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Wellcare Dual Access Sync (HMO-POS D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Wellcare Dual Access Sync (HMO-POS 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 Access Sync (HMO-POS D-SNP) in 2026, please refer to our full plan details page.
Wellcare Dual Access Sync (HMO-POS D-SNP) is a HMO-POS D-SNP plan offered by Centene Corporation available for enrollment in 2025 to people living in Select counties in KS. This plan received an overall rating of 3 out of 5 stars in 2026.
It's important to know that Wellcare Dual Access Sync (HMO-POS 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 Access Sync (HMO-POS 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 Access Sync (HMO-POS 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 Access Sync (HMO-POS D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $32.20. 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:
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Drug Coverage
The Wellcare Dual Access Sync (HMO-POS D-SNP) prescription drug plan has an annual drug deductible of $615. Tier 6 Select Care drugs are highly affordable with no copay across all standard and preferred pharmacy fills. Additionally, Tier 1 Preferred Generic and Tier 2 Generic medications offer low copays starting at $18 and $19, including no copay for three-month supplies filled through preferred mail order. For higher-tier medications, Tier 3 Preferred Brand drugs require a 22% coinsurance for all supply durations. Tier 4 Non-Preferred drugs have copays starting at $100 for a one-month supply, while Tier 5 Specialty Tier drugs require a 25% coinsurance.
Additional Benefits
The Wellcare Dual Access Sync (HMO-POS D-SNP) offers comprehensive medical coverage, featuring no copay and a 20% coinsurance for most outpatient, primary care, specialist, and diagnostic services. For inpatient hospital stays, members pay a $2,050 copay per stay with no coinsurance, while emergency room visits carry a $115 copay. Skilled nursing facility care is also available, offering no copay for days 1 through 20 and a $218 daily copay for days 21 through 70. This plan also includes key supplemental benefits like dental, vision, and hearing services, with no copay for routine dental care and annual eye exams. Prescription hearing aids are covered up to $750 per ear annually with no copay, and eyewear is covered up to a $500 yearly limit. Additionally, members benefit from no copay on home health services, fitness programs, and over-the-counter items.
Inpatient Hospital See details
Wellcare Dual Access Sync (HMO-POS D-SNP) offers partially covered inpatient acute and psychiatric hospital services, requiring prior authorization and a $2,050 copayment per stay with no coinsurance. Additional days, non-Medicare-covered stays, and room upgrades are not covered under this plan.
Outpatient Services See details
Outpatient services are covered by Wellcare Dual Access Sync (HMO-POS D-SNP) with no copayments and a 20% coinsurance for outpatient hospital, ambulatory surgical center, outpatient substance abuse, and outpatient blood services. Prior authorization is required for outpatient hospital, ambulatory surgical center, and outpatient substance abuse services, while the deductible is waived for blood services.
Partial Hospitalization See details
Wellcare Dual Access Sync (HMO-POS D-SNP) covers partial hospitalization services with no copay and a 20% coinsurance. Prior authorization is required to receive this benefit.
Ambulance and Transportation Services See details
Wellcare Dual Access Sync (HMO-POS D-SNP) covers ground and air ambulance services with a 20% coinsurance and no copay, requiring prior authorization. Transportation services are partially covered, offering up to 12 one-way trips per year to plan-approved locations with no copay and no coinsurance under prior authorization, though transportation to any health-related location is not covered.
Emergency Services See details
Emergency services are covered by Wellcare Dual Access Sync (HMO-POS D-SNP) with a $115 copay and no coinsurance, while urgently needed services have a $40 copay and no coinsurance, with both counting toward the deductible. Worldwide emergency and urgent services are partially covered up to a $50,000 limit with a $115 copay and no coinsurance, but worldwide emergency transportation is not covered.
Primary Care See details
Wellcare Dual Access Sync (HMO-POS D-SNP) covers primary care, specialist, therapy, psychiatric, and opioid treatment services with no copay and 20% coinsurance, while podiatry is covered with no copay and no coinsurance. Chiropractic care is partially covered, offering 12 routine visits yearly with no copay and no coinsurance (other chiropractic services are excluded), and telehealth benefits are available with a $0 to $40 copay and 20% coinsurance.
Preventive Services See details
Wellcare Dual Access Sync (HMO-POS D-SNP) covers annual physicals, fitness benefits, PERS, remote access, and alternative therapies with no copay and no coinsurance, whereas kidney disease education and other preventive screenings carry a 20% coinsurance and no copay. The preventive services benefit is partially covered, as health education, in-home safety assessments, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, chemotherapy wigs, weight management, therapeutic massage, adult day health, nutritional benefits, palliative care, in-home support, caregiver support, additional tobacco cessation counseling, disease management, telemonitoring, home safety modifications, and counseling are not covered.
Hearing Services See details
Hearing services are covered by Wellcare Dual Access Sync (HMO-POS D-SNP), offering one annual routine exam with no copay and a 20% coinsurance, and one fitting evaluation with no copay. Prescription hearing aids are covered up to $750 per ear yearly with no copay or coinsurance, though OTC, inner ear, outer ear, and over-the-ear hearing aids are not covered.
Vision Services See details
Wellcare Dual Access Sync (HMO-POS D-SNP) covers one routine eye exam per year with no copay and a 20% coinsurance, though other eye exams are not covered. Eyewear is covered up to a $500 annual limit, featuring contact lenses with no copay and a 20% coinsurance, and eyeglasses, lenses, frames, and upgrades with no copay and no coinsurance.
Dental Services See details
Wellcare Dual Access Sync (HMO-POS D-SNP) offers partially covered dental services, featuring no copay and no coinsurance for most preventive and comprehensive care, while Medicare-covered dental services have no copay and a 20% coinsurance. Maxillofacial prosthetics, implant services, and orthodontics are not covered under this plan.
Home Infusion bundled Services See details
Wellcare Dual Access Sync (HMO-POS D-SNP) covers home infusion bundled services with no copay, though prior authorization is required. Under this benefit, Part B insulin drugs require a $35 copay with no coinsurance, while chemotherapy, radiation, and other Part B drugs have a coinsurance of 0% to 20%.
Dialysis Services See details
Wellcare Dual Access Sync (HMO-POS D-SNP) covers dialysis services with no copay and a 20% coinsurance.
Medical Equipment See details
Medical equipment is covered by Wellcare Dual Access Sync (HMO-POS D-SNP) with no copay and a 20% coinsurance for durable medical equipment, prosthetics, medical supplies, and diabetic equipment. Prior authorization is required for these services, and diabetic supplies are limited to specified manufacturers.
Diagnostic and Radiological Services See details
Wellcare Dual Access Sync (HMO-POS D-SNP) covers diagnostic and radiological services with no copay, though a 20% coinsurance and prior authorization are required. Covered benefits include lab services, diagnostic procedures, therapeutic radiological services, and outpatient X-rays.
Home Health Services See details
Home Health Services are covered by Wellcare Dual Access Sync (HMO-POS D-SNP) with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Wellcare Dual Access Sync (HMO-POS D-SNP) covers Cardiac Rehabilitation Services with no copay, though only some services are covered. Specifically, standard cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) are not covered and require a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is partially covered by Wellcare Dual Access Sync (HMO-POS D-SNP) with no coinsurance, as additional days beyond the Medicare-covered limit are not covered. There is no copay for days 1 through 20 and days 71 through 100, while a daily copay of $218 applies for days 21 through 70, with prior authorization required.
Other Services See details
Wellcare Dual Access Sync (HMO-POS D-SNP) partially covers other services, offering over-the-counter (OTC) items and a chronic illness meal benefit with no copay and no coinsurance. Acupuncture and other additional services are not covered under this plan.
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