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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.

Overview IconKey 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:

Regular visits to your primary care doctor are covered and will have a copay of and coinsurance of 0% (no coinsurance).

Specialist Visits:

Visits to specialists are covered and will have a copay of and coinsurance of 20%. Specialist visits may require a referral from your primary care doctor or prior authorization.

Emergency Room:

Trips to the Emergency Room are covered, and will have a copay of and coinsurance of 0% (no coinsurance). Coverage may vary for in-network and out-of-network hospitals.

Urgent Care:

Trips to Urgent Care arecovered and will have a copay of and coinsurance of 0% (no coinsurance). Coverage may vary for in-network and out-of-network hospitals.

Sign up for Wellcare Dual Access Sync (HMO D-SNP)

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Drug Coverage IconDrug Coverage

The Wellcare Dual Access Sync (HMO D-SNP) prescription drug plan has an annual drug deductible of $615. Under this plan, you will pay no copay for Tier 1 preferred generics and Tier 6 select care drugs when filling prescriptions at preferred pharmacies. Tier 2 generic medications are also highly affordable, with copays starting at $14 for a one-month supply at preferred pharmacies and no copay for a three-month preferred mail order. For brand-name and specialty prescriptions, Tier 3 preferred brands require a 20% coinsurance, while Tier 5 specialty drugs carry a 25% coinsurance. Tier 4 non-preferred drugs require a $100 copay for a one-month supply at both preferred and standard pharmacies. Standard pharmacies and standard mail order options are available across most tiers but typically result in higher out-of-pocket costs than preferred services.

Additional Benefits IconAdditional Benefits

The Wellcare Dual Access Sync (HMO D-SNP) plan offers comprehensive medical coverage with no copay for primary care visits, home health services, and preventive care like annual physicals. Inpatient hospital stays require a $1,880 copay per admission with no coinsurance, while outpatient services, diagnostics, and dialysis generally have no copay and a 20% coinsurance. Emergency care is available with a $115 copay, which is waived if you are admitted, and urgent care visits require a $40 copay. For supplemental care, the plan features dental benefits with no copay or coinsurance up to a $5,000 annual limit, alongside a $400 yearly eyewear allowance and up to two covered hearing aids per year. Skilled nursing facility stays have no copay for days 1 to 20 and 71 to 100, though days 21 to 70 require a $218 daily copay. Additionally, members benefit from no copays or coinsurance on over-the-counter items, chronic illness meals, and up to 36 one-way transportation trips per year.

Inpatient Hospital See details

Inpatient hospital services, including acute and psychiatric stays, are covered by Wellcare Dual Access Sync (HMO D-SNP) with a $1,880 copayment per admission and no coinsurance. Prior authorization and referrals are required, and certain sub-services such as additional hospital 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. Prior authorization and referrals are required for most of these outpatient services, and there is no deductible for 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 receive this care.

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 or coinsurance. Covered transportation is limited to 36 one-way trips per year to plan-approved locations, meaning transportation to any other 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 urgent care with a $40 copay and no coinsurance, with both copays waived if admitted to the hospital within 24 hours. Worldwide emergency and urgent services are partially covered up to a $50,000 limit with a $115 copay and no coinsurance, though worldwide emergency transportation is not covered.

Primary Care See details

Primary Care benefits are partially covered by Wellcare Dual Access Sync (HMO D-SNP), offering primary care provider visits with no copay and no coinsurance, and specialist, therapy, and mental health services with no copay and 20% coinsurance. Podiatry and other chiropractic services are not covered, though routine chiropractic care is covered with no copay and no coinsurance for up to 12 visits per year.

Preventive Services See details

Wellcare Dual Access Sync (HMO D-SNP) offers partially covered preventive services, featuring an annual physical, fitness benefits, and remote access with no copay and no coinsurance, while kidney disease education and diabetes training require a referral and have no copay and a 20% coinsurance. Supplemental services including health education, in-home safety assessments, 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, tobacco cessation, disease management, telemonitoring, home safety modifications, and counseling are not covered.

Hearing Services See details

Hearing services are partially covered by Wellcare Dual Access Sync (HMO D-SNP) with no deductible, offering Medicare-covered exams and annual fitting evaluations with no copay or coinsurance, and annual routine exams with a 20% coinsurance and no copay. Up to two prescription hearing aids are covered each year with no copay or coinsurance up to a $1,500 maximum per ear, though OTC hearing aids and inner ear, outer ear, and 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), as other eye exam services are not covered, with prior authorization required and no deductibles. One routine eye exam is covered annually with no copay and a 20% coinsurance, while eyewear is covered up to $400 yearly with no copay (eyeglasses and upgrades have no coinsurance, and contact lenses require a 20% coinsurance).

Dental Services See details

Wellcare Dual Access Sync (HMO D-SNP) dental benefits are partially covered, offering Medicare-covered dental services with no copay and 20% coinsurance, and preventive and comprehensive dental services with no copay and no coinsurance up to a $5,000 annual limit. 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. Under this benefit, Medicare Part B insulin drugs require a $35 copay and no coinsurance, while Medicare Part B chemotherapy, radiation, and other drugs have no copay and a coinsurance ranging from 0% to 20%.

Dialysis Services See details

Wellcare Dual Access Sync (HMO D-SNP) covers dialysis services with no copay and a 20% coinsurance, although a referral is required to receive care.

Medical Equipment See details

Wellcare Dual Access Sync (HMO D-SNP) covers durable medical equipment, prosthetics, and diabetic supplies with no copay and a 20% coinsurance. Prior authorization is required for these benefits, and diabetic supplies are limited to specific manufacturers.

Diagnostic and Radiological Services See details

Wellcare Dual Access Sync (HMO D-SNP) covers diagnostic and radiological services, including lab work, diagnostic tests, therapeutic radiology, and outpatient X-rays, with no copay and a 20% coinsurance. Prior authorization and referrals are required for all of these covered services.

Home Health Services See details

Home Health Services are covered under the Wellcare Dual Access Sync (HMO D-SNP) plan with no copay and no coinsurance. Prior authorization and a referral are required to access this benefit.

Cardiac Rehabilitation Services See details

Wellcare Dual Access Sync (HMO D-SNP) covers some cardiac rehabilitation services with no copay, but sub-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 Sync (HMO D-SNP) with no coinsurance, featuring no copay for days 1 to 20 and days 71 to 100, and a $218 daily copay for days 21 to 70. Prior authorization and referrals are required for these services, though a prior three-day inpatient hospital stay is not.

Other Services See details

Wellcare Dual Access Sync (HMO D-SNP) offers partial coverage for other services, which includes over-the-counter (OTC) items and meal benefits for chronic illnesses with no copays or coinsurance. Acupuncture is not covered under this plan.

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