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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 IA. This plan received an overall rating of 2.5 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 $30.20. 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 $5000.00 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 has an annual drug deductible of $615. For Tier 1 preferred generics and Tier 2 generics, 1-month copays start as low as $18 and $19 at preferred pharmacies, while 3-month fills through preferred mail order have no copay. Additionally, Tier 6 select care drugs are highly affordable, with no copay for any supply size at preferred pharmacies or through preferred mail order. For brand-name and specialty medications, you will pay a 25% coinsurance for Tier 3 preferred brands and Tier 5 specialty drugs. Tier 4 non-preferred drugs require a $100 copay for a 1-month supply at both preferred and standard pharmacies. These cost-sharing details help clarify your potential out-of-pocket expenses when choosing this Medicare Advantage plan.
Additional Benefits
The Wellcare Dual Reserve (HMO-POS D-SNP) offers robust coverage with predictable costs, featuring no copays for primary care visits, preventive screenings, and home health care. For specialized medical needs, members pay a low $20 copay for specialist visits, while inpatient acute hospital stays require a $350 daily copay for the first five days. Outpatient services generally feature no coinsurance, with copays ranging from $0 to $250 depending on the service. This plan also includes extensive dental, vision, and hearing benefits, highlighted by a $3,000 annual limit for comprehensive dental care and a $1,000 annual hearing aid allowance per ear, both with no copays. Additionally, members receive up to 24 free one-way transportation trips per year and covered over-the-counter items at no cost. For durable medical equipment and dialysis services, members can expect no copay and a standard 20% coinsurance.
Inpatient Hospital See details
Wellcare Dual Reserve (HMO-POS D-SNP) partially covers inpatient hospital services with no coinsurance, requiring a $350 daily copay for days 1 through 5 of acute stays (no copay for days 6 and beyond) and a $275 daily copay for days 1 through 5 of psychiatric stays (no copay for days 6 through 90). Upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Wellcare Dual Reserve (HMO-POS D-SNP) covers outpatient hospital services with a $0 to $250 copay and observation services with a $130 to $250 copay, both with no coinsurance. Ambulatory surgical center services require a $200 copay, outpatient substance abuse sessions have a $25 copay, and outpatient blood services are covered with no copay, with all of these benefits featuring no 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 to receive this benefit.
Ambulance and Transportation Services See details
Wellcare Dual Reserve (HMO-POS D-SNP) covers ground and air ambulance services with a $250 copay and no coinsurance, requiring prior authorization. Transportation services are partially covered, offering up to 24 one-way trips per year to plan-approved locations with no copay and no coinsurance, while transportation to any health-related location is not covered.
Emergency Services See details
Emergency services are covered by Wellcare Dual Reserve (HMO-POS D-SNP) with a $130 copay, and urgent care is covered with a $35 copay, both featuring no coinsurance. Worldwide emergency and urgent care are partially covered up to a $50,000 limit with a $130 copay and no coinsurance, though worldwide emergency transportation is not covered.
Primary Care See details
Wellcare Dual Reserve (HMO-POS D-SNP) covers primary care provider services with no copay and no coinsurance, while specialist visits, physical therapy, occupational therapy, and opioid treatment require a $20 copay and no coinsurance. Mental health and psychiatric sessions have a $25 copay and no coinsurance, telehealth ranges from no copay to a $35 copay with no coinsurance, and chiropractic and podiatry services are not covered.
Preventive Services See details
Wellcare Dual Reserve (HMO-POS D-SNP) offers partially covered preventive services with no copays and no coinsurance for annual physicals, fitness benefits, alternative therapies, PERS, remote access, and various screenings, while kidney disease education requires a 20% coinsurance and no copay. Sub-services such as health education, nutritional/dietary benefits, in-home support, and home safety assessments are not covered.
Hearing Services See details
Wellcare Dual Reserve (HMO-POS D-SNP) offers partially covered hearing services, featuring a $20 copay and no coinsurance for Medicare-covered exams, alongside annual routine exams and fitting evaluations with no copay or coinsurance. Prescription hearing aids are covered up to $1,000 per ear annually with no copay or coinsurance, though inner ear, outer ear, over the ear, and OTC hearing aids are not covered.
Vision Services See details
Vision services are partially covered by Wellcare Dual Reserve (HMO-POS D-SNP), as other eye exam services are not covered. Covered eye exams feature no coinsurance and a copay of $0 to $20 (with no copay for one routine exam per year), while covered eyewear has no copay and no coinsurance up to a $300 annual maximum.
Dental Services See details
Wellcare Dual Reserve (HMO-POS D-SNP) covers Medicare-covered dental services with a $20 copay and no coinsurance, while preventive services are covered with no copay and no coinsurance. Comprehensive dental benefits are partially covered with no copay and no coinsurance up to a $3,000 annual limit, excluding maxillofacial prosthetics, implant services, and orthodontics.
Home Infusion bundled Services See details
Home infusion bundled services are covered by Wellcare Dual Reserve (HMO-POS D-SNP) with no copay, while Medicare Part B insulin drugs require a $35 copay and no coinsurance. Other covered Part B chemotherapy and radiation drugs require no copay and 0% to 20% coinsurance, with prior authorization and step therapy required for services.
Dialysis Services See details
Dialysis Services are covered by Wellcare Dual Reserve (HMO-POS D-SNP) with no copay and a 20% coinsurance.
Medical Equipment See details
Wellcare Dual Reserve (HMO-POS D-SNP) covers durable medical equipment, prosthetics, and medical supplies with no copay and a 20% coinsurance. Diabetic supplies are covered with no copay, while diabetic therapeutic shoes and inserts require a 20% coinsurance, with prior authorization required for these benefits.
Diagnostic and Radiological Services See details
Wellcare Dual Reserve (HMO-POS D-SNP) covers diagnostic and radiological services with prior authorization, offering diagnostic procedures with no coinsurance and a copay of $0 to $30, and lab services with no copay. Radiological services include outpatient X-rays with no copay but applicable coinsurance, diagnostic radiological services with a copay starting at $0, and therapeutic radiological services with a copay and a minimum 20% coinsurance.
Home Health Services See details
Wellcare Dual Reserve (HMO-POS D-SNP) covers home health services with no copay and no coinsurance. Prior authorization is required for these services.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are offered by Wellcare Dual Reserve (HMO-POS D-SNP) with no coinsurance, though in practice only some services are covered. Standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for PAD services are not covered under this benefit, carrying copays of $40, $50, $35, and $25 respectively.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by Wellcare Dual Reserve (HMO-POS D-SNP) with no coinsurance, featuring no copay for days 1 to 20 and 51 to 100, and a $218 daily copay for days 21 to 50. Prior authorization is required, and the plan allows admission without a prior three-day hospital stay, though additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Wellcare Dual Reserve (HMO-POS D-SNP) offers partial coverage for other services, which includes over-the-counter (OTC) items and chronic illness meal benefits with no copay and no coinsurance. However, a referral is required for the meal benefit, and acupuncture is not covered.
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1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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