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Wellpoint Medicare Advantage 2 (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Wellpoint Medicare Advantage 2 (HMO-POS). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Wellpoint Medicare Advantage 2 (HMO-POS) in 2026, please refer to our full plan details page.
Wellpoint Medicare Advantage 2 (HMO-POS) is a HMO-POS plan offered by Elevance Health, Inc. available for enrollment in 2025 to people living in Select counties in Tennessee. This plan received an overall rating of 3 out of 5 stars in 2026.
It's important to know that Wellpoint Medicare Advantage 2 (HMO-POS) 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 Wellpoint Medicare Advantage 2 (HMO-POS).
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 Medicare Advantage 2 (HMO-POS), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $0.00. 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 $200.00 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 $5200.00 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:
Sign up for Wellpoint Medicare Advantage 2 (HMO-POS)
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Drug Coverage
The Wellpoint Medicare Advantage 2 (HMO-POS) prescription drug plan features an annual drug deductible of $200. Under this plan, you will enjoy no copay for Tier 1 preferred generic drugs at preferred pharmacies, standard pharmacies, and standard mail order. Tier 2 generic drugs also feature no copay at preferred pharmacies and standard mail order, though standard pharmacies require a copay starting at $10 for a one-month supply. For brand-name and specialty medications, costs transition to a coinsurance model. Tier 3 preferred brand drugs require a 25% coinsurance, while Tier 4 non-preferred drugs and Tier 5 specialty drugs require 30% coinsurance at both preferred and standard pharmacies. These percentage-based costs apply to one-month, two-month, and three-month supplies, except for specialty drugs which are limited to a one-month supply.
Additional Benefits
The Wellpoint Medicare Advantage 2 (HMO-POS) plan offers comprehensive medical coverage with predictable out-of-pocket costs, including no copay and no coinsurance for primary care and telehealth visits. Specialist visits and outpatient substance abuse sessions require a $25 copay with no coinsurance, while emergency care has a $130 copay and no coinsurance. For inpatient hospital stays, there is no coinsurance and a $350 daily copay for the first six days, followed by no copay for subsequent days. Members also benefit from robust supplemental services, featuring no copay and no coinsurance for routine hearing and vision exams, alongside generous allowances for eyewear, hearing aids, and preventive dental care. Additionally, the plan provides up to 60 one-way transportation trips per year and a $55 quarterly over-the-counter allowance with no copay. Most medical equipment, home health services, and preventive care are covered with no copays, helping you manage your healthcare expenses effectively.
Inpatient Hospital See details
Inpatient hospital care is covered by Wellpoint Medicare Advantage 2 (HMO-POS) with no coinsurance, requiring a $350 daily copay for days 1 through 6 and no copay for days 7 and beyond. Prior authorization is required, and non-Medicare-covered stays and upgrades are not covered.
Outpatient Services See details
Wellpoint Medicare Advantage 2 (HMO-POS) covers outpatient hospital services with no coinsurance and copays ranging from $0 to $350, alongside observation services for a $350 copay per stay. Ambulatory surgical center and outpatient blood services are covered with no copay and no coinsurance, while outpatient substance abuse sessions require a $25 copay and no coinsurance.
Partial Hospitalization See details
Partial hospitalization services are covered by Wellpoint Medicare Advantage 2 (HMO-POS) with a $40.00 copay and no coinsurance. Prior authorization is required to receive these services.
Ambulance and Transportation Services See details
Wellpoint Medicare Advantage 2 (HMO-POS) covers ground and air ambulance services with a $246 copay and no coinsurance, though prior authorization is required. Transportation services are partially covered, offering up to 60 one-way trips per year to plan-approved locations with no copay and no coinsurance, while transportation to any health-related location is not covered.
Emergency Services See details
Wellpoint Medicare Advantage 2 (HMO-POS) covers emergency services with a $130 copay and urgently needed services with a $30 copay, both with no coinsurance. Worldwide emergency, urgent, and transportation services are also covered up to a $100,000 maximum benefit with a $130 copay and no coinsurance.
Primary Care See details
Wellpoint Medicare Advantage 2 (HMO-POS) features no copay and no coinsurance for primary care and telehealth visits, while specialist, therapy, and mental health services require a $25 copay and no coinsurance. Podiatry and other healthcare professional services range from no copay up to a $25 copay with no coinsurance, though chiropractic services are not covered in practice and prior authorization is required for specialty care.
Preventive Services See details
Preventive services under Wellpoint Medicare Advantage 2 (HMO-POS) are partially covered with no copay and no coinsurance for annual exams, kidney disease education, and select screenings, plus a $500 annual limit for home safety devices. Uncovered sub-services include fitness, health education, weight management, alternative therapies, nutritional/dietary benefits, in-home support, caregiver support, and therapeutic massage.
Hearing Services See details
Wellpoint Medicare Advantage 2 (HMO-POS) covers routine hearing exams and fitting evaluations once per year with no copay and no coinsurance, while Medicare-covered exams require a $25 copay and no coinsurance. Hearing aids are partially covered with no copay and no coinsurance up to a $3,000 annual limit for prescription aids and a $300 annual limit for OTC aids, though inner ear, outer ear, and over the ear prescription models are not covered.
Vision Services See details
Wellpoint Medicare Advantage 2 (HMO-POS) covers vision services with no coinsurance or deductibles, including one routine eye exam per year and eyewear up to a $300 annual limit with no copays. Other eye exam services and eyewear upgrades are not covered.
Dental Services See details
Dental services are partially covered by Wellpoint Medicare Advantage 2 (HMO-POS), providing preventive care with no copay and no coinsurance up to a $2,250 annual maximum. Comprehensive dental benefits are covered with no copay and a 25% coinsurance, but maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Wellpoint Medicare Advantage 2 (HMO-POS) covers home infusion bundled services with no copay, though prior authorization is required. Under this benefit, Medicare Part B insulin drugs are covered with a $35 copay and no coinsurance, while chemotherapy, radiation, and other Part B drugs are covered with a 0% to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered under the Wellpoint Medicare Advantage 2 (HMO-POS) plan with no copay and a 20% coinsurance.
Medical Equipment See details
Wellpoint Medicare Advantage 2 (HMO-POS) covers medical equipment with no copays for durable medical equipment (DME), prosthetics, medical supplies, and diabetic equipment. Coinsurance ranges from no coinsurance to 20% for DME, is 20% for prosthetics and medical supplies, and there is no coinsurance for diabetic equipment and supplies.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Wellpoint Medicare Advantage 2 (HMO-POS) with prior authorization required. Diagnostic tests range from no copay to a $150 copay with no coinsurance, lab services have no copay, and radiological services require a $90 copay for X-rays, a minimum $50 copay for diagnostic radiology, and a minimum 20% coinsurance for therapeutic radiology.
Home Health Services See details
Wellpoint Medicare Advantage 2 (HMO-POS) covers Home Health Services with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Wellpoint Medicare Advantage 2 (HMO-POS) covers some cardiac rehabilitation services with no coinsurance, though prior authorization is required. Standard cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered and require copays ranging from $15 to $35.
Skilled Nursing Facility (SNF) See details
Wellpoint Medicare Advantage 2 (HMO-POS) covers Skilled Nursing Facility (SNF) care with no coinsurance, featuring no copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required, and while a prior three-day hospital stay is not required for admission, additional days beyond the 100-day Medicare limit are not covered.
Other Services See details
Wellpoint Medicare Advantage 2 (HMO-POS) partially covers other services with no copay and no coinsurance, including chronic illness meal benefits, Medicare Community Resource Support, and a $55 quarterly over-the-counter allowance. Acupuncture is not covered under this benefit.
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1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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