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Wellpoint Full Dual Advantage Support (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Wellpoint Full Dual Advantage Support (HMO 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 Support (HMO D-SNP) in 2025, please refer to our full plan details page.
Wellpoint Full Dual Advantage Support (HMO D-SNP) is a HMO D-SNP plan offered by Elevance Health, Inc. available for enrollment in 2025 to people living in Tennessee. This plan received an overall rating of 3 out of 5 stars in 2025.
It's important to know that Wellpoint Full Dual Advantage Support (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:
Wellpoint Full Dual Advantage Support (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 Wellpoint Full Dual Advantage Support (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 Wellpoint Full Dual Advantage Support (HMO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $40.00. 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 Wellpoint Full Dual Advantage Support (HMO D-SNP) plan has a $590 deductible for prescription drugs. After meeting the deductible, you'll pay the costs for your drugs, but the specific amounts are not detailed in this summary. If you qualify for the low-income subsidy (LIS), also known as "Extra Help", you will pay $40.00 for Part D. After your total drug costs reach $2000.00, you will enter the catastrophic coverage phase, and you will pay nothing for Medicare Part D covered drugs.
Additional Benefits
The Wellpoint Full Dual Advantage Support (HMO D-SNP) plan offers comprehensive coverage, including inpatient and outpatient hospital services, with varying coinsurance rates. Emergency, urgent, and worldwide emergency services have copays, and ambulance services have a 20% coinsurance. Primary care, preventive, vision, hearing, and dental services are covered with no copay or a 20% coinsurance for certain services. This plan also includes coverage for home health, home infusion, and dialysis services, along with medical equipment and diagnostic services. Additionally, you'll find benefits like over-the-counter items, a meal benefit, and access to Medicare Community Resource Support, all with no copay.
Inpatient Hospital See details
Inpatient Hospital benefits, including acute and psychiatric care, are covered, but additional days, non-Medicare stays, and upgrades for acute and psychiatric care are not covered. Prior authorization is required for both acute and psychiatric care, and the coinsurance details are available in the plan documents.
Outpatient Services See details
Outpatient Services include coverage for Outpatient Hospital Services and Observation Services with a 20% coinsurance, Ambulatory Surgical Center (ASC) Services, and Outpatient Substance Abuse Services. Outpatient Blood Services are covered with no copay.
Partial Hospitalization See details
Partial Hospitalization is covered by the Wellpoint Full Dual Advantage Support (HMO D-SNP) plan with a $55 copay. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, with a 20% coinsurance for both Ground and Air Ambulance Services; 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 Services are covered. Emergency Services have a $110 copay, Urgently Needed Services have a $20 copay, and Worldwide Emergency Services have a $0 copay for Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation.
Primary Care See details
The Wellpoint Full Dual Advantage Support (HMO D-SNP) plan covers primary care physician services, chiropractic services, occupational therapy services, physician specialist services, mental health specialty services, podiatry services, other health care professional services, psychiatric services, physical therapy and speech-language pathology services, additional telehealth benefits, and opioid treatment program services. Primary care physician services, physician specialist services, and routine foot care have a 20% coinsurance, while chiropractic services and individual and group sessions for mental health and psychiatric services also have 20% coinsurance. Routine chiropractic care has no copay, and additional telehealth benefits have no copay.
Preventive Services See details
Preventive Services include an annual physical exam with no copay, and additional preventive services, kidney disease education, and other preventive services are covered. Glaucoma screenings, diabetes self-management training, barium enemas, digital rectal exams, and EKGs following a welcome visit have a 20% coinsurance. Health education, in-home safety assessments, counseling services, medical nutrition therapy, post-discharge in-home medication reconciliation, readmission prevention, wigs for hair loss, weight management programs, alternative therapies, therapeutic massage, adult day health services, nutritional/dietary benefits, home-based palliative care, in-home support services, support for caregivers, additional sessions of smoking and tobacco cessation counseling, enhanced disease management, and telemonitoring services are not covered. Personal emergency response systems (PERS), remote access technologies (including web/phone-based technologies and nursing hotline), home and bathroom safety devices and modifications, and fitness benefits are covered with no copay.
Hearing Services See details
Hearing services include routine hearing exams with no copay and at most 20% coinsurance, fitting/evaluation for hearing aids with no copay, prescription hearing aids with no copay and a maximum plan benefit of $3,000 per year, and OTC hearing aids with no copay and a maximum plan benefit of $300 per year. Prescription Hearing Aids - Inner Ear, Prescription Hearing Aids - Outer Ear, and Prescription Hearing Aids - Over the Ear are not covered.
Vision Services See details
Wellpoint Full Dual Advantage Support (HMO D-SNP) covers vision services including eye exams and eyewear. Routine eye exams have no copay and contact lenses, eyeglasses (lenses and frames), and eyeglass lenses have no copay; however, contact lenses have a 20% coinsurance, and eyewear has a combined maximum of $650 per year. Upgrades are not covered.
Dental Services See details
Dental services are covered, with a 20% coinsurance for Medicare Dental Services. Other dental services have a $6,000 maximum benefit per year, and oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatment, other preventive dental services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), maxillofacial prosthetics, implant services, oral and maxillofacial surgery, and orthodontics have no copay.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, with prior authorization required. 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 by the Wellpoint Full Dual Advantage Support (HMO D-SNP) plan. The coinsurance for Dialysis Services is between 20% and 20%.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with a coinsurance between 0% and 20%, and Prosthetics/Medical Supplies, with a 20% coinsurance for Medicare-covered services. Diabetic Equipment is covered with no copay for Diabetic Supplies and Diabetic Therapeutic Shoes/Inserts, but a copay may apply to Medicare-covered services. Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered under the Wellpoint Full Dual Advantage Support (HMO D-SNP) plan. Diagnostic Procedures/Tests, Lab Services, Diagnostic Radiological Services, Therapeutic Radiological Services, and Outpatient X-Ray Services have a coinsurance of at most 20%, and there is no copay.
Home Health Services See details
Home Health Services are covered by the Wellpoint Full Dual Advantage Support (HMO D-SNP) plan with no copay and no coinsurance. However, additional hours of care and personal care services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but the plan does not cover Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, or Additional Cardiac Rehabilitation Services. Prior authorization is required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) benefits are covered under the Wellpoint Full Dual Advantage Support (HMO D-SNP) plan. Prior authorization is required, and the plan uses the Medicare-defined cost share for tier 1, but additional days beyond Medicare-covered and non-Medicare-covered stays for SNF are not covered.
Other Services See details
The Wellpoint Full Dual Advantage Support (HMO D-SNP) plan covers Over-the-Counter (OTC) Items with no copay. The plan also covers a Meal Benefit with no copay, and other services such as Medicare Community Resource Support with no copay. However, acupuncture, 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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