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Wellcare Dual Liberty (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Wellcare Dual Liberty (HMO 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 Liberty (HMO D-SNP) in 2025, please refer to our full plan details page.
Wellcare Dual Liberty (HMO D-SNP) is a HMO D-SNP plan offered by Centene Corporation available for enrollment in 2025 to people living in Select counties in CA. This plan received an overall rating of 2.5 out of 5 stars in 2025.
It's important to know that Wellcare Dual Liberty (HMO 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 Liberty (HMO 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 Liberty (HMO 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 Liberty (HMO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $25.20. 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 Dual Liberty (HMO D-SNP) plan has a $590 deductible for prescription drugs. After you meet your deductible, you will pay the costs for your drugs based on the tier and pharmacy you use until your total drug costs reach $2,000. Once your total drug costs reach $2,000, you enter the catastrophic coverage phase and pay nothing for covered Part D drugs. If you qualify for the low-income subsidy, you will pay $25.20 per month for Part D.
Additional Benefits
The Wellcare Dual Liberty (HMO D-SNP) plan offers a range of benefits with varying cost-sharing. Inpatient hospital stays require a copay, while outpatient services often have a 20% coinsurance. Emergency services have a copay, and primary care services typically have a 20% coinsurance. Preventive services and home health services have no copay, and hearing and vision services have coinsurance and coverage limits. The plan also covers dental services with coinsurance and provides coverage for medical equipment with coinsurance. Prescription hearing aids are covered up to $1,000 per ear with no copay.
Inpatient Hospital See details
Inpatient Hospital benefits, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, are covered, but require prior authorization and a doctor's referral. For Inpatient Hospital-Acute, there is a copay of $1440 per admission or stay, and for Inpatient Hospital Psychiatric, there is a copay of $1937 per admission or stay; additional days and non-Medicare-covered stays are not covered.
Outpatient Services See details
Outpatient services are covered by the Wellcare Dual Liberty (HMO D-SNP) plan, including outpatient hospital services, observation services, ambulatory surgical center services, outpatient substance abuse services, and outpatient blood services. Outpatient hospital services have a 20% coinsurance and no copay, and observation services have a 20% coinsurance. For outpatient blood services, there is a 20% coinsurance, and three pints of blood have a deductible waived. Individual and group sessions for outpatient substance abuse have a 20% coinsurance.
Partial Hospitalization See details
Partial Hospitalization is covered under the Wellcare Dual Liberty (HMO D-SNP) plan, but requires prior authorization and a doctor's referral. You will pay 20% coinsurance for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Wellcare Dual Liberty (HMO D-SNP) plan. Ground and air ambulance services have a 20% coinsurance, and transportation services to a plan-approved health-related location have 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 are covered by the Wellcare Dual Liberty (HMO D-SNP) plan. For Emergency Services and Worldwide Emergency Coverage, there is a $110 copay, and for Urgently Needed Services, there is a $45 copay; there is no coinsurance for any of these services. Worldwide Urgent Coverage has a $110 copay and no coinsurance, while Worldwide Emergency Transportation is not covered.
Primary Care See details
Primary Care Physician Services, Chiropractic Services, Occupational Therapy Services, Physician Specialist Services, Mental Health Specialty Services, Podiatry Services, Other Health Care Professional, Psychiatric Services, Physical Therapy and Speech-Language Pathology Services, Additional Telehealth Benefits, and Opioid Treatment Program Services are covered, but some services require prior authorization and a doctor referral. Primary Care Physician Services, Chiropractic Services, Physician Specialist Services, Physical Therapy and Speech-Language Pathology Services, and Additional Telehealth Benefits have a 20% coinsurance, while Occupational Therapy Services, Mental Health Specialty Services, Psychiatric Services, and Opioid Treatment Program Services also have a 20% coinsurance. Podiatry Services have a 20% coinsurance with no copay, and Additional Telehealth Benefits have a copay between $0-$45. Routine Chiropractic Care is not covered.
Preventive Services See details
Preventive services include coverage for Medicare-covered services with no copay, annual physical exams with no copay, and additional preventive services including alternative therapies and fitness benefits with no copay. Kidney Disease Education Services, Glaucoma Screenings, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit are covered with 20% coinsurance. Health Education, In-Home Safety Assessment, Personal Emergency Response System (PERS), Medical Nutrition Therapy (MNT), Post discharge In-Home Medication Reconciliation, Re-admission Prevention, Wigs for Hair Loss Related to Chemotherapy, Weight Management Programs, Therapeutic Massage, Adult Day Health Services, Nutritional/Dietary Benefit, Home-Based Palliative Care, In-Home Support Services, Support for Caregivers of Enrollees, Additional Sessions of Smoking and Tobacco Cessation Counseling, Enhanced Disease Management, and Telemonitoring Services are not covered.
Hearing Services See details
Hearing exams are covered with a 20% coinsurance for routine hearing exams and no copay for Medicare-covered benefits and fitting/evaluation for hearing aids. Prescription hearing aids are covered up to $1,000 per ear with no copay for prescription hearing aids of all types, but inner, outer, and over-the-ear prescription hearing aids are not covered, and OTC hearing aids are not covered.
Vision Services See details
Vision services include eye exams and eyewear. Eye exams have no copay, but require a 20% coinsurance. Eyewear has a 20% coinsurance, with a maximum plan benefit coverage of $100 per year, and no copay for contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades.
Dental Services See details
Dental services are covered, with 20% coinsurance for Medicare Dental Services. Restorative Services, Prosthodontics (removable and fixed) are covered with no copay, but some services have visit limits. Adjunctive General Services, Endodontics, Periodontics, Maxillofacial Prosthetics, Implant Services, Oral and Maxillofacial Surgery, and Orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by the Wellcare Dual Liberty (HMO D-SNP) plan. Medicare Part B Insulin Drugs have a $35 copay, while Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the Wellcare Dual Liberty (HMO D-SNP) plan, but a doctor's referral is required. There is a 20% coinsurance for this benefit.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment. DME has a 20% coinsurance, and Prosthetic Devices, Medicare-covered Medical Supplies, Diabetic Supplies, and Diabetic Therapeutic Shoes/Inserts also have a 20% coinsurance; however, DME for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered by the Wellcare Dual Liberty (HMO D-SNP) plan. Diagnostic Procedures/Tests and Radiological Services have a coinsurance of up to 20%, while Lab Services have no copay and a coinsurance of up to 20%.
Home Health Services See details
Home Health Services are covered under the Wellcare Dual Liberty (HMO 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 covered with a doctor referral, but Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, SET for PAD Services, and Additional Cardiac Rehabilitation Services are not covered. This plan does not specify any cost sharing details (copay or coinsurance) for the Cardiac Rehabilitation Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Wellcare Dual Liberty (HMO D-SNP) plan, requiring prior authorization and a doctor's referral. There is no copay for days 1-20, and a $214 copay for days 21-100; additional days beyond Medicare-covered and non-Medicare-covered stays are not covered.
Other Services See details
Other Services include Over-the-Counter (OTC) Items with no copay. Acupuncture, Meal Benefit, 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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