Wellcare Dual Access (HMO D-SNP)

Wellcare Dual Access (HMO D-SNP) is a HMO D-SNP plan offered by New York Quality Healthcare Corporation available for the 2026 plan year to people living in Select counties in NY. This plan received an overall rating of 3 out of 5 stars in 2026.

It's important to know that Wellcare Dual Access (HMO D-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.

Key Plan Facts

Below are a few key facts and commonly-asked questions about Wellcare Dual Access (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.

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:

Drug Coverage

The Wellcare Dual Access (HMO D-SNP) prescription drug plan features an annual drug deductible of $615. For common medications, Tier 1 preferred generics start at an $18 copay and Tier 2 generics start at a $19 copay for a one-month supply at preferred pharmacies. You can maximize your savings by utilizing preferred mail order, which offers no copay for a three-month supply of Tier 1 and Tier 2 drugs. For brand-name and specialty medications, Tier 3 preferred brands and Tier 5 specialty drugs require a 25% coinsurance. Tier 4 non-preferred drugs have a $100 copay for a one-month supply at both preferred and standard pharmacies. Finally, Tier 6 select care drugs offer the lowest cost option with no copay for all supply lengths at preferred pharmacies and through preferred mail order.

Additional Benefits

The Wellcare Dual Access (HMO D-SNP) offers robust medical coverage with predictable costs, generally featuring no copay and a 20% coinsurance for primary care, specialists, outpatient hospital services, and medical equipment. Inpatient hospital stays require a copay of $2,225 per stay for acute care and $2,080 for psychiatric care, with no coinsurance. Emergency care is covered with a $115 copay, while skilled nursing facility stays are covered with no copay for days 1 to 20 and 71 to 100. Beneficiaries also enjoy dental, vision, and hearing benefits, including preventive and comprehensive dental care with no copay or coinsurance. Home health services, acupuncture, and over-the-counter items are also covered with no copay and no coinsurance. Additionally, Medicare Part B insulin is available with a $35 copay and no coinsurance, making daily health management highly affordable.

Plan Providers

Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross and Blue Shield, Aspire Health Plan, Dean Health Plan, Devoted Health, Florida Blue Medicare, Freedom Health, Health Care Service Corporation, HealthSpring^SM, HealthSun, Healthy Blue, Humana, Molina Healthcare, Mutual of Omaha, Medica Central Health Plan, Optimum HealthCare, Premera Blue Cross, SCAN Health Plan, Simply, UnitedHealthcare(R), Wellcare, WellPoint.