WellSense Choice (HMO)

WellSense Choice (HMO) is a HMO plan offered by Boston Medical Center Health Plan, Inc. available for the 2026 plan year to people living in Hillsborough_Choice. This plan received an overall rating of 3 out of 5 stars in 2026.

It's important to know that WellSense Choice (HMO) 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 WellSense Choice (HMO).

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.

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:

Drug Coverage

The WellSense Choice (HMO) Medicare plan features an annual prescription drug deductible of $495. For Tier 1 preferred generic drugs, members pay no copay for a 1-month or 3-month supply at standard pharmacies and through standard mail order. Tier 2 generic medications also feature no copay for mail order, while standard retail pharmacy purchases require a $10 copay for a 1-month supply or a $25 copay for a 3-month supply. Tier 3 preferred brand drugs carry a $47 standard retail copay or a $45 mail order copay for a 1-month supply. Tier 4 non-preferred drugs require a $100 retail copay or a $97 mail order copay for 1 month, with 3-month supplies costing $280 at retail and $275 through mail order. Finally, Tier 5 specialty drugs require a 27% coinsurance for a 1-month supply at both standard pharmacies and standard mail order.

Additional Benefits

The WellSense Choice (HMO) plan offers robust coverage for essential medical needs, featuring no copays for primary care physician visits, annual physical exams, and home health services. Specialist visits, routine eye exams, and routine hearing exams are accessible with a predictable $35 copay. For hospital care, inpatient acute stays require a $450 copay for the first seven days before dropping to no copay, while emergency room visits carry a $150 copay that is waived if you are admitted. This plan also provides valuable supplemental benefits, including no copays for preventive dental care, routine eyewear, and over-the-counter items up to $50 every three months. Comprehensive dental services are covered with a 50% coinsurance up to a $4,000 annual limit, and prescription hearing aids are available with copays ranging from $699 to $999. Additionally, most durable medical equipment and dialysis services are covered with a 20% coinsurance.

Plan Providers

Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross and Blue Shield, Aspire Health Plan, Dean Health Plan, Devoted Health, Florida Blue Medicare, Freedom Health, Health Care Service Corporation, HealthSpring^SM, HealthSun, Healthy Blue, Humana, Molina Healthcare, Mutual of Omaha, Medica Central Health Plan, Optimum HealthCare, Premera Blue Cross, SCAN Health Plan, Simply, UnitedHealthcare(R), Wellcare, WellPoint.