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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 WI. This plan received an overall rating of 3.5 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 $13.10. 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 Dual Access Sync (HMO-POS D-SNP) plan features a $400 annual drug deductible before coverage begins. For Tier 1 preferred generics and Tier 2 generics, copays start as low as $18 and $19 respectively, with no copay for three-month supplies filled through preferred mail order. Tier 3 preferred brand drugs require a consistent 20% coinsurance across all retail and mail-order options. Tier 4 non-preferred drugs carry copays ranging from $100 to $300, while Tier 5 specialty drugs require a 25% coinsurance for a one-month supply. Additionally, Tier 6 select care drugs are covered with no copay for all supply durations, whether filled at standard or preferred pharmacies. This plan offers diverse cost-saving opportunities depending on your drug tier and pharmacy choice.
Additional Benefits
The Wellcare Dual Access Sync (HMO-POS D-SNP) provides robust medical coverage, featuring no copays and a 20% coinsurance for primary care, outpatient services, diagnostics, and durable medical equipment. Inpatient hospital stays require a $1,860 copay per stay with no coinsurance, while skilled nursing facility stays have no copay for days 1 to 20 but require a $218 daily copay for days 21 to 70. Emergency room visits carry a $115 copay, which is waived if you are admitted to the hospital within 24 hours. For extra value, the plan offers dental care, home health services, and up to 48 one-way transportation trips per year with no copays or coinsurance. Routine vision and hearing exams are covered with no copay and a 20% coinsurance, supported by annual allowances of up to $500 for eyewear and $2,500 for prescription hearing aids. Members also benefit from over-the-counter items and chronic illness meal benefits with no copay and no coinsurance.
Inpatient Hospital See details
Wellcare Dual Access Sync (HMO-POS D-SNP) covers inpatient acute and psychiatric hospital stays with a $1,860.00 copayment per stay and no coinsurance, though prior authorization is required. This benefit is partially covered, as additional days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Wellcare Dual Access Sync (HMO-POS D-SNP) covers outpatient services—including outpatient hospital, ambulatory surgical center, substance abuse, and blood services—with no copay and a 20% coinsurance. Prior authorization is required for outpatient hospital, ambulatory surgical center, and outpatient substance abuse 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 for 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, subject to prior authorization. Additionally, the plan offers up to 48 one-way trips per year to plan-approved health-related locations with no copay and no coinsurance, while transportation to any other health-related locations is not covered.
Emergency Services See details
Wellcare Dual Access Sync (HMO-POS D-SNP) covers emergency services with a $115 copay and no coinsurance, and urgently needed services with a $40 copay and no coinsurance, with both copays waived if admitted to the hospital within 24 hours. Worldwide emergency and urgent services are partially 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 Dual Access Sync (HMO-POS D-SNP) covers primary care, specialist, therapy, psychiatric, and opioid treatment services with no copay and a 20% coinsurance, while additional telehealth benefits have a $0.00 to $40.00 copay and 20% coinsurance. Podiatry services, routine chiropractic care, and other chiropractic services are not covered.
Preventive Services See details
Preventive services are partially covered by Wellcare Dual Access Sync (HMO-POS D-SNP), with no copay and no coinsurance for annual physicals, fitness benefits, alternative therapies, PERS, and remote access technologies. Kidney education and other screenings (glaucoma, diabetes self-management, digital rectal exams, and EKGs) require no copay and a 20% coinsurance, while health education, in-home safety assessments, medical nutrition therapy, medication reconciliation, re-admission prevention, wigs, weight management, therapeutic massage, adult day health, nutritional benefits, palliative care, in-home support, caregiver support, tobacco cessation, disease management, telemonitoring, home modifications, and counseling are not covered.
Hearing Services See details
Hearing services are partially covered by Wellcare Dual Access Sync (HMO-POS D-SNP) with no deductible, offering routine hearing exams for a 20% coinsurance and no copay, and fitting evaluations and prescription hearing aids with no copay or coinsurance up to a $2,500 annual limit. However, OTC hearing aids and inner ear, outer ear, and over the ear prescription hearing aids are not covered.
Vision Services See details
Vision services are partially covered by the Wellcare Dual Access Sync (HMO-POS D-SNP) plan, which excludes other eye exam services. Routine eye exams are covered once per year with no copay, 20% coinsurance, and no deductible, while eyewear is covered up to $500 annually with no deductible and no copay, featuring a 20% coinsurance for contact lenses and no coinsurance for eyeglasses, lenses, frames, and upgrades.
Dental Services See details
Wellcare Dual Access Sync (HMO-POS D-SNP) dental services are partially covered, offering preventive and comprehensive options with no copay and no coinsurance, while Medicare-covered dental services require a 20% coinsurance and no copay. Maxillofacial prosthetics 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 plan, Medicare Part B insulin drugs have a $35 copay and no coinsurance, while chemotherapy, radiation, and other Part B drugs feature no copay and a coinsurance ranging from 0% to 20%.
Dialysis Services See details
Dialysis Services are covered by Wellcare Dual Access Sync (HMO-POS D-SNP) with no copay and a 20% coinsurance. This benefit ensures you have affordable access to necessary dialysis treatments with clearly defined out-of-pocket costs.
Medical Equipment See details
Wellcare Dual Access Sync (HMO-POS D-SNP) covers durable medical equipment, 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
Diagnostic and radiological services are covered by Wellcare Dual Access Sync (HMO-POS D-SNP) with no copay and a 20% coinsurance, though prior authorization is required. This coverage applies to outpatient diagnostic procedures, lab services, therapeutic radiological services, and outpatient X-rays.
Home Health Services See details
Wellcare Dual Access Sync (HMO-POS D-SNP) covers home health services with no copay and no coinsurance, though prior authorization is required for these services.
Cardiac Rehabilitation Services See details
Wellcare Dual Access Sync (HMO-POS D-SNP) offers Cardiac Rehabilitation Services with no copay, though only some services are covered in practice. Specifically, cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) services are not covered by the plan and require a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
Wellcare Dual Access Sync (HMO-POS D-SNP) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring 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 Medicare-covered limit are not covered.
Other Services See details
Wellcare Dual Access Sync (HMO-POS D-SNP) partially covers other services, offering over-the-counter (OTC) items and chronic illness meal benefits with no copay and no coinsurance. Acupuncture is not covered under this plan, and the meal benefit requires a referral.
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