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Wellcare Dual Liberty Open (PPO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Wellcare Dual Liberty Open (PPO D-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Wellcare Dual Liberty Open (PPO D-SNP) in 2025, please refer to our full plan details page.
Wellcare Dual Liberty Open (PPO D-SNP) is a PPO D-SNP plan offered by Centene Corporation available for enrollment in 2025 to people living in Select counties in WA. This plan received an overall rating of 2.5 out of 5 stars in 2025.
It's important to know that Wellcare Dual Liberty Open (PPO D-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
Wellcare Dual Liberty Open (PPO 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 Wellcare Dual Liberty Open (PPO 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 Wellcare Dual Liberty Open (PPO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $20.80. 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 combined Maximum Out-Of-Pocket cost of $14000.00 (in-network or out-of-network combined). You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $14000.00 for covered services, the plan will pay 100% of covered costs for the rest of the year.
The plan may have separate out-pocket-maximums for in-network and out-of-network services. See our full plan details page for more information.
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 Wellcare Dual Liberty Open (PPO D-SNP) plan has a $590 deductible for prescription drugs. If you qualify for the low-income subsidy, your monthly premium for Part D is $20.80. After the deductible, you will pay the costs for drugs in each tier until your total drug costs reach $2000, at which point you enter the catastrophic coverage phase where you will pay nothing for covered drugs. Refer to the plan's formulary for specific drug costs.
Additional Benefits
The Wellcare Dual Liberty Open (PPO D-SNP) plan offers a range of benefits, including coverage for inpatient hospital stays with a copay per admission, outpatient services with varying coinsurance, and emergency services with a copay. The plan also covers primary care, preventive services, hearing, vision, and dental services, with specific copays and coinsurance for each. Additional benefits include ambulance and transportation services, home health services with no copay, and services like acupuncture, over-the-counter items, and meal benefits. However, some services like cardiac rehabilitation, additional hours of care, and certain types of transportation are not covered.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, both requiring prior authorization. For Inpatient Hospital-Acute, the copay is $1820 per admission or stay, and for Inpatient Hospital Psychiatric, the copay is $1937 per admission or stay. Additional days, non-Medicare-covered stays, and upgrades are not covered for either type of inpatient hospital stay.
Outpatient Services See details
Outpatient services include outpatient hospital services, observation services, ambulatory surgical center (ASC) services, outpatient substance abuse services, and outpatient blood services. Outpatient hospital services have no copay and a 20% coinsurance, while observation services have a 20% coinsurance and no copay. Ambulatory Surgical Center (ASC) Services, individual sessions for outpatient substance abuse, and group sessions for outpatient substance abuse have a minimum and maximum coinsurance of 20%. Outpatient blood services have a 20% coinsurance.
Partial Hospitalization See details
Partial Hospitalization is covered under the Wellcare Dual Liberty Open (PPO D-SNP) plan, but requires prior authorization. You will pay 20% coinsurance for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Wellcare Dual Liberty Open (PPO D-SNP) plan. Ground and air ambulance services have a 20% coinsurance, while transportation services to a plan-approved health-related location have no copay and are limited to 12 one-way trips per year, using rideshare services, bus/subway, or medical transport. Transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, including Urgently Needed Services and Worldwide Emergency Coverage, are covered under the Wellcare Dual Liberty Open (PPO D-SNP) plan. For Emergency Services, there is a $110 copay with no coinsurance, and for Urgently Needed Services, there is a $45 copay with no coinsurance. Worldwide Emergency Transportation is not covered.
Primary Care See details
The Wellcare Dual Liberty Open (PPO D-SNP) plan covers primary care physician services, chiropractic services (with no copay), occupational therapy, 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 (with a copay between $0 and $45), and opioid treatment program services. Primary care physician services, physician specialist services, physical therapy, and additional telehealth benefits have 20% coinsurance. Mental health specialty services, podiatry services, other health care professional services, psychiatric services, and opioid treatment program services also have 20% coinsurance.
Preventive Services See details
Preventive services include no copay for an annual physical exam, and for additional services, there is a copay for Fitness Benefit, Remote Access Technologies, Home and Bathroom Safety Devices and Modifications, and Alternative Therapies. Kidney Disease Education Services, Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit all have a 20% coinsurance.
Hearing Services See details
Hearing Services include routine hearing exams, fitting/evaluation for hearing aids, and prescription hearing aids. Routine hearing exams and fitting/evaluation for hearing aids have no copay and a 20% coinsurance. Prescription hearing aids have a maximum benefit of $1,000 per ear per year, and no copay.
Vision Services See details
Vision Services include eye exams with a 20% coinsurance and no copay, as well as eyewear with a 20% coinsurance. Routine eye exams have no copay, while contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades have no copay. There is a combined maximum of $200 per year for eyewear.
Dental Services See details
Dental Services includes coverage for Medicare Dental Services with 20% coinsurance, and other services such as oral exams, dental x-rays, and other diagnostic and preventive services with no copay. Orthodontic services are covered up to a maximum of $1500 per year. Maxillofacial Prosthetics, Implant Services, and Orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, and require prior authorization. Insulin has a copay of $35, 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 Wellcare Dual Liberty Open (PPO D-SNP) plan, with a coinsurance between 20% and 20%.
Medical Equipment See details
Medical Equipment, including Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment, is covered. DME and Diabetic Supplies have a 20% coinsurance, while Prosthetic Devices and Medical Supplies have a 20% coinsurance. Diabetic Therapeutic Shoes/Inserts also have a 20% coinsurance. Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered by the Wellcare Dual Liberty Open (PPO D-SNP) plan. For Diagnostic Procedures/Tests, the plan has a coinsurance of at most 20%, while Lab Services have a coinsurance of at most 20% and no copay. Diagnostic Radiological Services, Therapeutic Radiological Services, and Outpatient X-Ray Services have a coinsurance of at most 20%, and Diagnostic Radiological Services have no copay.
Home Health Services See details
Home Health Services are covered by the Wellcare Dual Liberty Open (PPO D-SNP) plan with no copay and no coinsurance. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the Wellcare Dual Liberty Open (PPO D-SNP) plan. The plan does not cover Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, or SET for PAD Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered under the Wellcare Dual Liberty Open (PPO D-SNP) plan, but require prior authorization. There is no copay for days 1-20, and a $214 copay for days 21-100. Additional days beyond Medicare-covered and non-Medicare-covered stays are not covered.
Other Services See details
The Wellcare Dual Liberty Open (PPO D-SNP) plan covers acupuncture with no copay, but requires prior authorization and is limited to 12 treatments per year. Over-the-counter items and meal benefits are covered with no copay, and a doctor's referral is required for the meal benefit. Other services such as Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, and more are not covered.
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