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Wellpoint I CareMore Kidney Care (HMO-POS C-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Wellpoint I CareMore Kidney Care (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 I CareMore Kidney Care (HMO-POS C-SNP) in 2026, please refer to our full plan details page.
Wellpoint I CareMore Kidney Care (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 I CareMore Kidney Care (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 I CareMore Kidney Care (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 I CareMore Kidney Care (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 I CareMore Kidney Care (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. Additionally, this plan comes with a Part B Premium reduction of $7.00. You must continue to pay paying your reduced 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 $3000.00 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:
Sign up for Wellpoint I CareMore Kidney Care (HMO-POS C-SNP)
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Drug Coverage
The Wellpoint I CareMore Kidney Care (HMO-POS C-SNP) plan features an Enhanced Alternative drug benefit with no prescription drug deductible. During the initial coverage phase, there is no copay for Tier 1 preferred generic drugs and Tier 5 specialty tier drugs. For Tier 2 standard generic drugs, you will pay a $42 copay at preferred pharmacies and standard mail-order, or a $47 copay at standard pharmacies. For higher-tier medications, Tier 3 preferred brand drugs require a 25% coinsurance and Tier 4 non-preferred drugs require a 33% coinsurance. Once your yearly out-of-pocket drug costs reach $2,100.00, you enter the catastrophic coverage phase and pay nothing for covered Part D prescription drugs.
Additional Benefits
The Wellpoint I CareMore Kidney Care (HMO-POS C-SNP) plan offers robust medical coverage with no copays for most primary care, specialist visits, and home health services. Inpatient hospital stays require a $125 daily copay for the first five days and no copay thereafter, while skilled nursing facility stays feature no copay for the first 20 days. Emergency room visits carry a $120 copay, which is waived if you are admitted, while urgently needed care and routine diagnostic tests require no copay. This plan also provides comprehensive dental, vision, and hearing benefits with no copays or coinsurance, subject to specific annual limits. Members can take advantage of a $1,500 annual dental allowance, a $275 eyewear allowance, and up to $3,000 for prescription hearing aids. Additionally, the plan covers approved transportation, over-the-counter items, and home meals at no cost to help support your overall well-being.
Inpatient Hospital See details
Wellpoint I CareMore Kidney Care (HMO-POS C-SNP) partially covers inpatient hospital services with a $125 daily copay for days 1 to 5, no copay for days 6 to 90, and no coinsurance. Prior authorization is required for acute and psychiatric stays, while upgrades and non-Medicare-covered stays are not covered.
Outpatient Services See details
Wellpoint I CareMore Kidney Care (HMO-POS C-SNP) covers outpatient services with no coinsurance, featuring no copay for ambulatory surgical center and blood services, a $30 copay for substance abuse sessions, and copays up to $50 for hospital and observation services. Prior authorization is required for most of these covered outpatient services.
Partial Hospitalization See details
Wellpoint I CareMore Kidney Care (HMO-POS C-SNP) covers partial hospitalization benefits with a $30 copay and no coinsurance. Prior authorization is required for these services.
Ambulance and Transportation Services See details
Wellpoint I CareMore Kidney Care (HMO-POS C-SNP) covers ground and air ambulance services with a $195 copay and no coinsurance. Transportation services are partially covered, offering rides to plan-approved locations with no copay or coinsurance, while transportation to any health-related location is not covered.
Emergency Services See details
Wellpoint I CareMore Kidney Care (HMO-POS C-SNP) covers emergency services with a $120 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services require no copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered up to a maximum of $100,000 with a $120 copay and no coinsurance.
Primary Care See details
Primary care and specialist services are covered by Wellpoint I CareMore Kidney Care (HMO-POS C-SNP) with no copay or coinsurance for most visits, including therapy and mental health sessions. Chiropractic services are partially covered with a $20 copay, as routine chiropractic care is not covered, and opioid treatment requires a $30 copay with no coinsurance.
Preventive Services See details
Preventive services are partially covered by Wellpoint I CareMore Kidney Care (HMO-POS C-SNP) with no copay or coinsurance for covered options like annual physical exams, kidney disease education, and select fitness benefits. However, several sub-services are not covered, including health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, readmission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, palliative care, in-home support, caregiver support, smoking cessation, disease management, telemonitoring, and counseling.
Hearing Services See details
Wellpoint I CareMore Kidney Care (HMO-POS C-SNP) offers hearing exams, OTC hearing aids, and prescription hearing aids with no copays, deductibles, or coinsurance, though prior authorization is required. Prescription hearing aids are partially covered, excluding inner ear, outer ear, and over the ear types, and feature a $3,000 annual limit, while OTC hearing aids have a $300 annual limit.
Vision Services See details
Wellpoint I CareMore Kidney Care (HMO-POS C-SNP) provides partially covered vision services with no copay and no coinsurance for routine eye exams and eyewear. Covered eyewear, including contacts and eyeglasses, is subject to a $275 annual maximum benefit, while eyewear upgrades are not covered.
Dental Services See details
Dental services are partially covered by Wellpoint I CareMore Kidney Care (HMO-POS C-SNP) up to a maximum annual benefit of $1,500 with no copay and no coinsurance. Under this plan, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Wellpoint I CareMore Kidney Care (HMO-POS C-SNP) covers home infusion bundled services with prior authorization and step therapy requirements. Medicare Part B insulin drugs feature no copay and no coinsurance, while chemotherapy, radiation, and other Part B drugs have no copay and coinsurance ranging from no coinsurance to 20%.
Dialysis Services See details
Dialysis services are covered by the Wellpoint I CareMore Kidney Care (HMO-POS C-SNP) plan with no copay, although coinsurance information is not specified.
Medical Equipment See details
Medical equipment is covered by Wellpoint I CareMore Kidney Care (HMO-POS C-SNP) with prior authorization required. Durable medical equipment and prosthetics require no copay and 0% to 20% coinsurance, while diabetic supplies and therapeutic shoes or inserts are covered with no copay and no coinsurance.
Diagnostic and Radiological Services See details
Wellpoint I CareMore Kidney Care (HMO-POS C-SNP) covers diagnostic and radiological services, with prior authorization required for all services. Diagnostic tests, lab services, and outpatient X-rays feature no copay and no coinsurance, while diagnostic radiological services require a copay of $0 to $150 with no coinsurance, and therapeutic radiological services carry a 20% coinsurance with no copay.
Home Health Services See details
Home health services are covered by Wellpoint I CareMore Kidney Care (HMO-POS C-SNP) with no copay and no coinsurance. Prior authorization is required to receive these services.
Cardiac Rehabilitation Services See details
Wellpoint I CareMore Kidney Care (HMO-POS C-SNP) does not cover Cardiac Rehabilitation Services, as none of the sub-services, including cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation, are covered under the plan.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are partially covered by Wellpoint I CareMore Kidney Care (HMO-POS C-SNP), requiring no copay for days 1-20, a $100 daily copay for days 21-100, and no coinsurance. 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 I CareMore Kidney Care (HMO-POS C-SNP), offering over-the-counter items, meal benefits, and community resource support with no copay or coinsurance. Acupuncture and highly integrated services for dual-eligible SNPs are not covered under this benefit.
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