D-SNP) offers comprehensive healthcare coverage with many services requiring no copay, though coinsurance and specific copays apply to certain benefits. Inpatient hospital stays require a $1,940 copay per stay with no coinsurance, while outpatient services, primary care, specialist visits, and diagnostic tests generally feature no copay and a 20% coinsurance. Emergency care is available with a $115 copay, which is waived if you are admitted to the hospital within 24 hours. This plan also provides strong everyday health benefits, including home health care, preventive services, and routine dental care with no copay and no coinsurance. Additionally, members benefit from no-copay routine eye and hearing exams, a $400 annual eyewear allowance, and up to $750 per ear for prescription hearing aids. Transportation is also covered for up to 12 one-way trips per year with no copay and no coinsurance to plan-approved locations.
Inpatient Hospital See details
Wellcare Dual Access Sync (HMO D-SNP) partially covers inpatient hospital services, requiring a $1,940 copayment per stay and no coinsurance for acute and psychiatric admissions. Prior authorization and referrals are required, and additional days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Outpatient services are covered by Wellcare Dual Access Sync (HMO D-SNP) with no copay and a 20% coinsurance for outpatient hospital, ambulatory surgical center, substance abuse, and blood services. Most of these outpatient services require a referral and prior authorization, and no deductible applies to outpatient blood services.
Partial Hospitalization See details
Wellcare Dual Access Sync (HMO D-SNP) covers partial hospitalization services with no copay and a 20% coinsurance. Prior authorization and a referral are required to access this benefit.
Ambulance and Transportation Services See details
Wellcare Dual Access Sync (HMO D-SNP) covers ambulance services with a 20% coinsurance and no copay, while transportation services are partially covered with no copay and no coinsurance. Covered transportation is limited to 12 one-way trips per year to plan-approved health-related locations, and trips to any health-related location are not covered.
Emergency Services See details
Wellcare Dual Access Sync (HMO D-SNP) covers emergency services with a $115 copay and no coinsurance, and urgently needed services with a $40 copay and no coinsurance, with copays waived if admitted to the hospital within 24 hours. Worldwide emergency and urgent services are partially covered up to a $50,000 lifetime limit with a $115 copay and no coinsurance, though worldwide emergency transportation is not covered.
Primary Care See details
Wellcare Dual Access Sync (HMO D-SNP) covers primary care, specialist, mental health, psychiatric, and therapy services with no copay and 20% coinsurance, while telehealth benefits range from a $0 to $40 copay with 20% coinsurance. Chiropractic services are partially covered with up to 12 routine visits per year at no copay and no coinsurance, though other chiropractic services and podiatry services are not covered.
Preventive Services See details
Preventive services are partially covered by Wellcare Dual Access Sync (HMO D-SNP), featuring an annual physical exam, fitness benefits, and alternative therapies with no copay and no coinsurance. Other covered benefits, including kidney disease education and glaucoma screenings, require a referral and have no copay but carry a 20% coinsurance, while sub-services such as health education and in-home support are not covered.
Hearing Services See details
Wellcare Dual Access Sync (HMO D-SNP) provides partially covered hearing services with no deductible, featuring Medicare-covered exams and hearing aid fittings for no copay or coinsurance, alongside routine exams for no copay and 20% coinsurance. Prescription hearing aids are covered with no copay or coinsurance up to $750 per ear annually, though OTC hearing aids and inner-ear, outer-ear, or over-the-ear prescription models are not covered.
Vision Services See details
Vision services are partially covered by Wellcare Dual Access Sync (HMO D-SNP), featuring one routine eye exam annually with no copay, 20% coinsurance, and no deductible, though other eye exam services are not covered. Eyewear is covered up to $400 per year with no deductible, offering contact lenses with no copay and 20% coinsurance, and eyeglasses, lenses, frames, and upgrades with no copay and no coinsurance.
Dental Services See details
Dental services are covered by Wellcare Dual Access Sync (HMO D-SNP) with no copay and 20% coinsurance for Medicare-covered dental, and no copay or coinsurance for preventive and comprehensive services. The benefit is partially covered, as maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by Wellcare Dual Access Sync (HMO D-SNP) with no copay, though prior authorization is required. Under this benefit, Medicare Part B insulin drugs require a $35 copay and no coinsurance, while chemotherapy and other Part B drugs are covered with a 0% to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered by Wellcare Dual Access Sync (HMO D-SNP) with no copay and a 20% coinsurance, although a referral is required.
Medical Equipment See details
Medical equipment is covered by Wellcare Dual Access Sync (HMO D-SNP), including durable medical equipment, prosthetics, medical supplies, and diabetic services, 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
Wellcare Dual Access Sync (HMO D-SNP) covers diagnostic and radiological services, including lab work, X-rays, and therapeutic radiology, with no copay and a 20% coinsurance. These covered services require both prior authorization and a referral.
Home Health Services See details
Home Health Services are covered by Wellcare Dual Access Sync (HMO D-SNP) with no copay and no coinsurance. Prior authorization and a referral are required to receive these services.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by Wellcare Dual Access Sync (HMO D-SNP), as cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are all not covered. While there is no copay, these services require a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
Wellcare Dual Access Sync (HMO D-SNP) partially covers Skilled Nursing Facility (SNF) care with no coinsurance, offering no copay for days 1-20 and 71-100, and a $218 daily copay for days 21-70. Prior authorization and referrals are required, and additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Wellcare Dual Access Sync (HMO D-SNP) partially covers other services, providing over-the-counter items and chronic illness meal benefits with no copay and no coinsurance. However, acupuncture is not covered under this plan, and a referral is required to access the meal benefit.
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