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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 2026, 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 2026 to people living in Select Counties in PA. This plan received an overall rating of 3.5 out of 5 stars in 2026.
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 $32.70. 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 $615.00 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 $5400.00 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) prescription drug plan has an annual drug deductible of $615. For Select Care Drugs (Tier 6), there is no copay for any supply length at preferred or standard pharmacies and mail-order services. Tier 1 preferred generics and Tier 2 generics feature low copayments starting at $18 and $19 respectively for a 1-month supply at preferred pharmacies, with no copay for a 3-month supply via preferred mail order. Tier 3 preferred brand drugs and Tier 5 specialty drugs both require a 25% coinsurance at standard and preferred pharmacies. Tier 4 non-preferred drugs carry a $100 copay for a 1-month supply at both preferred and standard pharmacies, with preferred mail-order options offering savings on longer supplies. Understanding these copays, deductibles, and coinsurance rates helps Medicare beneficiaries choose the right prescription drug coverage.
Additional Benefits
The Wellcare Dual Select (HMO-POS D-SNP) plan offers comprehensive coverage with predictable cost-sharing, featuring no copay and no coinsurance for primary care visits, home health services, and routine preventive care. For specialist visits, patients can expect copays ranging from $15 to $25 with no coinsurance. Inpatient hospital stays require a $275 copay for days 1 to 6 and no copay for days 7 to 90, while emergency room visits carry a $130 copay that is waived if admitted. This plan also includes valuable supplemental benefits, such as routine dental, vision, and hearing services with no copay, including up to $1,000 yearly per ear for prescription hearing aids and a $300 annual allowance for eyewear. Additionally, members benefit from no copay for diabetic supplies and up to 12 one-way transportation trips per year to plan-approved locations. Durable medical equipment and dialysis services are both covered with no copay and a 20% coinsurance.
Inpatient Hospital See details
Inpatient hospital care is partially covered by Wellcare Dual Select (HMO-POS D-SNP) with no coinsurance, requiring a $275 copay for days 1 to 6 and no copay for days 7 to 90 per stay. Prior authorization is required, and additional days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Wellcare Dual Select (HMO-POS D-SNP) covers outpatient services with no coinsurance, featuring outpatient hospital copays from $0 to $200 and observation services from $130 to $200. Ambulatory surgical center services require a $150 copay with no coinsurance, while outpatient substance abuse sessions have a $25 copay and blood services are provided with no copay or coinsurance.
Partial Hospitalization See details
Wellcare Dual Select (HMO-POS D-SNP) covers partial hospitalization services with a $140.00 copay and no coinsurance. Prior authorization is required to receive this benefit.
Ambulance and Transportation Services See details
Wellcare Dual Select (HMO-POS D-SNP) covers ground and air ambulance services with a $280 copay and no coinsurance. Transportation services are partially covered with no copay or coinsurance for up to 12 one-way trips per year to plan-approved locations, while transportation to any other health-related location is not covered.
Emergency Services See details
Wellcare Dual Select (HMO-POS D-SNP) covers emergency services with a $130 copay and no coinsurance, which is waived if admitted to the hospital within 24 hours, and urgently needed services with a $40 copay and no coinsurance. Worldwide emergency and urgent care are partially covered up to a $50,000 maximum with a $130 copay and no coinsurance, but worldwide emergency transportation is not covered.
Primary Care See details
Wellcare Dual Select (HMO-POS D-SNP) covers primary care physician services with no copay and no coinsurance, while specialist visits, therapies, and mental health services require copays ranging from $15 to $25 and no coinsurance. Chiropractic services are partially covered with a $15 copay and no coinsurance, excluding routine and other chiropractic services, while podiatry services are not covered.
Preventive Services See details
Preventive Services are partially covered by Wellcare Dual Select (HMO-POS D-SNP), offering no copay and no coinsurance for annual physical exams, glaucoma screenings, diabetes training, and supplemental benefits like fitness and PERS, while kidney disease education has no copay and a 20% coinsurance. Uncovered sub-services include health education, in-home safety assessments, medical nutrition therapy, post-discharge medication reconciliation, readmission prevention, chemotherapy wigs, weight management, therapeutic massage, adult day health, nutritional/dietary benefits, palliative care, in-home support, caregiver support, additional tobacco cessation counseling, enhanced disease management, telemonitoring, home safety modifications, and counseling services.
Hearing Services See details
Hearing services are covered by Wellcare Dual Select (HMO-POS D-SNP), featuring a $15 copay and no coinsurance for Medicare-covered exams, and no copay or coinsurance for routine exams and fittings. Prescription hearing aids are partially covered with no copay or coinsurance up to $1,000 per ear yearly, but OTC, inner ear, outer ear, and over-the-ear hearing aids are not covered.
Vision Services See details
Vision services are partially covered by Wellcare Dual Select (HMO-POS D-SNP) with no coinsurance, featuring copays ranging from no copay to $15 for exams, though other eye exam services are not covered and prior authorization is required. One routine eye exam per year and covered eyewear—including contacts, eyeglasses, and upgrades—are available with no copay, up to a $300 annual maximum benefit.
Dental Services See details
Wellcare Dual Select (HMO-POS D-SNP) offers partially covered dental services, featuring a $15 copay and no coinsurance for Medicare-covered dental, and no copay or coinsurance for most preventive and comprehensive care. While many diagnostic, preventive, and restorative services are covered, maxillofacial prosthetics, implant services, and orthodontics are not covered under this plan.
Home Infusion bundled Services See details
Wellcare Dual Select (HMO-POS D-SNP) covers home infusion bundled services with no copay, though prior authorization is required. Under this plan, Medicare Part B insulin is covered with a $35 copay and no coinsurance, while Medicare Part B chemotherapy and other drugs carry a coinsurance of 0% to 20%.
Dialysis Services See details
Dialysis services are covered by Wellcare Dual Select (HMO-POS D-SNP) with no copay and a 20% coinsurance.
Medical Equipment See details
Medical Equipment is covered by Wellcare Dual Select (HMO-POS D-SNP) with no copay and 20% coinsurance for durable medical equipment, prosthetic devices, medical supplies, and diabetic therapeutic shoes or inserts. Diabetic supplies are covered with no copay, and prior authorization is required for these medical equipment benefits.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Wellcare Dual Select (HMO-POS D-SNP), offering diagnostic tests, lab work, and diagnostic radiology with no copay and no coinsurance, subject to prior authorization. Outpatient X-rays require a $25 copay and coinsurance, while therapeutic radiological services carry a 20% coinsurance.
Home Health Services See details
Wellcare Dual Select (HMO-POS D-SNP) covers home health services with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Wellcare Dual Select (HMO-POS D-SNP) covers cardiac rehabilitation services with no copay and no coinsurance, but only some services are covered. Standard cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered by the plan.
Skilled Nursing Facility (SNF) See details
Wellcare Dual Select (HMO-POS D-SNP) covers Skilled Nursing Facility (SNF) services with no coinsurance, though prior authorization is required and additional days beyond the Medicare-covered limit are not covered. There is no copay for days 1 to 20 and days 51 to 100, while a $218 daily copay applies for days 21 to 50.
Other Services See details
Other services are partially covered by Wellcare Dual Select (HMO-POS D-SNP), featuring over-the-counter (OTC) items and meal benefits with no copay and no coinsurance. Acupuncture and other additional services under this benefit category are not covered.
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