Wellpoint Premium Savings (HMO)

Wellpoint Premium Savings (HMO) is a HMO plan offered by Elevance Health, Inc. available for enrollment in 2025 to people living in Pima County. This plan received an overall rating of 3 out of 5 stars in 2026.

It's important to know that Wellpoint Premium Savings (HMO) 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 Wellpoint Premium Savings (HMO).

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 Wellpoint Premium Savings (HMO) plan features an enhanced alternative drug benefit with a $125.00 prescription drug deductible. During the initial coverage phase, you will enjoy no copay for tier 1 preferred generic drugs at preferred pharmacies and standard mail delivery, while standard pharmacies charge a $10.00 copay. Other drug tiers require coinsurance, ranging from 25% for standard generics up to 31% for non-preferred drugs, though tier 5 specialty drugs have no copay. Once your yearly out-of-pocket drug costs reach $2,100.00, you enter the catastrophic coverage phase and pay nothing for covered Part D prescriptions. Additionally, individuals who qualify for the low-income subsidy, or Extra Help, can benefit from a reduced Part D premium of $0.00.

Additional Benefits

The Wellpoint Premium Savings (HMO) plan offers comprehensive coverage for essential medical services with predictable out-of-pocket costs. Primary care doctor visits range from no copay to a $10 copay, while specialist visits feature a copay of up to $30, with no coinsurance for either service. For hospital care, inpatient stays require a $225 daily copay for days 1 through 5 followed by no copay for days 6 through 90, and emergency room visits feature a $150 copay that is waived upon admission. In addition to medical care, the plan provides valuable routine benefits to support your overall wellness. Members pay no copay and no coinsurance for routine vision exams, eyewear up to a $225 annual limit, and routine hearing exams, which include up to a $300 annual allowance for over-the-counter hearing aids. Covered dental services require a copay ranging from no copay to $30 with no coinsurance, and the plan includes an over-the-counter item allowance of $79 every three months at no cost.