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Wellcare Meridian Dual Align (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Wellcare Meridian Dual Align (HMO D-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Wellcare Meridian Dual Align (HMO D-SNP) in 2026, please refer to our full plan details page.
Wellcare Meridian Dual Align (HMO D-SNP) is a HMO D-SNP plan offered by Centene Corporation available for enrollment in 2026 to people living in Statewide in IL. The overall rating for this plan is not yet available for 2026.
It's important to know that Wellcare Meridian Dual Align (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:
Wellcare Meridian Dual Align (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 Wellcare Meridian Dual Align (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 Wellcare Meridian Dual Align (HMO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $14.20. 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 $400.00 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 Meridian Dual Align (HMO D-SNP) prescription drug plan features a $400 annual drug deductible. For Tier 1 preferred generic drugs, copays start as low as $18 at preferred pharmacies, while Tier 2 generic drugs start at a $19 copay. You can save on prescription costs by using preferred mail-order services, which offer no copay for a three-month supply of both Tier 1 and Tier 2 medications. Tier 3 preferred brand drugs require a 20% coinsurance across all pharmacy and mail-order options, and Tier 5 specialty drugs require a 25% coinsurance for a one-month supply. Tier 4 non-preferred drugs carry a $100 copay for a one-month supply at both standard and preferred pharmacies. Additionally, Tier 6 select care drugs are highly affordable, featuring no copay for all supply durations and pharmacy types.
Additional Benefits
The Wellcare Meridian Dual Align (HMO D-SNP) offers robust medical coverage, featuring a $2,050 copay per admission with no coinsurance for inpatient hospital stays. Many essential services, including primary care, specialist visits, outpatient procedures, and diagnostic tests, are covered with no copay and a 20% coinsurance. Emergency care is available with a $115 copay and no coinsurance, while skilled nursing facility stays require no copay for days 1 to 20 and a $218 daily copay for days 21 to 70. This plan also provides valuable supplemental benefits, including home health services, fitness benefits, and over-the-counter items with no copay and no coinsurance. Most dental services are covered with no copay and no coinsurance, whereas routine vision and hearing exams require no copay and a 20% coinsurance. Furthermore, members can access up to $300 yearly for eyewear and up to $1,000 per ear for prescription hearing aids with no copay or coinsurance.
Inpatient Hospital See details
Wellcare Meridian Dual Align (HMO D-SNP) provides partially covered inpatient hospital services for acute and psychiatric stays, which require prior authorization and a $2,050 copayment per admission with no coinsurance. Specific exclusions apply, as additional days, upgrades, and non-Medicare-covered stays are not covered under this plan.
Outpatient Services See details
Wellcare Meridian Dual Align (HMO D-SNP) covers outpatient services, including outpatient hospital, ambulatory surgical center, outpatient substance abuse, and blood services, with no copays and a 20% coinsurance. Prior authorization is required for outpatient hospital, ambulatory surgical center, and outpatient substance abuse services.
Partial Hospitalization See details
Partial hospitalization services are covered by Wellcare Meridian Dual Align (HMO D-SNP) with no copay and a 20% coinsurance. Prior authorization is required to access this benefit.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered by Wellcare Meridian Dual Align (HMO D-SNP) with a 20% coinsurance and no copay for ground and air ambulance services, which require prior authorization. While transportation is listed as covered, some services are covered but transportation to plan-approved or any health-related locations is not covered.
Emergency Services See details
Wellcare Meridian Dual Align (HMO D-SNP) covers emergency services with a $115 copay and no coinsurance, and urgently needed services with a $40 copay and no coinsurance, with copays waived if admitted to the hospital within 24 hours. Worldwide emergency and urgent care are also covered up to a $50,000 limit with a $115 copay and no coinsurance, though worldwide emergency transportation is not covered.
Primary Care See details
Wellcare Meridian Dual Align (HMO D-SNP) covers primary care, specialist, outpatient therapy, psychiatric, and mental health services with no copay and 20% coinsurance, though prior authorization is required for most services. Podiatry services and routine chiropractic care are not covered, while telehealth benefits require 20% coinsurance and a copay ranging from $0.00 to $40.00.
Preventive Services See details
Wellcare Meridian Dual Align (HMO D-SNP) provides partially covered preventive services, including annual physicals, fitness benefits, and alternative therapies with no copay and no coinsurance, as well as kidney education and glaucoma screenings with no copay and a 20% coinsurance. Sub-services not covered include health education, in-home safety assessments, medical nutrition therapy, post-discharge medication reconciliation, readmission prevention, chemotherapy wigs, weight management, therapeutic massage, adult day health, nutritional benefits, palliative care, caregiver support, smoking cessation, disease management, telemonitoring, home modifications, and counseling.
Hearing Services See details
Wellcare Meridian Dual Align (HMO D-SNP) partially covers hearing services, offering one annual routine exam with no copay and a 20% coinsurance, alongside one annual fitting evaluation with no copay or coinsurance. Up to two prescription hearing aids are covered every year with a $1,000 limit per ear and no copay or coinsurance, though OTC, inner ear, outer ear, and over-the-ear hearing aids are not covered.
Vision Services See details
Vision services are partially covered by Wellcare Meridian Dual Align (HMO D-SNP) with no deductibles, requiring prior authorization and excluding non-routine eye exams. One annual routine eye exam is covered with no copay and a 20% coinsurance, while eyewear is covered up to $300 yearly with no copay, featuring a 20% coinsurance for contact lenses and no coinsurance for eyeglasses.
Dental Services See details
Wellcare Meridian Dual Align (HMO D-SNP) offers partially covered dental services with no copay and no coinsurance, though prophylaxis (cleaning), maxillofacial prosthetics, implant services, and orthodontics are not covered. Medicare-covered dental services require a 20% coinsurance and no copay, and covered orthodontic services feature a $4,000 annual maximum benefit.
Home Infusion bundled Services See details
Wellcare Meridian Dual Align (HMO D-SNP) covers Home Infusion bundled Services with no copay, though prior authorization and step therapy are required. Under this benefit, Medicare Part B chemotherapy and other Part B drugs have no copay and a coinsurance of 0% to 20%, while Part B insulin is covered with a $35 copay and no coinsurance.
Dialysis Services See details
Wellcare Meridian Dual Align (HMO D-SNP) covers dialysis services with no copay and a 20% coinsurance. This plan ensures you have access to necessary renal dialysis treatments while clearly outlining your out-of-pocket costs.
Medical Equipment See details
Wellcare Meridian Dual Align (HMO D-SNP) covers medical equipment, including durable medical equipment, prosthetics, medical supplies, and diabetic equipment, with no copay and a 20% coinsurance. Prior authorization is required for these services, and diabetic supplies are limited to specified manufacturers.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered under the Wellcare Meridian Dual Align (HMO D-SNP) with no copay and a 20% coinsurance. Covered benefits include lab services, diagnostic tests, therapeutic radiological services, and outpatient X-rays, all of which require prior authorization.
Home Health Services See details
Wellcare Meridian Dual Align (HMO D-SNP) covers Home Health Services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Wellcare Meridian Dual Align (HMO D-SNP) does not cover Cardiac Rehabilitation Services in practice. Sub-services including cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation are not covered and carry a 20% coinsurance and no copay.
Skilled Nursing Facility (SNF) See details
Wellcare Meridian Dual Align (HMO D-SNP) covers Skilled Nursing Facility (SNF) services with no coinsurance, featuring no copay for days 1 to 20 and 71 to 100, and a $218 daily copay for days 21 to 70. Prior authorization is required, and additional days beyond the standard 100-day Medicare limit are not covered.
Other Services See details
Wellcare Meridian Dual Align (HMO D-SNP) partially covers other services, offering over-the-counter (OTC) items and meal benefits with no copay and no coinsurance, while acupuncture is not covered. The meal benefit requires a referral, and OTC items are provided via reimbursement with no maximum limit on coverage.
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