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Wellcare Dual Reserve (HMO-POS D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Wellcare Dual Reserve (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 Reserve (HMO-POS D-SNP) in 2026, please refer to our full plan details page.
Wellcare Dual Reserve (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 Reserve (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 Reserve (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 Reserve (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 Reserve (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 $7500.00 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 Reserve (HMO-POS D-SNP) plan features an annual drug deductible of $615. For Tier 6 select care drugs, members pay no copay across all pharmacy options. Tier 1 preferred generics and Tier 2 generics offer affordable copays starting at $18 and $19 respectively, with no copay for three-month supplies filled through preferred mail order. Tier 3 preferred brand drugs require a 20% coinsurance, while Tier 4 non-preferred drugs carry copays starting at $100 for a one-month supply. Tier 5 specialty drugs incur a 25% coinsurance for a one-month supply. Choosing preferred pharmacies and mail-order services helps maximize savings on your prescription medications.
Additional Benefits
The Wellcare Dual Reserve (HMO-POS D-SNP) plan offers comprehensive coverage with no copays and no coinsurance for primary care visits, home health services, and routine preventive care. Members also benefit from no copays and no coinsurance for routine hearing exams, eyewear up to a two hundred dollar annual limit, and preventive and comprehensive dental services up to a three thousand dollar annual maximum. Specialist visits require a thirty dollar copay, while urgent care and emergency services are covered with copayments of forty dollars and one hundred fifteen dollars. For inpatient hospital stays, the plan features a four hundred dollar daily copay for the first six days, followed by no copay for days seven through one hundred twenty. Outpatient services, diagnostic labs, and home infusion services are available with no coinsurance and low to no copayments. Additionally, vital needs like durable medical equipment, diabetic supplies, and dialysis services are covered, typically requiring no copay and a twenty percent coinsurance.
Inpatient Hospital See details
Wellcare Dual Reserve (HMO-POS D-SNP) offers partially covered inpatient hospital services with no coinsurance, requiring prior authorization, a $400 daily copay for days 1 through 6 of acute stays (no copay for days 7 through 120), and an $1,800 copay per psychiatric stay. Non-Medicare-covered stays, upgrades, and additional psychiatric days are not covered.
Outpatient Services See details
Wellcare Dual Reserve (HMO-POS D-SNP) covers outpatient services with no coinsurance, featuring a $0 to $300 copay for outpatient hospital services and a $250 copay for ambulatory surgical center services. Outpatient substance abuse sessions require a $25 copay, while outpatient blood services are covered with no copay or deductible.
Partial Hospitalization See details
Wellcare Dual Reserve (HMO-POS D-SNP) covers partial hospitalization with a $105.00 copay and no coinsurance. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered under the Wellcare Dual Reserve (HMO-POS D-SNP) plan, featuring a $285 copay and no coinsurance for ground and air ambulance transport. Transportation benefits are partially covered with no copay or coinsurance for up to 12 one-way trips per year to plan-approved health-related locations, though transportation to any health-related location is not covered.
Emergency Services See details
Wellcare Dual Reserve (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, with copays waived if admitted to the hospital within 24 hours. Worldwide emergency and urgent care are partially covered up to a $50,000 maximum with a $115 copay and no coinsurance, but worldwide emergency transportation is not covered.
Primary Care See details
Wellcare Dual Reserve (HMO-POS D-SNP) provides primary care physician services with no copay and no coinsurance, and specialist visits with a $30 copay and no coinsurance. Other benefits like physical, occupational, and speech therapies feature a $10 copay and no coinsurance, though chiropractic benefits are only partially covered since routine and other chiropractic services are not covered.
Preventive Services See details
Wellcare Dual Reserve (HMO-POS D-SNP) provides partially covered preventive services with no copay and no coinsurance for annual physicals, fitness benefits, alternative therapies, personal emergency response systems, and remote access technologies, though kidney disease education requires a 20% coinsurance and no copay. Sub-services that are not covered under this plan include health education, in-home safety assessments, medical nutrition therapy, post-discharge medication reconciliation, readmission prevention, wigs for hair loss, weight management, therapeutic massage, adult day health, nutritional or dietary benefits, home-based palliative care, in-home support, caregiver support, additional tobacco cessation counseling, enhanced disease management, telemonitoring, home and bathroom safety modifications, and counseling.
Hearing Services See details
Wellcare Dual Reserve (HMO-POS D-SNP) covers Medicare-covered hearing exams for a $30 copay and no coinsurance, while routine exams and fittings have no copay, no coinsurance, and no deductible. Prescription hearing aids are partially covered with no copay or coinsurance up to $500 per ear annually, though OTC, inner ear, outer ear, and over-the-ear hearing aids are not covered.
Vision Services See details
Vision services are partially covered by Wellcare Dual Reserve (HMO-POS D-SNP), featuring eye exams with a $0 to $30 copay and no coinsurance, though other eye exam services are not covered. Eyewear is covered with no copay, no coinsurance, and no deductible up to a $200 annual limit for contacts, frames, lenses, and upgrades.
Dental Services See details
Dental services are partially covered by Wellcare Dual Reserve (HMO-POS D-SNP), which offers Medicare-covered dental services for a $30 copay and no coinsurance, and preventive and comprehensive dental services for no copay and no coinsurance up to a $3,000 annual maximum. While most dental services require prior authorization, maxillofacial prosthetics, implant services, and orthodontics are not covered by the plan.
Home Infusion bundled Services See details
Wellcare Dual Reserve (HMO-POS D-SNP) covers home infusion bundled services with no copay, though prior authorization and step therapy are required. Under this benefit, Medicare Part B insulin has a $35 copay and no coinsurance, while chemotherapy and other Part B drugs have no copay and 0% to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered under the Wellcare Dual Reserve (HMO-POS D-SNP) plan with no copay and a 20% coinsurance.
Medical Equipment See details
Wellcare Dual Reserve (HMO-POS D-SNP) covers medical equipment with no copay and 20% coinsurance for durable medical equipment, prosthetics, medical supplies, and diabetic therapeutic shoes or inserts. Diabetic supplies are covered with no copay, although prior authorization is required and diabetic supplies are limited to specified manufacturers.
Diagnostic and Radiological Services See details
Wellcare Dual Reserve (HMO-POS D-SNP) covers diagnostic services with no coinsurance, featuring no copay for lab services and up to a $20 copay for diagnostic procedures. Radiological services require prior authorization and include a $50 copay for outpatient X-rays, a minimum 20% coinsurance for therapeutic services, and no copay for diagnostic radiological services.
Home Health Services See details
Home health services are covered by Wellcare Dual Reserve (HMO-POS D-SNP) with no copay and no coinsurance. Prior authorization is required to receive these services.
Cardiac Rehabilitation Services See details
Wellcare Dual Reserve (HMO-POS D-SNP) covers some Cardiac Rehabilitation Services with no coinsurance, but in practice, standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) services are not covered and require copayments ranging from $20 to $40.
Skilled Nursing Facility (SNF) See details
Wellcare Dual Reserve (HMO-POS D-SNP) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring no copay for days 1 to 20 and 61 to 100, and a $218 daily copay for days 21 to 60. Prior authorization is required, and additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Wellcare Dual Reserve (HMO-POS D-SNP) partially covers other services, providing over-the-counter (OTC) items and a limited-duration meal benefit with no copay and no coinsurance, while acupuncture is not covered. A referral is required for the meal benefit, which is available for chronic illnesses or medical conditions that require you to remain at home.
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