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Wellpoint Chronic Care (HMO-POS C-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Wellpoint Chronic Care (HMO-POS C-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Wellpoint Chronic Care (HMO-POS C-SNP) in 2026, please refer to our full plan details page.
Wellpoint Chronic Care (HMO-POS C-SNP) is a HMO-POS C-SNP plan offered by Elevance Health, Inc. available for enrollment in 2025 to people living in Select counties in Arizona. This plan received an overall rating of 3 out of 5 stars in 2026.
It's important to know that Wellpoint Chronic Care (HMO-POS C-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
Wellpoint Chronic Care (HMO-POS C-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 Wellpoint Chronic Care (HMO-POS C-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 Wellpoint Chronic Care (HMO-POS C-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $0.00. 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 $150.00 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 $2700.00 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 Wellpoint Chronic Care (HMO-POS C-SNP) plan features an Enhanced Alternative drug benefit with a $150 prescription drug deductible. Beneficiaries who qualify for the low-income subsidy will pay nothing for their Part D coverage. During the initial coverage phase, you will benefit from no copay on Tier 1 preferred generic drugs at preferred pharmacies or through standard mail, as well as no copay on Tier 5 specialty drugs. For other tiers, costs are based on coinsurance, including 20% to 25% for Tier 2 standard generics, 30% for Tier 3 preferred brands, and 31% for Tier 4 non-preferred drugs. Once your yearly out-of-pocket drug expenses reach $2,100, you enter the catastrophic coverage phase and pay nothing for covered Medicare Part D prescriptions. This plan offers clear, structured cost-sharing to help you manage your medication expenses efficiently.
Additional Benefits
The Wellpoint Chronic Care (HMO-POS C-SNP) plan offers comprehensive medical coverage with low out-of-pocket costs for essential services. Members benefit from no copay for primary care visits, telehealth, and home health services, while specialist visits require a copay between $15 and $35. Inpatient hospital stays feature a $200 daily copay for the first five days and no copay for days six through ninety, with no coinsurance required. This plan also includes valuable everyday wellness benefits, such as dental care up to $1,500 annually and routine vision exams with no copay. Additionally, members receive no-copay hearing exams, up to $1,500 for prescription hearing aids, and a $107 quarterly allowance for over-the-counter items. Transportation is covered for up to 72 one-way trips per year to plan-approved locations with no copay or coinsurance.
Inpatient Hospital See details
Wellpoint Chronic Care (HMO-POS C-SNP) partially covers inpatient hospital services, requiring a $200 daily copay for days 1 through 5, no copay for days 6 through 90, and no coinsurance for acute and psychiatric stays. Prior authorization is required, and while unlimited additional days are covered with no copay, upgrades for acute care and non-Medicare-covered stays are not covered.
Outpatient Services See details
Outpatient services are covered by Wellpoint Chronic Care (HMO-POS C-SNP) with no coinsurance. Copays range from no copay for ambulatory surgical center and blood services, to $35 for outpatient substance abuse sessions, and up to $175 for outpatient hospital and observation services.
Partial Hospitalization See details
Partial hospitalization benefits are covered by Wellpoint Chronic Care (HMO-POS C-SNP) with a $30 copay and no coinsurance. Prior authorization is required to receive these services.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered by Wellpoint Chronic Care (HMO-POS C-SNP), featuring a $195 copay and no coinsurance for ground and air ambulance services. Transportation benefits are partially covered, offering up to 72 one-way trips per year to plan-approved locations with no copay and no coinsurance, though transportation to any health-related location is not covered.
Emergency Services See details
Wellpoint Chronic Care (HMO-POS C-SNP) covers emergency services with a $150 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services are covered with a $15 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered up to a $100,000 limit with a $150 copay and no coinsurance.
Primary Care See details
Primary care benefits under Wellpoint Chronic Care (HMO-POS C-SNP) are covered with no coinsurance, featuring no copay for primary care and telehealth visits, and copays ranging from $15 to $35 for specialist, therapy, and mental health services. Chiropractic services are only partially covered by the plan, as routine chiropractic care is not covered.
Preventive Services See details
Wellpoint Chronic Care (HMO-POS C-SNP) provides partially covered preventive services with no copay and no coinsurance for covered care like annual physicals, glaucoma screenings, and diabetes self-management. However, several supplemental services are not covered, including health education, weight management programs, alternative therapies, and personal emergency response systems.
Hearing Services See details
Hearing services are covered by Wellpoint Chronic Care (HMO-POS C-SNP) with no copay or coinsurance for exams, fittings, OTC hearing aids up to $300 annually, and prescription hearing aids up to $1,500 annually. However, prescription hearing aids are only partially covered, as inner ear, outer ear, and over the ear models are not covered.
Vision Services See details
Vision services are partially covered by Wellpoint Chronic Care (HMO-POS C-SNP), as eyewear upgrades are not covered. Covered benefits include routine eye exams with no copay, other eye exams for a $0 to $30 copay, and up to $225 annually for eyewear with no copay, all with no deductibles or coinsurance.
Dental Services See details
Dental services are partially covered by Wellpoint Chronic Care (HMO-POS C-SNP) up to an annual maximum of $1,500, featuring no coinsurance and no copay for most preventive and comprehensive services, while Medicare-covered dental services have a copay of up to $30. Maxillofacial prosthetics, implant services, and orthodontics are not covered under this plan.
Home Infusion bundled Services See details
Home infusion bundled services are covered by Wellpoint Chronic Care (HMO-POS C-SNP) and require prior authorization. Medicare Part B insulin drugs have a $35 copay and no coinsurance, while chemotherapy, radiation, and other Part B drugs have no copay and a coinsurance ranging from no coinsurance up to 20%.
Dialysis Services See details
Dialysis services are covered by the Wellpoint Chronic Care (HMO-POS C-SNP) plan with no copay and no coinsurance.
Medical Equipment See details
Wellpoint Chronic Care (HMO-POS C-SNP) covers medical equipment, offering diabetic supplies and therapeutic shoes or inserts with no copay. Durable medical equipment, prosthetic devices, and medical supplies are covered with no coinsurance to 20% coinsurance, and prior authorization is required.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered under Wellpoint Chronic Care (HMO-POS C-SNP), featuring no copay and no coinsurance for lab services and diagnostic tests. Members will pay a $0 to $150 copay with no coinsurance for diagnostic radiological services, a $15 copay with no coinsurance for outpatient X-rays, and a 20% coinsurance with no copay for therapeutic radiological services.
Home Health Services See details
Home Health Services are covered by Wellpoint Chronic Care (HMO-POS C-SNP) with no copay and no coinsurance. Prior authorization is required to receive these services.
Cardiac Rehabilitation Services See details
Wellpoint Chronic Care (HMO-POS C-SNP) technically covers Cardiac Rehabilitation Services, but in practice, some services are covered while Cardiac Rehabilitation, Intensive Cardiac Rehabilitation, Pulmonary Rehabilitation, and SET for PAD Services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) benefits are covered by Wellpoint Chronic Care (HMO-POS C-SNP) with no copay for days 1 to 20 and a $218 daily copay for days 21 to 100, with no coinsurance required. This benefit is partially covered as prior authorization is required and additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Other services are partially covered by Wellpoint Chronic Care (HMO-POS C-SNP) with no copay or coinsurance for covered benefits, which include community resource support, meal benefits for chronic illnesses, and up to $107 every three months for over-the-counter items. Acupuncture and highly integrated dual-eligible SNP services are not covered under this plan.
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* 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.
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