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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 2026, 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 2026.
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 $25.80. 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 $395.00 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 $13900.00 (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 $13900.00 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 features an annual prescription drug deductible of $395. For Tier 6 select care drugs, you will pay no copay regardless of whether you use a standard or preferred pharmacy. Tier 1 preferred generic and Tier 2 generic medications also offer savings, including no copay for a three-month supply when using a preferred mail-order service. For Tier 3 preferred brand drugs and Tier 5 specialty medications, you will pay a 25% coinsurance. Tier 4 non-preferred drugs require a copay starting at $100 for a one-month supply at both standard and preferred pharmacies. Understanding these tier-based copays and coinsurance rates helps you maximize your benefits and minimize out-of-pocket prescription costs.
Additional Benefits
The Wellcare Dual Liberty Open (PPO D-SNP) offers comprehensive medical coverage, featuring an inpatient hospital admission copay of $1,870 and no coinsurance. Most outpatient services, primary care visits, specialist consultations, and diagnostic tests require no copay but carry a 20% coinsurance. Emergency care is available with a $115 copay, while urgent care visits require a $40 copay, both of which are waived if you are admitted to the hospital within 24 hours. This plan also includes valuable supplemental benefits, such as preventive and comprehensive dental care with no copay and no coinsurance up to a $3,000 annual limit. Additionally, members benefit from no copay and no coinsurance for home health services, over-the-counter items, and routine transportation for up to 24 one-way trips per year. Vision and hearing services are also covered, featuring no copays for routine exams alongside generous allowance limits for eyewear and prescription hearing aids.
Inpatient Hospital See details
Wellcare Dual Liberty Open (PPO D-SNP) covers inpatient acute and psychiatric hospital stays with a $1,870 copay per admission and no coinsurance, though prior authorization is required. This benefit is partially covered as additional days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Wellcare Dual Liberty Open (PPO D-SNP) covers outpatient services—including outpatient hospital, ambulatory surgical center, substance abuse, and blood services—with no copay and a 20% coinsurance. Prior authorization is required for ambulatory surgical center, outpatient hospital, and outpatient substance abuse services.
Partial Hospitalization See details
Partial hospitalization services are covered by Wellcare Dual Liberty Open (PPO D-SNP) with no copay and a 20% coinsurance, although prior authorization is required.
Ambulance and Transportation Services See details
Wellcare Dual Liberty Open (PPO D-SNP) covers ground and air ambulance services with a 20% coinsurance and no copay, subject to prior authorization. Transportation services are partially covered with no copay and no coinsurance for up to 24 one-way trips per year to plan-approved locations, though transportation to any health-related location is not covered.
Emergency Services See details
Wellcare Dual Liberty Open (PPO D-SNP) covers emergency services with a $115 copay and no coinsurance, and urgent care with a $40 copay and no coinsurance, with both copays waived if admitted to the hospital within 24 hours. Worldwide emergency and urgent services are partially covered up to a $50,000 limit with a $115 copay and no coinsurance, though worldwide emergency transportation is not covered.
Primary Care See details
Wellcare Dual Liberty Open (PPO D-SNP) covers primary care, specialist, psychiatric, and therapy services with no copay and 20% coinsurance, while podiatry services require no copay and no coinsurance for up to 6 routine visits per year. Some chiropractic services are covered, but routine care and other chiropractic services are not covered. Telehealth options are also available with a $0 to $40 copay and 20% coinsurance.
Preventive Services See details
Wellcare Dual Liberty Open (PPO D-SNP) covers preventive services, offering an annual physical exam, fitness benefits, remote access technologies, personal emergency response systems, and alternative therapies with no copay and no coinsurance. Some additional preventive benefits like health education, nutritional benefits, and weight management programs are not covered, while kidney disease education and other screenings are covered with no copay and a 20% coinsurance.
Hearing Services See details
Hearing services are covered by Wellcare Dual Liberty Open (PPO D-SNP) with no deductible, offering one routine hearing exam annually with a 20% coinsurance and no copay, and one fitting evaluation with no copay. Prescription hearing aids are covered with no copay or coinsurance up to a $1,500 maximum per ear each year, though OTC hearing aids and inner, outer, or over-the-ear prescription models are not covered.
Vision Services See details
Wellcare Dual Liberty Open (PPO D-SNP) partially covers vision services with no deductibles, offering one routine eye exam per year with no copay and a 20% coinsurance, though other eye exam services are not covered. Eyewear is covered up to a $600 annual limit with no copay for glasses, frames, lenses, and upgrades, while contact lenses require a 20% coinsurance.
Dental Services See details
Wellcare Dual Liberty Open (PPO D-SNP) dental services are partially covered, offering Medicare-covered services with no copay and a 20% coinsurance, and preventive and comprehensive care with no copay and no coinsurance up to a $3,000 annual limit. 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 Wellcare Dual Liberty Open (PPO D-SNP) with no copay, though prior authorization is required. Medicare Part B chemotherapy and other Part B drugs carry a 0% to 20% coinsurance, while Part B insulin is covered with a $35 copay and no coinsurance.
Dialysis Services See details
Dialysis Services are covered by Wellcare Dual Liberty Open (PPO D-SNP) with no copay and a 20% coinsurance.
Medical Equipment See details
Medical Equipment benefits under the Wellcare Dual Liberty Open (PPO D-SNP) are covered with no copay and a 20% coinsurance for durable medical equipment, prosthetics, medical supplies, and diabetic equipment. Prior authorization is required for these services, and diabetic supplies are limited to specified manufacturers.
Diagnostic and Radiological Services See details
Wellcare Dual Liberty Open (PPO D-SNP) covers diagnostic and radiological services with no copay and a 20% coinsurance, though prior authorization is required. Covered benefits include outpatient diagnostic procedures, lab services, diagnostic and therapeutic radiological services, and outpatient X-rays.
Home Health Services See details
Home Health Services are covered by Wellcare Dual Liberty Open (PPO D-SNP) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the Wellcare Dual Liberty Open (PPO D-SNP) plan, as all sub-services—including cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation—are not covered and require a 20% coinsurance despite a $0 copay.
Skilled Nursing Facility (SNF) See details
Wellcare Dual Liberty Open (PPO D-SNP) covers Skilled Nursing Facility (SNF) care with no coinsurance, requiring prior authorization but no prior three-day inpatient hospital stay. There is no copay for days 1 through 20 and days 71 through 100, while days 21 through 70 require a $218 daily copay; additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Wellcare Dual Liberty Open (PPO D-SNP) partially covers other services, providing over-the-counter (OTC) items with no copay and no coinsurance. Acupuncture, meal benefits, and other additional services are not covered.
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