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Wellpoint Full Dual Advantage Secure (HMO-POS D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Wellpoint Full Dual Advantage Secure (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 Wellpoint Full Dual Advantage Secure (HMO-POS D-SNP) in 2026, please refer to our full plan details page.
Wellpoint Full Dual Advantage Secure (HMO-POS D-SNP) is a HMO-POS D-SNP plan offered by Elevance Health, Inc. available for enrollment in 2025 to people living in Select Counties in New Jersey. This plan received an overall rating of 3 out of 5 stars in 2026.
It's important to know that Wellpoint Full Dual Advantage Secure (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:
Wellpoint Full Dual Advantage Secure (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 Wellpoint Full Dual Advantage Secure (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 Wellpoint Full Dual Advantage Secure (HMO-POS D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $32.10. 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 combined Maximum Out-Of-Pocket cost of $13900.00 (in-network or out-of-network combined). You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $13900.00 for covered services, the plan will pay 100% of covered costs for the rest of the year.
The plan may have separate out-pocket-maximums for in-network and out-of-network services. See our full plan details page for more information.
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 Full Dual Advantage Secure (HMO-POS D-SNP)
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Drug Coverage
The Wellpoint Full Dual Advantage Secure (HMO-POS D-SNP) prescription drug plan features an annual drug deductible of $615. Members enjoy no copay for Tier 1 (Preferred Generic), Tier 2 (Generic), and Tier 6 (Select Care Drugs) medications. This zero-cost coverage applies to one-month, two-month, and three-month supplies filled at standard retail pharmacies or through standard mail order. For Tier 3 (Preferred Brand) and Tier 4 (Non-Preferred Drug) prescriptions, you will pay a 25% coinsurance for one-month, two-month, or three-month supplies. Tier 5 (Specialty Tier) drugs also carry a 25% coinsurance, which is limited to a one-month supply. These coinsurance rates are the same whether you use a standard pharmacy or standard mail order.
Additional Benefits
The Wellpoint Full Dual Advantage Secure (HMO-POS D-SNP) plan offers comprehensive medical coverage with no copay and no coinsurance for inpatient hospital stays, skilled nursing facility care, and primary care visits. Outpatient care, diagnostic services, and specialist visits generally feature no copay but may require a 20% coinsurance. For urgent medical needs, emergency room visits require a $115 copay and urgently needed services have a $40 copay. Many supplemental benefits, including home health care, ambulance services, and diabetic supplies, are covered with no copay and no coinsurance. However, routine dental, vision, and hearing services are not covered under this plan. Other essential services like dialysis, physical therapy, and durable medical equipment typically carry no copay but are subject to up to 20% coinsurance.
Inpatient Hospital See details
Wellpoint Full Dual Advantage Secure (HMO-POS D-SNP) covers inpatient acute and psychiatric hospital services with no copay and no coinsurance, though prior authorization is required. Additional days, non-Medicare-covered stays, and room upgrades are not covered.
Outpatient Services See details
Wellpoint Full Dual Advantage Secure (HMO-POS D-SNP) covers outpatient services with no copay, though a 20% coinsurance and prior authorization apply to outpatient hospital, observation, ambulatory surgical center, and outpatient substance abuse services. Outpatient blood services are covered with no copay and no coinsurance.
Partial Hospitalization See details
Wellpoint Full Dual Advantage Secure (HMO-POS D-SNP) covers partial hospitalization services with a $105.00 copay and no coinsurance. Prior authorization is required for these covered services.
Ambulance and Transportation Services See details
Wellpoint Full Dual Advantage Secure (HMO-POS D-SNP) covers ground and air ambulance services with no copay and no coinsurance, though prior authorization is required. Transportation services to plan-approved or any other health-related locations are not covered under this plan.
Emergency Services See details
Emergency services are covered by Wellpoint Full Dual Advantage Secure (HMO-POS D-SNP) with a $115 copay and no coinsurance, while urgently needed services have a $40 copay and no coinsurance. Worldwide emergency, urgent, and transportation services are also covered with no copay and no coinsurance, up to a maximum benefit limit of $100,000.
Primary Care See details
Wellpoint Full Dual Advantage Secure (HMO-POS D-SNP) covers primary care, specialist, and telehealth services with no copay and no coinsurance, although specialist visits require prior authorization. Therapy, mental health, psychiatric, and opioid treatment services are covered with no copay and a 20% coinsurance, while chiropractic and podiatry services are not covered.
Preventive Services See details
Preventive services are partially covered under the Wellpoint Full Dual Advantage Secure (HMO-POS D-SNP) plan, with annual physicals, kidney disease education, and fitness benefits requiring no copay and no coinsurance. Other preventive benefits like glaucoma screenings and diabetes self-management training have no copay and a 20% coinsurance, while services such as health education, medical nutrition therapy, and weight management programs are not covered.
Hearing Services See details
Wellpoint Full Dual Advantage Secure (HMO-POS D-SNP) offers hearing services with no copay, no coinsurance, and no deductible, though prior authorization is required. While some services are covered, routine hearing exams, fitting and evaluation for hearing aids, over-the-counter hearing aids, and all types of prescription hearing aids—including inner ear, outer ear, and over the ear—are not covered.
Vision Services See details
Vision services are covered by Wellpoint Full Dual Advantage Secure (HMO-POS D-SNP) with no copay and 20% coinsurance, though in practice, routine eye exams, contact lenses, and eyeglasses are not covered.
Dental Services See details
Dental services are partially covered by Wellpoint Full Dual Advantage Secure (HMO-POS D-SNP), with Medicare-covered dental care requiring no copay and a 20% coinsurance. Routine and comprehensive dental services, including oral exams, cleanings, x-rays, fluoride, restorative care, and orthodontics, are not covered under this plan.
Home Infusion bundled Services See details
Home infusion bundled services are covered by Wellpoint Full Dual Advantage Secure (HMO-POS D-SNP) with no copay, requiring prior authorization. Part B insulin drugs have a $35 copay and no coinsurance, while chemotherapy and other Part B drugs have no copay and 0% to 20% coinsurance.
Dialysis Services See details
Wellpoint Full Dual Advantage Secure (HMO-POS D-SNP) covers dialysis services with no copay and a 20% coinsurance.
Medical Equipment See details
Wellpoint Full Dual Advantage Secure (HMO-POS D-SNP) covers durable medical equipment with no copay and 0% to 20% coinsurance, and prosthetic devices and medical supplies with no copay and 20% coinsurance. Diabetic supplies and therapeutic shoes are fully covered with no copay and no coinsurance from specified manufacturers.
Diagnostic and Radiological Services See details
Wellpoint Full Dual Advantage Secure (HMO-POS D-SNP) covers diagnostic and radiological services with no copay and a 20% coinsurance, subject to prior authorization. This includes coverage for diagnostic procedures, lab services, therapeutic radiological services, and outpatient X-rays.
Home Health Services See details
Wellpoint Full Dual Advantage Secure (HMO-POS D-SNP) covers home health services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Wellpoint Full Dual Advantage Secure (HMO-POS D-SNP) covers Cardiac Rehabilitation Services with no copay and prior authorization required. While some services are covered, standard cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered and require a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is covered by Wellpoint Full Dual Advantage Secure (HMO-POS D-SNP) with no copay and no coinsurance, though prior authorization is required. This benefit is partially covered as additional days beyond the Medicare-covered limit are not covered, but the plan does allow for admission without a prior three-day inpatient hospital stay.
Other Services See details
Wellpoint Full Dual Advantage Secure (HMO-POS D-SNP) provides partial coverage for other services with no copay and no coinsurance, which includes over-the-counter items, Medicare community resource support, and up to 24 acupuncture treatments annually with prior authorization. Meal benefits are not covered under this plan.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
* 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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