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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 Select Counties in MI. 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 $8.80. 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 $200.00 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 an annual drug deductible of $200. Under this plan, Tier 6 Select Care Drugs are available with no copay across all pharmacies and mail-order options. You can also save on Tier 1 Preferred Generic and Tier 2 Generic prescriptions, which feature no copay when ordering a 3-month supply through a preferred mail-order pharmacy. For brand-name and specialty medications, Tier 3 Preferred Brands require a 20% coinsurance, while Tier 5 Specialty Tier drugs carry a 25% coinsurance for a 1-month supply. Tier 4 Non-Preferred Drugs have copays starting at $100 for a 1-month supply. Standard 1-month copays for Tier 1 and Tier 2 generics range from $18 to $20 depending on whether you use a preferred or standard pharmacy.
Additional Benefits
The Wellcare Meridian Dual Align (HMO D-SNP) offers comprehensive medical coverage with no copays for primary care, outpatient services, and diagnostic tests, though these services typically carry a 20% coinsurance. Inpatient hospital stays require a copayment of $2,200 for acute care and $2,080 for psychiatric care with no coinsurance. Emergency room visits feature a $115 copay, while skilled nursing facility stays require no copay for days 1 through 20. This plan also provides key supplemental benefits, including preventive services, home health, and certain dental care with no copay and no coinsurance. Vision and hearing benefits offer routine exams and eyewear with no copay, alongside a $1,500 hearing aid benefit per ear and a $229 vision allowance. Additionally, members can access over-the-counter items and home-delivered meals with no copay and no coinsurance.
Inpatient Hospital See details
Wellcare Meridian Dual Align (HMO D-SNP) covers inpatient hospital services with no coinsurance, requiring a copayment of $2,200 per stay for acute care and $2,080 per stay for psychiatric care. Prior authorization is required for these covered stays, while upgrades, additional days, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Wellcare Meridian Dual Align (HMO D-SNP) covers outpatient services, including hospital, ambulatory surgical center, substance abuse, and blood services, with no copays and a 20% coinsurance. Prior authorization is required for outpatient hospital, ambulatory surgical center, and substance abuse services, and there is no deductible for outpatient blood services.
Partial Hospitalization See details
Wellcare Meridian Dual Align (HMO D-SNP) covers partial hospitalization services with no copay and a 20% coinsurance. Prior authorization is required for these services.
Ambulance and Transportation Services See details
Wellcare Meridian Dual Align (HMO D-SNP) covers ground and air ambulance services with a 20% coinsurance and no copay, requiring prior authorization. Transportation services to plan-approved or other health-related locations are 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 partially covered up to a $50,000 maximum benefit 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, mental health, and physical therapy services with no copay and 20% coinsurance, though prior authorization is typically required. Podiatry and chiropractic services are not covered, while additional telehealth benefits are available with a $0 to $40 copay and 20% coinsurance.
Preventive Services See details
Wellcare Meridian Dual Align (HMO D-SNP) offers partially covered preventive services, providing annual physical exams, fitness benefits, alternative therapies, and personal emergency response systems with no copay and no coinsurance. Kidney disease education, glaucoma screenings, and diabetes self-management training are covered with no copay and 20% coinsurance, while other sub-services such as health education, nutritional benefits, and in-home safety assessments are not covered.
Hearing Services See details
Wellcare Meridian Dual Align (HMO D-SNP) hearing services are partially covered, offering one annual routine hearing exam with a 20% coinsurance and no copay, and one fitting/evaluation with no copay or coinsurance. Up to two prescription hearing aids are covered per year with a $1,500 maximum benefit per ear and no copay or coinsurance, while OTC, inner ear, outer ear, and over the ear hearing aids are not covered.
Vision Services See details
Wellcare Meridian Dual Align (HMO D-SNP) partially covers vision services with no deductibles, offering routine eye exams and eyewear like eyeglasses and contacts with no copays, though routine exams and contact lenses are subject to a 20% coinsurance. Other eye exam services are not covered under this plan, which features a maximum benefit limit of $229.
Dental Services See details
Wellcare Meridian Dual Align (HMO D-SNP) partially covers dental services, offering Medicare-covered dental care with no copay and a 20% coinsurance, and other covered dental services with no copay and no coinsurance. Prophylaxis (cleanings), fluoride treatment, maxillofacial prosthetics, implant services, and orthodontics are not covered under this plan.
Home Infusion bundled Services See details
Wellcare Meridian Dual Align (HMO D-SNP) covers home infusion bundled services with no copay, though prior authorization is required. Under this benefit, Medicare Part B insulin drugs have a $35 copay with no coinsurance, while chemotherapy, radiation, and other Part B drugs require a 0% to 20% coinsurance.
Dialysis Services See details
Wellcare Meridian Dual Align (HMO D-SNP) covers dialysis services with no copay and a 20% coinsurance. This benefit ensures you have affordable access to necessary renal dialysis treatments and equipment.
Medical Equipment See details
Wellcare Meridian Dual Align (HMO D-SNP) covers medical equipment, including durable medical equipment (DME), prosthetics, medical supplies, and diabetic equipment, with no copay and a 20% coinsurance. Prior authorization is required for these benefits, and diabetic supplies are limited to specified manufacturers.
Diagnostic and Radiological Services See details
Wellcare Meridian Dual Align (HMO D-SNP) covers diagnostic and radiological services with a 20% coinsurance and no copay, though prior authorization is required. This coverage includes Medicare-covered lab services, diagnostic procedures, diagnostic and therapeutic radiological services, and outpatient X-rays.
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) offers Cardiac Rehabilitation Services with no copay, but in practice some services are covered while standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for peripheral artery disease (PAD) rehabilitation services are not covered and require a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
Wellcare Meridian Dual Align (HMO D-SNP) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring prior authorization but no prior three-day inpatient hospital stay. There is no copay for days 1 through 20 and days 71 through 100, a $218 copay for days 21 through 70, and additional days beyond the Medicare-covered 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 a meal benefit with no copay and no coinsurance, while acupuncture is not covered. The meal benefit requires a referral, and OTC items are eligible for reimbursement with no maximum coverage limit.
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