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.
Below are a few key facts and commonly-asked questions about Wellcare Dual Access Sync (HMO D-SNP).
The cost of a Medicare Advantage Plan is made up of four main parts.
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.
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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.
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 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 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.
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.
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.
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 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.
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 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 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).
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.
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%.
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.
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.
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 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.
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) 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.
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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* 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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