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Wellpoint I CareMore Home Care (HMO I-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Wellpoint I CareMore Home Care (HMO I-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Wellpoint I CareMore Home Care (HMO I-SNP) in 2026, please refer to our full plan details page.
Wellpoint I CareMore Home Care (HMO I-SNP) is a HMO I-SNP plan offered by Elevance Health, Inc. available for enrollment in 2025 to people living in Maricopa County. This plan received an overall rating of 3 out of 5 stars in 2026.
It's important to know that Wellpoint I CareMore Home Care (HMO I-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
Wellpoint I CareMore Home Care (HMO I-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 I CareMore Home Care (HMO I-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 I CareMore Home Care (HMO I-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 $1500.00 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 I CareMore Home Care (HMO I-SNP) plan features an Enhanced Alternative drug benefit with a $150 prescription drug deductible. After meeting this deductible, you will enter the initial coverage phase where Tier 1 preferred generics and Tier 5 specialty drugs have no copay at standard pharmacies and standard mail-order services. For other drug tiers during this phase, you will pay a coinsurance of 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 costs reach $2,100, you enter the catastrophic coverage phase and pay nothing for covered Medicare Part D prescription drugs. Additionally, beneficiaries who qualify for the low-income subsidy, also known as Extra Help, can reduce their Part D costs to $0. To ensure your specific medications are covered, make sure to review the plan's formulary.
Additional Benefits
The Wellpoint I CareMore Home Care (HMO I-SNP) plan offers robust coverage with no copayments or coinsurance for many essential services, including primary care, preventive care, and home health services. For hospital stays, inpatient care requires a $150 daily copay for the first five days and no copay thereafter, while emergency room visits carry a $120 copay that is waived if you are admitted. Outpatient services and diagnostic tests are also highly accessible, with many procedures requiring no copay or coinsurance. This plan also features strong supplemental benefits to help manage your everyday health costs, including routine vision, hearing, and dental care with no copay or coinsurance. Dental care is covered up to a $1,500 annual limit, and vision coverage includes a routine exam plus up to $275 yearly for eyewear. Additionally, members benefit from up to 18 one-way transportation trips to approved locations and a $200 quarterly allowance for over-the-counter items with no copay.
Inpatient Hospital See details
Inpatient hospital benefits are partially covered by Wellpoint I CareMore Home Care (HMO I-SNP), with covered acute and psychiatric stays requiring a $150 daily copay for days 1 through 5, no copay for days 6 through 90, and no coinsurance. Prior authorization is required for these stays, which include unlimited additional days at no copay, though upgrades and non-Medicare-covered stays are not covered.
Outpatient Services See details
Outpatient services are covered by Wellpoint I CareMore Home Care (HMO I-SNP) with no coinsurance, featuring no copay for ambulatory surgical center, outpatient substance abuse, and blood services. Outpatient hospital and observation services require prior authorization and carry copays ranging from no copay up to $175.
Partial Hospitalization See details
Wellpoint I CareMore Home Care (HMO I-SNP) covers partial hospitalization benefits with no 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 I CareMore Home Care (HMO I-SNP), with ground and air ambulance services requiring a $250 copay and no coinsurance. Transportation benefits are partially covered, offering up to 18 one-way trips to plan-approved health-related locations with no copay or coinsurance, while transportation to any health-related location is not covered.
Emergency Services See details
Emergency services are covered by Wellpoint I CareMore Home Care (HMO I-SNP) with a $120 copay and no coinsurance, with the copay waived if you are admitted to the hospital within 24 hours. Urgently needed services have no copay and no coinsurance, and worldwide emergency, urgent, and transportation services are covered up to a $100,000 lifetime maximum with a $120 copay and no coinsurance.
Primary Care See details
Wellpoint I CareMore Home Care (HMO I-SNP) covers most primary care benefits with no copay and no coinsurance, though visits to other health care professionals may require a copay of up to $20. Chiropractic services are only partially covered, as routine chiropractic care is not covered.
Preventive Services See details
Preventive services are covered by Wellpoint I CareMore Home Care (HMO I-SNP) with no copay and no coinsurance for annual physicals, kidney disease education, remote access technologies, and select screenings. However, many additional services, including fitness benefits, health education, and personal emergency response systems, are not covered.
Hearing Services See details
Hearing services are covered by Wellpoint I CareMore Home Care (HMO I-SNP) with no copay and no coinsurance, including annual routine exams, fitting evaluations, and OTC hearing aids up to a $300 yearly limit. Prescription hearing aids are partially covered up to a $3,000 annual limit, but inner ear, outer ear, and over the ear prescription hearing aids are not covered.
Vision Services See details
Wellpoint I CareMore Home Care (HMO I-SNP) partially covers vision services with no copay, no deductible, and no coinsurance, though eyewear upgrades are not covered. The plan includes one routine eye exam and up to a $275 combined maximum benefit for eyewear, such as contacts and eyeglasses, every year.
Dental Services See details
Wellpoint I CareMore Home Care (HMO I-SNP) offers partially covered dental services with no copay and no coinsurance up to a maximum annual benefit of $1,500. Covered care includes preventive and restorative treatments, but maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Wellpoint I CareMore Home Care (HMO I-SNP) covers home infusion bundled services, which require prior authorization and step therapy. Under this plan, Medicare Part B insulin drugs have a $35 copay and no coinsurance, while chemotherapy and other Part B drugs have no copay and coinsurance ranging from no coinsurance to 20%.
Dialysis Services See details
Dialysis services are covered by Wellpoint I CareMore Home Care (HMO I-SNP) with no copay and a 20% coinsurance.
Medical Equipment See details
Wellpoint I CareMore Home Care (HMO I-SNP) covers medical equipment with prior authorization, offering durable medical equipment, prosthetics, and medical supplies for no copay and 0% to 20% coinsurance. Diabetic supplies and therapeutic shoes or inserts are also covered with no copay and no coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered by Wellpoint I CareMore Home Care (HMO I-SNP), with prior authorization required. There is no copay or coinsurance for diagnostic procedures, lab services, and outpatient X-rays, while diagnostic radiological services carry a copay of $0 to $150 with no coinsurance, and therapeutic radiological services require a 20% coinsurance with no copay.
Home Health Services See details
Wellpoint I CareMore Home Care (HMO I-SNP) covers Home Health Services with no copay and no coinsurance. Prior authorization is required to receive these benefits.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the Wellpoint I CareMore Home Care (HMO I-SNP) plan, as all associated sub-services—including cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation—are excluded from coverage.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are partially covered by Wellpoint I CareMore Home Care (HMO I-SNP) with no copay and no coinsurance for days 1 through 100. Prior authorization is required, and additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Wellpoint I CareMore Home Care (HMO I-SNP) partially covers Other Services, offering Medicare Community Resource Support and a $200 quarterly allowance for Over-the-Counter (OTC) items with no copay and no coinsurance. Acupuncture, meal benefits, and Dual Eligible SNPs with Highly Integrated Services are not covered.
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