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Wellcare Dual Select (HMO-POS D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Wellcare Dual Select (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 Select (HMO-POS D-SNP) in 2025, please refer to our full plan details page.
Wellcare Dual Select (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 OR. This plan received an overall rating of 3 out of 5 stars in 2025.
It's important to know that Wellcare Dual Select (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 Select (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 Select (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 Select (HMO-POS D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $21.70. 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 Maximum Out-Of-Pocket cost of $9350.00 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 Select (HMO-POS D-SNP) plan has a deductible of $590. Once you meet your deductible, you will pay the costs for your drugs in each tier. After your total drug costs reach $2000, you will enter the next coverage phase. If you qualify for the low-income subsidy (LIS), your Part D premium will be $21.70. Once you reach the catastrophic coverage phase, you pay nothing for Medicare Part D covered drugs, but you may still pay a share of the costs for excluded drugs.
Additional Benefits
The Wellcare Dual Select (HMO-POS D-SNP) plan offers a range of benefits with varying cost-sharing. Inpatient hospital stays have a $1960 copay, while outpatient services often involve a 20% coinsurance. Emergency services have a $110 copay. Preventive services such as annual physicals and hearing exams have no copay, and vision services include eye exams and eyewear with no copay. Dental services also have no copay for many services, and the plan also covers additional services such as ambulance, transportation, and skilled nursing facility services.
Inpatient Hospital See details
Inpatient Hospital benefits, including acute and psychiatric care, are covered by the Wellcare Dual Select (HMO-POS D-SNP) plan. For each admission or stay, you will pay a copay of $1960.00.
Outpatient Services See details
Outpatient Services include coverage for outpatient hospital services with a 20% coinsurance and no copay, and observation services with a 20% coinsurance and a $110 copay. Ambulatory Surgical Center Services and Outpatient Substance Abuse Services are also covered, with a minimum coinsurance of 20% and a maximum coinsurance of 20%. Outpatient Blood Services are covered with a 20% coinsurance.
Partial Hospitalization See details
Partial Hospitalization is covered under the Wellcare Dual Select (HMO-POS D-SNP) plan, but requires prior authorization. You will pay 20% coinsurance for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Wellcare Dual Select (HMO-POS D-SNP) plan. Ground and Air Ambulance Services have a 20% coinsurance, and Transportation Services to a plan-approved health-related location has no copay, with 12 one-way trips per year available via rideshare, bus/subway, or medical transport. 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 by the Wellcare Dual Select (HMO-POS D-SNP) plan. Emergency Services and Worldwide Emergency Coverage have a $110 copay, while Urgently Needed Services have a $45 copay, and all have no coinsurance. Worldwide Emergency Transportation is not covered.
Primary Care See details
The Wellcare Dual Select (HMO-POS D-SNP) plan covers Primary Care, with a 20% coinsurance for Primary Care Physician Services. Chiropractic Services, including routine care, are covered with no copay, but routine chiropractic care is limited to 24 visits per year. Other benefits include Occupational Therapy Services, Physician Specialist Services, Mental Health Specialty Services, Podiatry Services, Other Health Care Professional, Psychiatric Services, Physical Therapy and Speech-Language Pathology Services, Additional Telehealth Benefits, and Opioid Treatment Program Services, all with a 20% coinsurance. The additional telehealth benefit has a copay that ranges from $0.00 to $45.00.
Preventive Services See details
The Wellcare Dual Select (HMO-POS D-SNP) plan covers preventive services with no copay for an annual physical exam. Additional preventive services, including fitness benefits, alternative therapies, therapeutic massage, remote access technologies, and home and bathroom safety devices, are covered, but may require a copay. Kidney disease education services, glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKGs following a welcome visit are covered with 20% coinsurance.
Hearing Services See details
Hearing exams and prescription hearing aids are covered. Routine hearing exams have no copay and a coinsurance of 20%, and fitting/evaluation for hearing aids have no copay.
Vision Services See details
The Wellcare Dual Select (HMO-POS D-SNP) plan covers vision services, including eye exams with no copay and 20% coinsurance, and eyewear with no copay, with a combined maximum benefit of $300 per year. Contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades are also covered with no copay.
Dental Services See details
Dental services are covered, including Medicare Dental Services with 20% coinsurance. 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 are covered with no copay. Orthodontic services are covered up to a $5,000 maximum benefit. Maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, and require prior authorization. Medicare Part B Insulin Drugs have a $35 copay, while the coinsurance for Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs ranges from 0% to 20%.
Dialysis Services See details
Dialysis Services are covered by the Wellcare Dual Select (HMO-POS D-SNP) plan. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment benefits are covered by the Wellcare Dual Select (HMO-POS D-SNP) plan, including Durable Medical Equipment (DME) with a 20% coinsurance, and Prosthetics/Medical Supplies with a 20% coinsurance for Medicare-covered devices and supplies; however, Durable Medical Equipment for use outside the home is not covered. Diabetic Supplies have no copay, and Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including Diagnostic Procedures/Tests, Lab Services, Diagnostic Radiological Services, Therapeutic Radiological Services, and Outpatient X-Ray Services. Diagnostic Procedures/Tests and Therapeutic Radiological Services have a coinsurance of at most 20%, while Lab Services and Diagnostic Radiological Services have no copay and a coinsurance of at most 20%. Outpatient X-Ray Services have no copay.
Home Health Services See details
Home Health Services are covered by the Wellcare Dual Select (HMO-POS D-SNP) plan with no copay and no coinsurance. However, additional hours of care and personal care services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but the plan does not cover any of the sub-services. There is coinsurance for the covered services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Wellcare Dual Select (HMO-POS D-SNP) plan, but require prior authorization. For days 1-20, there is no copay, and for days 21-100, there is a $214 copay.
Other Services See details
Other Services includes acupuncture with no copay, up to 24 treatments per year, and Over-the-Counter (OTC) Items with no copay. The plan also covers a Meal Benefit with no copay and requires a doctor referral. However, 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, 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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