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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 generics and Tier 2 generics, copays start as low as $18 and $19 respectively for a one-month supply at preferred pharmacies, with no copay for a three-month supply filled via preferred mail order. Additionally, Tier 6 select care drugs are highly affordable, offering no copay at preferred pharmacies or through preferred mail order. For higher-tier medications, Tier 3 preferred brands and Tier 5 specialty drugs require a 25% coinsurance. Tier 4 non-preferred drugs carry a flat cost, starting at a $100 copay for a one-month supply at both standard and preferred pharmacies. Choosing preferred pharmacies and utilizing preferred mail order services generally provides the most cost-effective options for your prescriptions under this plan.
Additional Benefits
The Wellcare Dual Access Sync (HMO D-SNP) plan provides robust medical coverage, offering no copay for primary care, home health care, and routine preventive services. For specialist consultations, outpatient procedures, and durable medical equipment, members will pay no copay alongside a 20% coinsurance. Major services like inpatient hospital stays require a $2,000 copay per admission, while emergency room care has a $115 copay. This plan also features generous supplemental benefits, including up to $5,000 for dental care and a $400 annual eyewear allowance with no copay. Hearing aids are covered up to $1,500 per ear annually with no copay, and members receive up to 12 one-way transportation trips per year at no cost. Additional perks include covered over-the-counter items and meals for chronic illnesses with no copay or coinsurance.
Inpatient Hospital See details
Wellcare Dual Access Sync (HMO D-SNP) partially covers inpatient acute and psychiatric hospital services with a $2,000 copayment per admission or stay and no coinsurance. Prior authorization and referrals are required, but additional days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Wellcare Dual Access Sync (HMO D-SNP) covers outpatient services—including outpatient hospital, ambulatory surgical center, outpatient substance abuse, and outpatient blood services—with no copayment and a 20% coinsurance. Prior authorization or referrals are required for most of these covered services.
Partial Hospitalization See details
Partial hospitalization is covered by Wellcare Dual Access Sync (HMO D-SNP) with no copay and a 20% coinsurance. Prior authorization and a referral are required to receive these services.
Ambulance and Transportation Services See details
Wellcare Dual Access Sync (HMO D-SNP) covers ground and air ambulance services with a 20% coinsurance and no copay. Transportation services are partially covered, offering up to 12 one-way trips per year to plan-approved locations with no copay or coinsurance, though transportation to any health-related location is 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. Worldwide emergency services are partially covered up to a $50,000 limit with a $115 copay and no coinsurance, but worldwide emergency transportation is not covered.
Primary Care See details
Wellcare Dual Access Sync (HMO D-SNP) primary care and specialist services are partially covered, excluding podiatry and non-routine chiropractic care. Covered primary care physician and routine chiropractic services require no copay and no coinsurance, while specialist visits, therapy, and mental health services have no copay and a 20% coinsurance.
Preventive Services See details
Wellcare Dual Access Sync (HMO D-SNP) covers preventive services, offering an annual physical, fitness benefits, and personal emergency response systems with no copay and no coinsurance. Other services, including kidney disease education and glaucoma screenings, require a referral and have no copay but a 20% coinsurance. The benefit is partially covered, as sub-services like health education, weight management programs, and in-home safety assessments are not covered.
Hearing Services See details
Wellcare Dual Access Sync (HMO D-SNP) covers hearing services with no deductible, offering routine hearing exams at a 20% coinsurance and no copay, and fitting evaluations with no copay or coinsurance. Prescription hearing aids are partially covered with no copay or coinsurance up to $1,500 per ear yearly, though OTC, inner ear, outer ear, and over the ear hearing aids are not covered.
Vision Services See details
Wellcare Dual Access Sync (HMO D-SNP) provides partially covered vision services, offering one routine eye exam per year with no copay and 20% coinsurance, while other eye exam services are not covered. Covered eyewear includes a $400 annual maximum with no deductible, featuring no copay and no coinsurance for eyeglasses, and no copay with 20% coinsurance for contact lenses.
Dental Services See details
Wellcare Dual Access Sync (HMO D-SNP) offers partially covered dental services, featuring no copay and a 20% coinsurance for Medicare-covered dental care, and no copay or coinsurance for most preventive and comprehensive services up to a $5,000 annual limit. However, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Wellcare Dual Access Sync (HMO D-SNP) covers home infusion bundled services with no copay, though prior authorization is required. For related medications, Medicare Part B insulin drugs have a $35 copay and no coinsurance, while chemotherapy and other Part B drugs have a coinsurance ranging from 0% to 20%.
Dialysis Services See details
Dialysis services are covered under the Wellcare Dual Access Sync (HMO D-SNP) plan with no copay and a 20% coinsurance. A referral is required to receive these covered services.
Medical Equipment See details
Wellcare Dual Access Sync (HMO D-SNP) covers durable medical equipment, prosthetics, medical supplies, and diabetic equipment with no copay and 20% coinsurance. Prior authorization is required for these covered 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 with no copayment, though a 20% coinsurance, prior authorization, and referrals are required. This coverage includes Medicare-covered diagnostic procedures, lab services, diagnostic and therapeutic radiological services, and outpatient X-rays.
Home Health Services See details
Wellcare Dual Access Sync (HMO D-SNP) covers Home Health Services with no copay and no coinsurance. Both a referral and prior authorization are required to receive these covered services.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are offered by Wellcare Dual Access Sync (HMO D-SNP) with no copay and a referral requirement, indicating some services are covered; however, cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) rehabilitation services are not covered and carry a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by Wellcare Dual Access Sync (HMO D-SNP) with no coinsurance, featuring no copay for days 1 to 20 and 71 to 100, and a $218 daily copay for days 21 to 70. Prior authorization and referrals are required, and additional days beyond the standard 100 Medicare-covered days are not covered.
Other Services See details
Wellcare Dual Access Sync (HMO D-SNP) partially covers other services, offering over-the-counter (OTC) items and chronic illness meal benefits with no copay and no coinsurance. Acupuncture is not covered under this plan, and a referral is required to receive the meal benefit.
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