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Wellcare Dual Liberty Open (PPO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Wellcare Dual Liberty Open (PPO 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 Liberty Open (PPO D-SNP) in 2025, please refer to our full plan details page.
Wellcare Dual Liberty Open (PPO D-SNP) is a PPO D-SNP plan offered by Centene Corporation available for enrollment in 2025 to people living in Select Counties in NC. This plan received an overall rating of 3.5 out of 5 stars in 2025.
It's important to know that Wellcare Dual Liberty Open (PPO 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 Liberty Open (PPO 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 Liberty Open (PPO 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 Liberty Open (PPO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $39.20. 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 $590.00 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 combined Maximum Out-Of-Pocket cost of $14000.00 (in-network or out-of-network combined). You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $14000.00 for covered services, the plan will pay 100% of covered costs for the rest of the year.
The plan may have separate out-pocket-maximums for in-network and out-of-network services. See our full plan details page for more information.
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 Liberty Open (PPO D-SNP) plan has a $590 deductible for prescription drugs. After the deductible is met, you will pay the cost for your drugs based on the tier and pharmacy you use until your total drug costs reach $2,000. Once your yearly out-of-pocket drug costs reach $2,000, you will enter the catastrophic coverage phase, where you will pay nothing for your Part D covered drugs. If you qualify for the low-income subsidy, your monthly premium will be $39.20.
Additional Benefits
The Wellcare Dual Liberty Open (PPO D-SNP) plan offers a wide range of benefits, including coverage for inpatient hospital stays with a $1,720 copay per admission. Outpatient services, primary care, preventive services, and many others are covered with either no copay or a 20% coinsurance. The plan also provides coverage for hearing and vision services, with no copay for routine exams and a yearly allowance for eyewear and hearing aids. Dental services are covered with no copay for many services, and a 20% coinsurance for Medicare dental services. Additionally, the plan includes coverage for ambulance services, emergency services, home health services, and skilled nursing facility care with varying cost-sharing.
Inpatient Hospital See details
Inpatient Hospital benefits, including acute and psychiatric care, are covered with a copay of $1,720 per admission or stay. Additional days and non-Medicare-covered stays for both acute and psychiatric care are not covered.
Outpatient Services See details
Outpatient Services include coverage for Outpatient Hospital Services with a 20% coinsurance and no copay, Observation Services with a 20% coinsurance, Ambulatory Surgical Center (ASC) Services with a 20% coinsurance, Outpatient Substance Abuse Services with a 20% coinsurance for individual and group sessions, and Outpatient Blood Services with a 20% coinsurance and a waived three-pint deductible. Prior authorization is required for some services.
Partial Hospitalization See details
Partial Hospitalization is covered, but requires prior authorization. You will pay a 20% coinsurance for this benefit.
Ambulance and Transportation Services See details
The Wellcare Dual Liberty Open (PPO D-SNP) plan covers ambulance services with a 20% coinsurance for both ground and air ambulance services. Transportation services to plan-approved health-related locations are covered with no copay, offering up to 24 one-way trips per year via rideshare, bus/subway, or medical transport, while transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Coverage are covered under the Wellcare Dual Liberty Open (PPO D-SNP) plan. For Emergency Services, the copay is $110, and there is no coinsurance, while the copay is $45 for Urgently Needed Services, and there is no coinsurance. Worldwide Emergency Coverage has a $110 copay, and no coinsurance. Worldwide Emergency Transportation is not covered.
Primary Care See details
The Wellcare Dual Liberty Open (PPO D-SNP) plan covers primary care physician services, chiropractic services, occupational therapy, physician specialist services, mental health specialty services, podiatry services, other health care professional services, psychiatric services, physical therapy and speech-language pathology services, additional telehealth benefits, and opioid treatment program services, all with a 20% coinsurance. Routine chiropractic care is not covered, and additional telehealth benefits have a copay between $0 and $45.
Preventive Services See details
Preventive services include coverage for Medicare-covered preventive services with no copay, an annual physical exam with no copay, and additional preventive services. Additional preventive services may have a copay depending on the service, and other services like health education and in-home safety assessments are not covered. Services such as kidney disease education and glaucoma screening have a 20% coinsurance.
Hearing Services See details
Hearing services include hearing exams with at most 20% coinsurance, and prescription hearing aids with a $1,500 annual benefit per ear, and routine hearing exams and fitting/evaluation for hearing aids with no copay. Prescription hearing aids are covered, but inner ear, outer ear, and over the ear hearing aids are not covered, and OTC hearing aids are not covered.
Vision Services See details
Vision services include eye exams and eyewear. Eye exams have no copay and 20% coinsurance, while routine eye exams have no copay. Eyewear has a 20% coinsurance and no copay for contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades, with a combined maximum benefit of $400 per year.
Dental Services See details
Dental Services are covered, with a 20% coinsurance for Medicare Dental Services. Other dental services include oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatment, other preventive dental services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), and oral and maxillofacial surgery with no copay. Orthodontic Services are covered up to a maximum of $3,000 per year, while maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs with a $35 copay. Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs are covered with coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by the Wellcare Dual Liberty Open (PPO D-SNP) plan. The coinsurance for dialysis services is between 20% and 20%.
Medical Equipment See details
Medical Equipment is covered by the Wellcare Dual Liberty Open (PPO D-SNP) plan, including Durable Medical Equipment with 20% coinsurance and Prosthetics/Medical Supplies and Diabetic Equipment with 20% coinsurance for some services. Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services, including diagnostic procedures/tests, lab services, diagnostic radiological services, therapeutic radiological services, and outpatient X-ray services, are covered. For diagnostic procedures/tests, and diagnostic, therapeutic, and outpatient radiological services, you may pay up to 20% coinsurance. Lab services have no copay and a coinsurance of up to 20%.
Home Health Services See details
Home Health Services are covered by the Wellcare Dual Liberty Open (PPO D-SNP) plan with no copay and no coinsurance. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the Wellcare Dual Liberty Open (PPO D-SNP) plan. The plan does not cover Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, or SET for PAD Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Wellcare Dual Liberty Open (PPO D-SNP) plan. There is no copay for days 1-20, and a $214 copay for days 21-100.
Other Services See details
Other Services include Over-the-Counter (OTC) Items with no copay. Acupuncture, Meal Benefit, Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, and Self-Directed Personal Assistance Services are not covered.
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