Wellcare Sunshine Health Dual Align (HMO D-SNP)

Wellcare Sunshine Health Dual Align (HMO D-SNP) is a HMO D-SNP plan offered by Sunshine State Health Plan, Inc. available for the 2026 plan year 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 Sunshine Health Dual Align (HMO D-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.

Key Plan Facts

Below are a few key facts and commonly-asked questions about Wellcare Sunshine Health Dual Align (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.

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:

Drug Coverage

The Wellcare Sunshine Health Dual Align (HMO D-SNP) prescription drug plan features an annual drug deductible of $615. For Tier 1 preferred generics, you can expect a $1 copay for a 1-month supply at preferred pharmacies, or no copay for a 3-month supply using preferred mail order. Additionally, Tier 6 select care drugs are fully covered with no copay across all pharmacy and mail-order options. For Tier 2 generic drugs, the plan has a $19 copay for a 1-month supply at preferred pharmacies, while Tier 3 preferred brand drugs require a 20% coinsurance. Tier 4 non-preferred drugs carry a $100 copay for a 1-month supply at both preferred and standard pharmacies. Finally, Tier 5 specialty drugs require a 25% coinsurance for a 1-month supply at both preferred and standard pharmacies.

Additional Benefits

The Wellcare Sunshine Health Dual Align (HMO D-SNP) offers comprehensive medical coverage with no copay for primary care visits, home health services, and select preventive care. However, specialist visits, outpatient hospital services, and diagnostic tests require a 20% coinsurance with no copay. For acute needs, emergency room visits carry a $115 copay, urgent care has a $40 copay, and inpatient acute hospital stays require a $2,230 copay per admission. This plan also features supplemental benefits, including up to 36 one-way transportation trips per year and preventive dental care with no copay or coinsurance. Additionally, members receive no-copay allowances of up to $1,500 per ear annually for prescription hearing aids and $400 yearly for eyewear. Many specialized services, including durable medical equipment, dialysis, and Medicare-covered dental care, require prior authorization and carry a 20% coinsurance.

Plan Providers

Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross and Blue Shield, Aspire Health Plan, Dean Health Plan, Devoted Health, Florida Blue Medicare, Freedom Health, Health Care Service Corporation, HealthSpring^SM, HealthSun, Healthy Blue, Humana, Molina Healthcare, Mutual of Omaha, Medica Central Health Plan, Optimum HealthCare, Premera Blue Cross, SCAN Health Plan, Simply, UnitedHealthcare(R), Wellcare, WellPoint.