Wellcare Fidelis Dual Align (HMO D-SNP)

Wellcare Fidelis Dual Align (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 NY. This plan received an overall rating of 3 out of 5 stars in 2026.

It's important to know that Wellcare Fidelis Dual Align (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 Fidelis Dual Align (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 Fidelis Dual Align (HMO D-SNP) prescription drug plan features an annual drug deductible of $615. For Tier 6 select care drugs, you will pay no copay for your prescriptions at standard or preferred pharmacies as well as through mail order. Tier 1 preferred generics and Tier 2 generics are also highly affordable, starting at an $18 and $19 copay respectively for a one-month supply at preferred pharmacies, with no copay available for three-month supplies ordered through preferred mail delivery. For brand-name and specialty medications, Tier 3 preferred brands require a $47 copay for a one-month supply at both standard and preferred pharmacies. Tier 4 non-preferred drugs are subject to a 31% coinsurance, while Tier 5 specialty tier drugs carry a 25% coinsurance for a one-month supply. Understanding these cost-sharing tiers helps you accurately estimate your out-of-pocket prescription drug costs with this Medicare plan.

Additional Benefits

The Wellcare Fidelis Dual Align (HMO D-SNP) plan offers comprehensive coverage for core medical needs, featuring inpatient acute hospital stays with a $2,230 copay per stay and inpatient psychiatric stays with a $2,080 copay. For outpatient care, primary and specialist visits, diagnostics, and medical equipment, members generally pay no copay alongside a 20% coinsurance. Emergency services are covered with a $115 copay, which is waived if admitted, while urgent care requires a $40 copay. Preventive care, home health services, and certain dental and vision benefits are available with no copay and no coinsurance, though some routine vision, hearing, and dental services require a 20% coinsurance. For skilled nursing facility care, there is no coinsurance and no copay for days 1 to 20 and 71 to 100, while days 21 to 70 carry a $218 daily copay. Additionally, members can access over-the-counter items and chronic illness meals with no copay and no coinsurance.