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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 2025 to people living in Select counties in MS. This plan received an overall rating of 3 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 $14.20. 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 $5500.00 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) prescription drug plan has an annual drug deductible of $615. For cost savings, Tier 6 Select Care Drugs feature no copay across all standard and preferred pharmacies as well as mail-order services. Tier 1 Preferred Generic and Tier 2 Generic medications are also highly affordable, starting at $18 and $19 copays respectively for a one-month supply, and offering no copay for a three-month supply when using preferred mail order. For higher-tier medications, Tier 3 Preferred Brand drugs require a 23% to 24% coinsurance depending on your pharmacy choice. Tier 4 Non-Preferred Drugs carry a $100 copay for a one-month supply at both preferred and standard pharmacies. Specialty drugs in Tier 5 require a 25% coinsurance for a one-month supply at both preferred and standard pharmacies.
Additional Benefits
The Wellcare Dual Reserve (HMO-POS D-SNP) plan offers comprehensive healthcare coverage with no copay for primary care visits, annual physicals, and home health services. For specialized care, members pay a low $15 copay for specialist visits and no copay for routine vision exams, preventive dental care, and hearing aid fittings. Inpatient hospital stays require a $325 copay for days one through seven, while emergency room visits carry a $130 copay. Additionally, the plan features generous allowances, including up to $4,000 for covered dental services and up to $300 for routine eyewear with no copay. Members also benefit from no copay on over-the-counter items, home-delivered meals, and up to 24 one-way transportation trips per year to plan-approved locations. A standard 20% coinsurance applies to durable medical equipment and dialysis services, ensuring predictable costs for essential medical needs.
Inpatient Hospital See details
Inpatient hospital care is partially covered by Wellcare Dual Reserve (HMO-POS D-SNP), as upgrades, additional days, and non-Medicare-covered stays are not covered. Covered acute stays require a $325 copay for days 1 to 7 (no copay for days 8 to 90) and psychiatric stays require a $300 copay for days 1 to 5 (no copay for days 6 to 90), both with no coinsurance.
Outpatient Services See details
Wellcare Dual Reserve (HMO-POS D-SNP) covers outpatient services with no coinsurance, featuring a $0 to $250 copay for hospital services and a $130 to $250 copay per stay for observation services. Ambulatory surgical center services require a $150 copay with no coinsurance, outpatient substance abuse sessions have a $25 copay with no coinsurance, and outpatient blood services are covered with no copay or coinsurance.
Partial Hospitalization See details
Wellcare Dual Reserve (HMO-POS D-SNP) covers partial hospitalization services with a $140.00 copay and no coinsurance. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered by Wellcare Dual Reserve (HMO-POS D-SNP), featuring a $230 copay and no coinsurance for ground and air ambulance services. Transportation benefits are partially covered, offering up to 24 one-way trips per year to plan-approved locations with no copay and no coinsurance, though trips to any health-related location are not covered.
Emergency Services See details
Wellcare Dual Reserve (HMO-POS D-SNP) covers emergency room visits with a $130 copay and urgent care with a $30 copay, featuring no coinsurance for either service and waived copays if admitted to the hospital within 24 hours. Worldwide emergency and urgent care are partially covered up to a $50,000 maximum with a $130 copay and no coinsurance, but worldwide emergency transportation is not covered.
Primary Care See details
Wellcare Dual Reserve (HMO-POS D-SNP) covers primary care visits with no copay and no coinsurance, and specialist visits with a $15 copay and no coinsurance. Therapy services require a $20 copay, mental health and psychiatric sessions require a $25 copay, and telehealth copays range from $0 to $30, all with no coinsurance, while podiatry and chiropractic services are not covered.
Preventive Services See details
Wellcare Dual Reserve (HMO-POS D-SNP) covers preventive services with no copay and no coinsurance for annual physicals, fitness benefits, remote access, alternative therapies, and routine screenings, while kidney disease education has no copay but a 20% coinsurance. This benefit is partially covered, as services such as health education, in-home safety assessments, personal emergency response systems, and weight management programs are not covered.
Hearing Services See details
Wellcare Dual Reserve (HMO-POS D-SNP) hearing services are partially covered, offering Medicare-covered exams for a $15 copay and no coinsurance, alongside routine exams and fitting evaluations with no copay and no coinsurance. Prescription hearing aids are covered up to $500 per ear annually with no copay and no coinsurance, but OTC hearing aids as well as inner ear, outer ear, and over the ear prescription hearing aids are not covered.
Vision Services See details
Vision services are partially covered by Wellcare Dual Reserve (HMO-POS D-SNP), offering no coinsurance and a copay ranging from no copay to $15 for exams, though other eye exam services are not covered. Routine eye exams and eyewear, including contacts and eyeglasses, feature no copay and no coinsurance up to a $300 annual maximum, with prior authorization required.
Dental Services See details
Wellcare Dual Reserve (HMO-POS D-SNP) partially covers dental services with a $15 copay and no coinsurance for Medicare-covered dental, and no copay or coinsurance for covered preventive and comprehensive services, which are subject to a $4,000 annual limit. Prior authorization is required for most services, and maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by Wellcare Dual Reserve (HMO-POS D-SNP) with no copay, subject to prior authorization. Under this benefit, Medicare Part B insulin drugs require a $35 copay and no coinsurance, while chemotherapy, radiation, and other Part B drugs have no copay and a coinsurance of 0% to 20%.
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
Medical equipment is covered by Wellcare Dual Reserve (HMO-POS D-SNP) with no copay and a 20% coinsurance for durable medical equipment, prosthetics, and medical supplies. Diabetic supplies are covered with no copay, while diabetic therapeutic shoes or inserts require a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Wellcare Dual Reserve (HMO-POS D-SNP) with prior authorization required. Diagnostic tests and procedures have no coinsurance and a $0 to $20 copay, lab services and diagnostic radiology have no copay, and outpatient x-rays require a $25 copay plus coinsurance, while therapeutic radiology has a minimum 20% coinsurance.
Home Health Services See details
Home Health Services are covered by Wellcare Dual Reserve (HMO-POS D-SNP) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac rehabilitation services are offered with no coinsurance under Wellcare Dual Reserve (HMO-POS D-SNP); however, while some services are covered, specific treatments like standard cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation are not covered.
Skilled Nursing Facility (SNF) See details
Wellcare Dual Reserve (HMO-POS D-SNP) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring prior authorization and no prior three-day inpatient hospital stay. There is no copay for days 1 through 20 and days 51 through 100, but a $218 daily copay applies for days 21 through 50, 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 meal benefit with no copay and no coinsurance. Acupuncture is not covered under this plan, and the meal benefit requires a referral.
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