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Wellpoint Chronic Care 2 (HMO-POS C-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Wellpoint Chronic Care 2 (HMO-POS C-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Wellpoint Chronic Care 2 (HMO-POS C-SNP) in 2026, please refer to our full plan details page.
Wellpoint Chronic Care 2 (HMO-POS C-SNP) is a HMO-POS C-SNP plan offered by Elevance Health, Inc. available for enrollment in 2025 to people living in Pima County. This plan received an overall rating of 3.5 out of 5 stars in 2026.
It's important to know that Wellpoint Chronic Care 2 (HMO-POS C-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
Wellpoint Chronic Care 2 (HMO-POS C-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 Wellpoint Chronic Care 2 (HMO-POS C-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 Wellpoint Chronic Care 2 (HMO-POS C-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $0.00. 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 no drug deductible. Your prescription medication coverage will start immediately.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $8300.00 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 Wellpoint Chronic Care 2 (HMO-POS C-SNP) plan offers an Enhanced Alternative drug benefit with a $0 prescription drug deductible. During the initial coverage phase, you will have no copay for Tier 1 preferred generic drugs at preferred pharmacies and standard mail, as well as no copay for Tier 5 specialty drugs. For standard generic, preferred brand, and non-preferred drugs, your costs will range from 15% to 33% coinsurance depending on the tier and pharmacy type. After your yearly out-of-pocket drug costs reach $2,100.00, you enter the catastrophic coverage phase and pay nothing for Medicare Part D covered drugs. Additionally, beneficiaries who qualify for the low-income subsidy, or Extra Help, can reduce their drug premium costs to $0.00. This prescription drug plan provides structured and affordable coverage options to help manage your healthcare budget.
Additional Benefits
The Wellpoint Chronic Care 2 (HMO-POS C-SNP) plan offers comprehensive coverage for everyday health needs, featuring no copays for primary care visits, telehealth, home health, and dialysis services. For specialist and therapy visits, copays range from no copay to $35, while inpatient hospital stays require a $265 daily copay for the first six days and no copay for days 7 through 90. Emergency care is accessible with a $115 copay, which is waived if you are admitted, and urgent care visits require a $15 copay. This plan also includes valuable supplemental benefits, such as no copays for preventive and comprehensive dental care up to a $1,200 annual limit, and a $175 yearly allowance for eyewear. Members benefit from no copays on hearing exams and hearing aids up to a $1,500 annual limit, alongside a $48 quarterly over-the-counter allowance. Most diabetic supplies and diagnostic lab tests require no copay, while durable medical equipment features no copay and a coinsurance ranging from no coinsurance to 20%.
Inpatient Hospital See details
Wellpoint Chronic Care 2 (HMO-POS C-SNP) partially covers inpatient hospital acute and psychiatric services, which require a $265 copay per day for days 1 through 6, no copay for days 7 through 90, and no coinsurance. Prior authorization is required for these services, and non-Medicare-covered stays and upgrades are not covered.
Outpatient Services See details
Wellpoint Chronic Care 2 (HMO-POS C-SNP) covers outpatient services with no coinsurance, featuring no copay for ambulatory surgical center and blood services. Patients will pay a $25 copay for outpatient substance abuse sessions and between $0 and $175 for outpatient hospital and observation services, with prior authorization required for most care.
Partial Hospitalization See details
Wellpoint Chronic Care 2 (HMO-POS C-SNP) covers partial hospitalization services with a $30 copay and no coinsurance. Prior authorization is required to access these covered benefits.
Ambulance and Transportation Services See details
Wellpoint Chronic Care 2 (HMO-POS C-SNP) covers ambulance and transportation services, though transportation is only partially covered because transportation to any health-related location is not covered. Ground and air ambulance services require a $195 copay and no coinsurance, while plan-approved transportation services offer up to 12 one-way trips per year with no copay.
Emergency Services See details
Wellpoint Chronic Care 2 (HMO-POS C-SNP) covers emergency services with a $115 copay and no coinsurance, with the copay waived if you are admitted to the hospital within 24 hours. Urgently needed services require a $15 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered up to a $100,000 lifetime limit with a $115 copay and no coinsurance.
Primary Care See details
Wellpoint Chronic Care 2 (HMO-POS C-SNP) covers primary care and telehealth visits with no copays or coinsurance, while other services like specialist, therapy, and podiatry visits require copays ranging from $0 to $35 with no coinsurance. Chiropractic services are partially covered, as routine chiropractic care is not covered by the plan.
Preventive Services See details
Preventive services are partially covered by Wellpoint Chronic Care 2 (HMO-POS C-SNP) with no copay and no coinsurance for annual physicals, kidney disease education, glaucoma screenings, diabetes training, memory fitness, and remote access technologies. However, sub-services such as health education, in-home safety assessments, PERS, medical nutrition therapy, medication reconciliation, re-admission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, in-home support, caregiver support, smoking cessation, disease management, telemonitoring, safety devices, and counseling are not covered.
Hearing Services See details
Wellpoint Chronic Care 2 (HMO-POS C-SNP) covers hearing exams and hearing aids with no copays or coinsurance, though prior authorization is required. Prescription hearing aids are partially covered up to $1,500 annually (excluding inner ear, outer ear, and over-the-ear types), and over-the-counter hearing aids are covered up to $300 yearly.
Vision Services See details
Vision services are partially covered by Wellpoint Chronic Care 2 (HMO-POS C-SNP), which offers one annual routine eye exam with no copay and other exams for a $0 to $35 copay, with no coinsurance. Covered eyewear has no copay or coinsurance up to a $175 yearly limit, although upgrades are not covered.
Dental Services See details
Dental services are partially covered by Wellpoint Chronic Care 2 (HMO-POS C-SNP), featuring a $1,200 annual maximum with no copay and no coinsurance for covered preventive and comprehensive services. Medicare-covered dental services require no coinsurance and a copay ranging from no copay to $35, while maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Wellpoint Chronic Care 2 (HMO-POS C-SNP) covers home infusion bundled services, which require prior authorization. Under this plan, Medicare Part B insulin drugs require a $35 copay and no coinsurance, while chemotherapy, radiation, and other Part B drugs feature no copay and a coinsurance ranging from no coinsurance to 20%.
Dialysis Services See details
Dialysis services are covered by Wellpoint Chronic Care 2 (HMO-POS C-SNP) with no copay and no coinsurance.
Medical Equipment See details
Wellpoint Chronic Care 2 (HMO-POS C-SNP) covers medical equipment, offering diabetic supplies and therapeutic shoes or inserts with no copay and no coinsurance. Durable medical equipment, prosthetics, and medical supplies are covered with no copay and coinsurance ranging from no coinsurance to 20%.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Wellpoint Chronic Care 2 (HMO-POS C-SNP) with prior authorization. Members pay no copay and no coinsurance for diagnostic tests and lab services, a $15 copay for outpatient X-rays, a $0 to $150 copay with no coinsurance for diagnostic radiology, and a 20% coinsurance with no copay for therapeutic radiology.
Home Health Services See details
Wellpoint Chronic Care 2 (HMO-POS C-SNP) covers home health services with no copay and no coinsurance. Prior authorization is required to access these fully covered services.
Cardiac Rehabilitation Services See details
Wellpoint Chronic Care 2 (HMO-POS C-SNP) technically covers Cardiac Rehabilitation Services, but in practice only some services are covered as Cardiac Rehabilitation, Intensive Cardiac Rehabilitation, Pulmonary Rehabilitation, and SET for PAD services are not covered.
Skilled Nursing Facility (SNF) See details
Wellpoint Chronic Care 2 (HMO-POS C-SNP) partially covers Skilled Nursing Facility (SNF) services, offering no copay and no coinsurance for days 1 through 20, and a $218 daily copay with no coinsurance for days 21 through 100. Prior authorization is required, and additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Other Services are partially covered by Wellpoint Chronic Care 2 (HMO-POS C-SNP) with no copay or coinsurance for covered benefits, though acupuncture and Dual Eligible SNP services are not covered. Covered services include Medicare Community Resource Support, a meal benefit, and an over-the-counter (OTC) allowance of $48 every three months.
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* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
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