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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. Beneficiaries enjoy no copay for Tier 1 preferred generic drugs at preferred pharmacies and preferred mail order, and no copay for Tier 6 select care drugs at any pharmacy. Tier 2 generic drugs are also affordable, with copays starting at $14 for a one-month supply at preferred pharmacies or no copay for a three-month preferred mail order. For higher-tier medications, Tier 3 preferred brand drugs require a 20% coinsurance, and Tier 5 specialty drugs carry a 25% coinsurance for a one-month supply. Tier 4 non-preferred drugs have a $100 copay for a one-month supply at both standard and preferred pharmacies. Utilizing preferred pharmacies and preferred mail-order services is the best way to minimize your out-of-pocket prescription costs under this plan.
Additional Benefits
The Wellcare Dual Access Sync (HMO D-SNP) plan offers comprehensive medical coverage, featuring no copay and no coinsurance for primary care visits, routine preventive care, and home health services. For specialized care, outpatient hospital services, and diagnostic tests, members typically pay no copay and a 20% coinsurance. Inpatient hospital stays require a copay of $2,230 per acute admission, while emergency room visits incur a $115 copay which is waived upon admission. This plan also includes valuable supplemental benefits such as preventive and comprehensive dental care with no copay and no coinsurance, and up to $1,500 annually for prescription hearing aids. Vision benefits feature no copay and a $400 annual limit for covered eyewear, alongside up to 36 one-way transportation trips to plan-approved locations per year with no copay. Additionally, members can access over-the-counter items and chronic illness meals with no copay and no coinsurance.
Inpatient Hospital See details
Wellcare Dual Access Sync (HMO D-SNP) covers inpatient acute hospital stays with a $2,230 copay per admission and psychiatric hospital stays with a $2,080 copay per admission, both with no coinsurance. Prior authorization and referrals are required for these services, while upgrades, additional days, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Wellcare Dual Access Sync (HMO D-SNP) covers outpatient services with no copays, though a 20% coinsurance applies to outpatient hospital, observation, ambulatory surgical center, and outpatient substance abuse services. Outpatient blood services also feature no copay and a 20% coinsurance, with no deductible and the cost waived for the first three pints of blood.
Partial Hospitalization See details
Partial hospitalization is covered under the Wellcare Dual Access Sync (HMO D-SNP) plan with no copay and a 20% coinsurance. Prior authorization and a referral are required to access these services.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered under the Wellcare Dual Access Sync (HMO D-SNP) plan, subject to prior authorization. Ambulance services require a 20% coinsurance and no copay, while transportation is partially covered with no copay and no coinsurance for up to 36 one-way trips per year to plan-approved locations (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 urgently needed services with a $40 copay, both featuring no coinsurance and copays waived upon hospital admission within 24 hours. Worldwide emergency and urgent care are also covered up to a $50,000 maximum 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) offers primary care physician services with no copay and no coinsurance, while specialist visits, mental health, and therapy services are covered with no copay and a 20% coinsurance. Routine chiropractic care is covered for up to 12 visits per year with no copay and no coinsurance, but other chiropractic and podiatry services are not covered.
Preventive Services See details
Wellcare Dual Access Sync (HMO D-SNP) covers annual physical exams and select supplemental benefits like fitness, PERS, alternative therapies, and remote access with no copay and no coinsurance, while kidney education and other screenings require a referral and 20% coinsurance with no copay. Additional preventive services are only partially covered, excluding health education, in-home safety assessments, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, wigs, weight management, therapeutic massage, adult day health, nutritional/dietary benefits, home-palliative care, in-home support, caregiver support, additional smoking cessation, enhanced disease management, telemonitoring, home safety modifications, and counseling.
Hearing Services See details
Hearing services are partially covered by Wellcare Dual Access Sync (HMO D-SNP) with no deductible, featuring one routine hearing exam per year for a 20% coinsurance and no copay, and fitting evaluations with no copays or coinsurance. The plan also covers up to $1,500 annually for prescription hearing aids with no copays or coinsurance, though OTC hearing aids and inner ear, outer ear, and over-the-ear prescription models are not covered.
Vision Services See details
Wellcare Dual Access Sync (HMO D-SNP) partially covers vision services, offering one annual routine eye exam with no copay and a 20% coinsurance, while other eye exam services are not covered. Covered eyewear, including eyeglasses and contact lenses, features no copay, a 20% coinsurance for contacts, and no deductible, up to a $400 yearly limit.
Dental Services See details
Dental services are partially covered under the Wellcare Dual Access Sync (HMO D-SNP) plan, with maxillofacial prosthetics, implant services, and orthodontics excluded from coverage. Medicare-covered dental services require no copay and a 20% coinsurance, while other covered preventive and comprehensive dental benefits feature no copay and no coinsurance.
Home Infusion bundled Services See details
Wellcare Dual Access Sync (HMO D-SNP) covers home infusion bundled services with no copay, requiring prior authorization. Under this benefit, Medicare Part B chemotherapy, radiation, and other drugs have no copay and a 0% to 20% coinsurance, while Medicare Part B insulin is covered with a $35 copay and no coinsurance.
Dialysis Services See details
Wellcare Dual Access Sync (HMO D-SNP) covers dialysis services with no copay and a 20% coinsurance, though a referral is required to receive care.
Medical Equipment See details
Wellcare Dual Access Sync (HMO D-SNP) covers medical equipment, including durable medical equipment (DME), 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 with no copay, but a 20% coinsurance applies to all diagnostic procedures, lab services, therapeutic radiological services, and outpatient X-rays. These covered services require both prior authorization and a referral.
Home Health Services See details
Wellcare Dual Access Sync (HMO D-SNP) covers home health services with no copay and no coinsurance. Prior authorization and a referral are required to access this benefit.
Cardiac Rehabilitation Services See details
Cardiac rehabilitation services are covered under Wellcare Dual Access Sync (HMO D-SNP) with no copay and no coinsurance, though a referral is required. While some services are covered, cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered and are subject to a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
Wellcare Dual Access Sync (HMO D-SNP) covers Skilled Nursing Facility (SNF) services 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, though a prior three-day inpatient hospital stay is not.
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 benefit.
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1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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