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Wellpoint Full Dual Advantage 2 (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Wellpoint Full Dual Advantage 2 (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 2 (HMO D-SNP) in 2026, please refer to our full plan details page.
Wellpoint Full Dual Advantage 2 (HMO D-SNP) is a HMO D-SNP plan offered by Elevance Health, Inc. available for enrollment in 2026 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 Full Dual Advantage 2 (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 2 (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 2 (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 2 (HMO D-SNP), 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 $615.00 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 $9250.00 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 Full Dual Advantage 2 (HMO D-SNP)
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Drug Coverage
The Wellpoint Full Dual Advantage 2 (HMO D-SNP) prescription drug plan features an annual drug deductible of $615. Under this plan, you will pay no copay for Tier 1 preferred generic and Tier 6 select care drugs filled at standard pharmacies or through standard mail order. This no-copay benefit applies to one-month, two-month, and three-month supplies. For Tier 2 generic, Tier 3 preferred brand, and Tier 4 non-preferred drug prescriptions, you will pay a 25% coinsurance for standard pharmacy and standard mail order fills. Tier 5 specialty tier medications also require a 25% coinsurance for a one-month supply. This clear structure helps you easily plan your out-of-pocket costs for generic, brand-name, and specialty medications.
Additional Benefits
The Wellpoint Full Dual Advantage 2 (HMO D-SNP) offers comprehensive healthcare coverage with no copay for inpatient hospital stays, home health services, and skilled nursing facility care. For outpatient services, diagnostic tests, and doctor visits, members generally pay no copay and a 20% coinsurance. Emergency room visits require a $115 copay, while urgent care services are available with a $20 copay. This plan also features robust supplemental benefits, including preventive and comprehensive dental care up to a $6,000 annual limit with no copay or coinsurance. Vision and hearing benefits are also available, offering routine exams and hearing aids up to plan allowance limits with no copay and low to no coinsurance. Additionally, members benefit from over-the-counter items and unlimited transportation to approved locations with no copay or coinsurance.
Inpatient Hospital See details
Inpatient hospital services are covered by Wellpoint Full Dual Advantage 2 (HMO D-SNP) with no copay or coinsurance, though prior authorization is required. This benefit is partially covered because additional days, upgrades, and non-Medicare-covered stays are not covered for acute and psychiatric inpatient care.
Outpatient Services See details
Wellpoint Full Dual Advantage 2 (HMO D-SNP) covers outpatient services with no copay, although a 20% coinsurance applies to outpatient hospital, observation, ambulatory surgical center, and outpatient substance abuse services. Outpatient blood services are covered with no copay and no coinsurance.
Partial Hospitalization See details
Partial hospitalization is covered under the Wellpoint Full Dual Advantage 2 (HMO D-SNP) plan with a $105.00 copay and no coinsurance. Prior authorization is required to access this benefit.
Ambulance and Transportation Services See details
Wellpoint Full Dual Advantage 2 (HMO D-SNP) covers ground and air ambulance services with a 20% coinsurance and no copay, subject to prior authorization. Transportation services are partially covered with no copay and no coinsurance for unlimited one-way trips to plan-approved locations, but transportation to any health-related location is not covered.
Emergency Services See details
Wellpoint Full Dual Advantage 2 (HMO D-SNP) covers emergency services with a $115 copay and no coinsurance, while urgently needed services require a $20 copay and no coinsurance. Worldwide emergency, urgent, and transportation services are also covered with no copay or coinsurance up to a maximum plan benefit limit of $100,000.
Primary Care See details
Wellpoint Full Dual Advantage 2 (HMO D-SNP) covers primary care, specialist, therapy, podiatry, and mental health services with no copay and 20% coinsurance, while telehealth benefits feature no copay and no coinsurance. Chiropractic services are partially covered, providing routine care with no copay and 20% coinsurance, but excluding other chiropractic services.
Preventive Services See details
Wellpoint Full Dual Advantage 2 (HMO D-SNP) offers partially covered preventive services, with annual physicals, kidney disease education, and select supplemental benefits having no copay and no coinsurance, while other services like glaucoma screenings and EKGs have a 20% coinsurance and no copay. Sub-services that are not covered include health education, in-home safety assessments, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, chemotherapy wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional benefits, home-palliative care, in-home support, caregiver support, extra smoking cessation, enhanced disease management, telemonitoring, and counseling.
Hearing Services See details
Wellpoint Full Dual Advantage 2 (HMO D-SNP) covers hearing services, including annual routine exams with a 20% coinsurance and no copay, and fitting evaluations with no copay or coinsurance. Prescription hearing aids are partially covered with no copay or coinsurance up to $3,000 annually, but inner ear, outer ear, and over-the-ear types are not covered. OTC hearing aids are also covered with no copay or coinsurance up to $300 annually.
Vision Services See details
Wellpoint Full Dual Advantage 2 (HMO D-SNP) partially covers vision services, offering one annual routine eye exam with no copay and a 20% coinsurance, while other eye exams are not covered. Covered eyewear is subject to a $650 annual limit, featuring eyeglasses with no copay and no coinsurance, and contact lenses with no copay and 20% coinsurance, though upgrades are not covered.
Dental Services See details
Dental services are partially covered by Wellpoint Full Dual Advantage 2 (HMO D-SNP), offering preventive and comprehensive care up to a $6,000 annual limit with no copay and no coinsurance, though Medicare-covered dental services require a 20% coinsurance and no copay. Maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by Wellpoint Full Dual Advantage 2 (HMO D-SNP) with no copay, though prior authorization is required. Medicare Part B chemotherapy, radiation, and other Part B drugs require between no coinsurance and 20% coinsurance, while Part B insulin is covered with a $35 copay and no coinsurance.
Dialysis Services See details
Dialysis services are covered by Wellpoint Full Dual Advantage 2 (HMO D-SNP) with no copay and a 20% coinsurance.
Medical Equipment See details
Wellpoint Full Dual Advantage 2 (HMO D-SNP) covers medical equipment with no copays for durable medical equipment (DME), prosthetics, medical supplies, and diabetic services. Members will pay a 0% to 20% coinsurance for DME, a 20% coinsurance for prosthetics and medical supplies, and no coinsurance for diabetic supplies and therapeutic shoes.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered under the Wellpoint Full Dual Advantage 2 (HMO D-SNP) with no copay and a 20% coinsurance, subject to prior authorization. This coverage applies to outpatient diagnostic procedures, lab services, diagnostic and therapeutic radiological services, and X-rays.
Home Health Services See details
Home health services are covered by the Wellpoint Full Dual Advantage 2 (HMO D-SNP) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by Wellpoint Full Dual Advantage 2 (HMO D-SNP) with no copay and a 20% coinsurance, although prior authorization is required. While some services are covered, specific sub-services including standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for peripheral artery disease (PAD) rehabilitation are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is covered by Wellpoint Full Dual Advantage 2 (HMO D-SNP) with no copay and no coinsurance, although prior authorization is required. The plan allows for admission without a prior three-day inpatient hospital stay, but additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Wellpoint Full Dual Advantage 2 (HMO D-SNP) partially covers other services, which include over-the-counter (OTC) items, meal benefits for chronic illness, and Medicare Community Resource Support with no copay and no coinsurance. Acupuncture is not covered under this plan.
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