A non-government entity
Wellcare Dual Access (HMO-POS D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Wellcare Dual Access (HMO-POS 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 (HMO-POS D-SNP) in 2026, please refer to our full plan details page.
Wellcare Dual Access (HMO-POS D-SNP) is a HMO-POS D-SNP plan offered by Centene Corporation available for enrollment in 2026 to people living in Select counties in GA. This plan received an overall rating of 3.5 out of 5 stars in 2026.
It's important to know that Wellcare Dual Access (HMO-POS 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 (HMO-POS 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 (HMO-POS 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 (HMO-POS D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $25.40. 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:
Sign up for Wellcare Dual Access (HMO-POS D-SNP)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
Drug Coverage
The Wellcare Dual Access (HMO-POS D-SNP) prescription drug plan features an annual deductible of $615. Under this plan, Tier 6 select care drugs are highly affordable with no copay across all pharmacies and mail-order options. Tier 1 preferred generic and Tier 2 generic drugs offer low copays starting at $18 and $19 for a one-month supply, and you can enjoy no copay on three-month supplies filled via preferred mail order. For brand-name and specialty prescriptions, Tier 3 preferred brand drugs require a 20% coinsurance, while Tier 5 specialty medications 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 preferred and standard retail pharmacies. Reviewing these copayments and coinsurance details can help you determine if this Wellcare plan is the right fit for your prescription needs.
Additional Benefits
The Wellcare Dual Access (HMO-POS D-SNP) plan offers comprehensive healthcare coverage, featuring no copays and a 20% coinsurance for most outpatient services, primary care visits, specialist consultations, and diagnostic tests. For inpatient hospital stays, members pay a flat copay per stay with no coinsurance, while emergency room visits incur a $115 copay. Skilled nursing facility care is also covered with no coinsurance, requiring no copay for days 1 through 20 and days 71 through 100. Beyond standard medical care, this plan provides robust supplemental benefits, including comprehensive dental coverage up to a $4,000 annual limit and eyewear coverage up to a $400 yearly limit with no copays. Members also benefit from a $1,000 annual hearing aid allowance, acupuncture, and over-the-counter items, all available with no copay or coinsurance. To make accessing care easier, the plan covers up to 24 one-way transportation trips per year to approved health locations with no copay or coinsurance.
Inpatient Hospital See details
Wellcare Dual Access (HMO-POS D-SNP) partially covers inpatient hospital services with no coinsurance, requiring a $2,230 copay per stay for acute care and a $2,080 copay per stay for psychiatric care. Prior authorization is required, and additional days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Wellcare Dual Access (HMO-POS D-SNP) covers outpatient services, including outpatient hospital, ambulatory surgical center, substance abuse, and blood services, with no copay and a 20% coinsurance. Prior authorization is required for most of these outpatient services, and there is no deductible for blood services.
Partial Hospitalization See details
Partial hospitalization is covered by Wellcare Dual Access (HMO-POS D-SNP) with no copay and a 20% coinsurance, though prior authorization is required.
Ambulance and Transportation Services See details
Wellcare Dual Access (HMO-POS D-SNP) covers ground and air ambulance services with a 20% coinsurance and no copay, subject to prior authorization. The plan also partially covers transportation services with no copay or coinsurance, providing up to 24 one-way trips per year to plan-approved health-related locations via rideshare, bus, subway, or medical transport.
Emergency Services See details
Wellcare Dual Access (HMO-POS 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 and urgent care 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
Wellcare Dual Access (HMO-POS D-SNP) covers primary care, specialist, therapy, psychiatric, and opioid treatment services with no copay and 20% coinsurance, though prior authorization is often required. Chiropractic services are partially covered, providing up to 12 routine visits per year with no copay and no coinsurance, while other chiropractic services and podiatry services are not covered.
Preventive Services See details
Wellcare Dual Access (HMO-POS D-SNP) preventive services are partially covered, featuring annual physical exams, fitness benefits, remote access technologies, personal emergency response systems, and alternative therapies with no copay and no coinsurance. However, sub-services such as health education, in-home safety assessments, medical nutrition therapy, medication reconciliation, re-admission prevention, wigs, weight management, therapeutic massage, adult day health, nutritional/dietary benefits, home-based palliative care, in-home support, caregiver support, tobacco cessation, enhanced disease management, telemonitoring, home safety modifications, and counseling are not covered. Kidney disease education and other select screenings are covered with no copay and 20% coinsurance.
Hearing Services See details
Wellcare Dual Access (HMO-POS D-SNP) provides partially covered hearing services, including routine hearing exams with a 20% coinsurance and no copay, and fitting evaluations and prescription hearing aids with no copay or coinsurance up to a $1,000 annual limit. However, OTC hearing aids and inner-ear, outer-ear, or over-the-ear prescription hearing aids are not covered.
Vision Services See details
Vision services are partially covered by Wellcare Dual Access (HMO-POS D-SNP) with no deductibles, offering one routine eye exam annually with no copay and 20% coinsurance, while other eye exams are not covered. Eyewear is covered up to a $400 yearly maximum, offering eyeglasses with no copay or coinsurance, and contact lenses with no copay and 20% coinsurance.
Dental Services See details
Wellcare Dual Access (HMO-POS D-SNP) covers Medicare-approved dental services with no copay and 20% coinsurance, and preventive and comprehensive dental care with no copay and no coinsurance up to a $4,000 annual limit. The dental benefit is partially covered, as maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Wellcare Dual Access (HMO-POS D-SNP) covers home infusion bundled services with no copay and no coinsurance, though prior authorization is required. Under this benefit, Medicare Part B chemotherapy, radiation, and other Part B 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
Dialysis Services are covered by the Wellcare Dual Access (HMO-POS D-SNP) plan with no copay and a 20% coinsurance.
Medical Equipment See details
Wellcare Dual Access (HMO-POS D-SNP) covers medical equipment, including durable medical equipment (DME), 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 (HMO-POS D-SNP) covers diagnostic and radiological services with no copay, though a 20% coinsurance applies to Medicare-covered diagnostic procedures, lab services, radiological services, and outpatient X-rays. Prior authorization is required for all of these covered diagnostic and radiological services.
Home Health Services See details
Wellcare Dual Access (HMO-POS D-SNP) covers home health services with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Wellcare Dual Access (HMO-POS D-SNP) covers some cardiac rehabilitation services with no copay, but cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) services 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 (HMO-POS D-SNP) with no coinsurance, requiring prior authorization but no prior three-day inpatient hospital stay. There is no copay for days 1 to 20 and days 71 to 100, a $218 copay for days 21 to 70, and additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Wellcare Dual Access (HMO-POS D-SNP) partially covers other services, offering acupuncture, over-the-counter items, and meal benefits with no copay and no coinsurance. Sub-services including Other 1, Other 2, Other 3, and Dual Eligible SNPs with Highly Integrated Services are not covered.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
*/SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
MedicareAdvantageRX.com is owned and operated by Dog Media Solutions LLC.
This is a promotional communication.
Every year, Medicare evaluates plans based on a 5-star rating system.
Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
* 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.
Enrollment in Medicare/Medicare Advantage may be limited to certain times of the year unless you qualify for a Special Enrollment Period
We do not offer every plan available in your area. Currently, we represent 18 organizations, which offer 52,101 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
We represent Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan's contract renewal.
Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.
Please contact Medicare.gov ,1-800-MEDICARE , or your local State Health Insurance Program (SHIP) to get information on all of your options.
Medicare has neither approved nor endorsed any information on this site.
Speak with a licensed insurance agent: 1-877-649-2073 / TTY 711 | 8am - 11pm ET | 7 days a week
© 2023 Dog Media Solutions LLC. All rights reserved