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Wellcare 'Ohana Dual Liberty (HMO-POS D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Wellcare 'Ohana Dual Liberty (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 'Ohana Dual Liberty (HMO-POS D-SNP) in 2025, please refer to our full plan details page.
Wellcare 'Ohana Dual Liberty (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 HI. This plan received an overall rating of 3 out of 5 stars in 2025.
It's important to know that Wellcare 'Ohana Dual Liberty (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 'Ohana Dual Liberty (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 'Ohana Dual Liberty (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 'Ohana Dual Liberty (HMO-POS D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $41.80. 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 $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 'Ohana Dual Liberty (HMO-POS D-SNP) plan has a $590.00 deductible for prescription drugs. After meeting the deductible, you will pay the costs for drugs in each tier until your total drug costs reach $2000.00, at which point you enter the next coverage phase. If you qualify for the low-income subsidy (LIS), also known as "Extra Help", your Part D premium is $41.80. Once your yearly out-of-pocket drug costs reach $2000.00, you will pay nothing for covered drugs.
Additional Benefits
The Wellcare 'Ohana Dual Liberty (HMO-POS D-SNP) plan offers a variety of benefits, including coverage for inpatient hospital stays with a $2,000 copay per admission. Outpatient services such as hospital visits, substance abuse, and blood services are covered with a 20% coinsurance, and there is no copay for preventive services like an annual physical. This plan also covers emergency services with a copay, and offers coverage for primary care services, hearing and vision exams, and dental services, often with coinsurance. It also offers benefits for home infusion, dialysis, and medical equipment with coinsurance, and covers home health services. Additionally, the plan includes acupuncture treatments, and over-the-counter items with no copay.
Inpatient Hospital See details
Inpatient Hospital benefits, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, are covered with a copay of $2,000 per admission or stay. Additional days for Inpatient Hospital-Acute and Psychiatric, and Non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute and Psychiatric are not covered.
Outpatient Services See details
Outpatient services include 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, and outpatient blood services with a 20% coinsurance. The outpatient blood services also have a waived three (3) pint deductible.
Partial Hospitalization See details
Partial Hospitalization is covered under the Wellcare 'Ohana Dual Liberty (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 under the Wellcare 'Ohana Dual Liberty (HMO-POS D-SNP) plan. Ground and Air Ambulance Services have a 20% coinsurance, with no copay. Transportation Services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Coverage have a copay of $110, $45, and $110, respectively, with no coinsurance. Worldwide Urgent Coverage has a copay of $110 with no coinsurance, and Worldwide Emergency Transportation is not covered.
Primary Care See details
Primary Care services are covered, including Primary Care Physician Services, Chiropractic Services, Occupational Therapy Services, Physician Specialist Services, Mental Health Specialty Services, Other Health Care Professional, Psychiatric Services, Physical Therapy and Speech-Language Pathology Services, Additional Telehealth Benefits, and Opioid Treatment Program Services. Primary Care Physician Services, Chiropractic Services, Physician Specialist Services, Physical Therapy and Speech-Language Pathology Services, and Additional Telehealth Benefits have a 20% coinsurance. Occupational Therapy Services, Individual Sessions for Mental Health Specialty Services, Group Sessions for Mental Health Specialty Services, Other Health Care Professional, Individual Sessions for Psychiatric Services, Group Sessions for Psychiatric Services, and Opioid Treatment Program Services have a minimum and maximum coinsurance of 20%. Routine Chiropractic Care is not covered, and Additional Telehealth Benefits have a copay between $0 and $45.
Preventive Services See details
Preventive services include an annual physical exam with no copay, and additional preventive services with a copay. Kidney disease education services, glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKG following a Welcome Visit are covered with 20% coinsurance.
Hearing Services See details
Hearing exams, including routine exams and fitting/evaluation for hearing aids, are covered by the Wellcare 'Ohana Dual Liberty (HMO-POS D-SNP) plan. Routine hearing exams and fitting/evaluation for hearing aids have no copay, and routine hearing exams have a 20% coinsurance. Prescription hearing aids are covered with a maximum benefit of $500 per year, and covered hearing aids have no copay. OTC hearing aids are not covered.
Vision Services See details
The Wellcare 'Ohana Dual Liberty (HMO-POS D-SNP) plan covers vision services, including eye exams with a 20% coinsurance and no copay, and eyewear with a 20% coinsurance. Routine eye exams have no copay, and the plan covers one routine eye exam every year. Contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades have no copay. There is a combined maximum plan benefit coverage amount of $100.00 for all eyewear every year.
Dental Services See details
Dental Services include coverage for Medicare Dental Services with 20% coinsurance, and Other Diagnostic and Other Preventive Dental Services, with no copay. Oral Exams, Dental X-Rays, Prophylaxis (Cleaning), Fluoride Treatment, Maxillofacial Prosthetics, Implant Services, and Orthodontics are not covered. Orthodontic Services are covered up to a maximum of $3,000 per year, and Prosthodontics, fixed is covered with no copay.
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 with 0-20% coinsurance, and Other Medicare Part B Drugs with 0-20% coinsurance. Prior authorization is required.
Dialysis Services See details
Dialysis Services are covered by the Wellcare 'Ohana Dual Liberty (HMO-POS D-SNP) plan. The coinsurance for dialysis services is 20%.
Medical Equipment See details
Medical Equipment benefits are covered, including Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment. Durable Medical Equipment has a 20% coinsurance and requires authorization, while Durable Medical Equipment for use outside the home is not covered. Prosthetic Devices and Diabetic Supplies also have a 20% coinsurance. Medical Supplies have a 20% coinsurance, and Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered under the Wellcare 'Ohana Dual Liberty (HMO-POS D-SNP) plan. Diagnostic Procedures/Tests and Radiological Services have a coinsurance of at most 20%, while Lab Services have no copay and a coinsurance of at most 20%.
Home Health Services See details
Home Health Services are covered by the Wellcare 'Ohana Dual Liberty (HMO-POS 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 'Ohana Dual Liberty (HMO-POS D-SNP)' plan. Specifically, Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, and Additional Cardiac Rehabilitation Services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Wellcare 'Ohana Dual Liberty (HMO-POS D-SNP) plan, with a $0 copay for days 1-20 and a $214 copay for days 21-100. Additional days beyond Medicare-covered and non-Medicare-covered stays for SNF are not covered.
Other Services See details
The "Other Services" benefit covers acupuncture with no copay, but requires prior authorization and is limited to 24 treatments per year. Over-the-counter (OTC) items are also covered with no copay, including nicotine replacement therapy and Naloxone. However, meal benefits, 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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