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Wellpoint Select (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Wellpoint Select (HMO-POS). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Wellpoint Select (HMO-POS) in 2026, please refer to our full plan details page.
Wellpoint Select (HMO-POS) is a HMO-POS plan offered by Elevance Health, Inc. available for enrollment in 2025 to people living in Bexar County. This plan received an overall rating of 3.5 out of 5 stars in 2026.
It's important to know that Wellpoint Select (HMO-POS) 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 Wellpoint Select (HMO-POS).
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 Wellpoint Select (HMO-POS), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $0.00. 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 no drug deductible. Your prescription medication coverage will start immediately.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $3500.00 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 Wellpoint Select (HMO-POS) Medicare plan features a $0 prescription drug deductible, meaning your coverage begins immediately. You will pay no copay for Tier 1 preferred generic and Tier 6 select care drugs at both preferred and standard pharmacies, as well as through standard mail order. Tier 2 generic drugs also have no copay at preferred pharmacies and standard mail order, though standard pharmacies charge a copay starting at $10 for a one-month supply. For higher-tier medications, costs are based on coinsurance rather than flat copays. Tier 3 preferred brand drugs require a 25% coinsurance, while Tier 4 non-preferred drugs carry a 30% coinsurance. Tier 5 specialty drugs require a 33% coinsurance for a one-month supply across all pharmacy types.
Additional Benefits
The Wellpoint Select (HMO-POS) plan offers robust medical coverage with no copays or coinsurance for primary care visits, preventive screenings, lab services, and home health care. Specialist visits and urgent care services require a budget-friendly $20 copay, while inpatient hospital stays carry a $100 daily copay for the first five days and no copay for additional days. Emergency room visits feature a $90 copay, which is waived if you are admitted to the hospital within 24 hours. In addition to core medical care, this plan provides valuable extra benefits including routine dental, vision, and hearing exams with no copays. Members can utilize generous annual allowances such as up to $1,500 for dental care, $250 for eyewear, and $62 every three months for over-the-counter health items. To make accessing care easier, the plan also covers up to 84 one-way transportation trips per year to approved health locations with no copay or coinsurance.
Inpatient Hospital See details
Wellpoint Select (HMO-POS) covers inpatient acute and psychiatric hospital stays with no coinsurance, requiring a $100 daily copay for days 1 through 5 and no copay for days 6 and beyond. Prior authorization is required, and non-Medicare-covered stays and upgrades are not covered.
Outpatient Services See details
Wellpoint Select (HMO-POS) covers outpatient services with no coinsurance, offering no copay for ambulatory surgical center and outpatient blood services. Outpatient hospital services require a copay of $0 to $95, observation services carry a $95 copay per stay, and outpatient substance abuse sessions have a $20 copay.
Partial Hospitalization See details
Partial hospitalization is covered by Wellpoint Select (HMO-POS) with a $20.00 copay and no coinsurance. Prior authorization is required to receive these services.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered by Wellpoint Select (HMO-POS), featuring a $260 copay and no coinsurance for both ground and air ambulance services. Transportation benefits are partially covered, offering up to 84 one-way trips per year to plan-approved health-related locations with no copay and no coinsurance, while transportation to any health-related location is not covered.
Emergency Services See details
Wellpoint Select (HMO-POS) covers emergency services with a $90 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services are covered with a $20 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered up to a $100,000 maximum limit with a $90 copay and no coinsurance.
Primary Care See details
Primary Care benefits offered by Wellpoint Select (HMO-POS) feature no copay and no coinsurance for primary care and telehealth visits, alongside a $0 to $20 copay and no coinsurance for podiatry services. Specialist visits, therapy services, and mental health care require a $20 copay and no coinsurance, and while some chiropractic services are covered, routine chiropractic care and other chiropractic services are not.
Preventive Services See details
Wellpoint Select (HMO-POS) covers preventive services, including annual physicals, kidney education, and screenings, with no copay and no coinsurance. The benefit is partially covered because health education, in-home safety assessments, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, chemotherapy hair loss wigs, weight management programs, alternative therapies, therapeutic massage, adult day health services, nutritional or dietary benefits, home-based palliative care, in-home support services, caregiver support, additional smoking and tobacco cessation counseling, fitness benefits, enhanced disease management, telemonitoring services, and counseling services are not covered. However, personal emergency response systems and up to $500 yearly in home safety modifications are covered with no copay and no coinsurance.
Hearing Services See details
Wellpoint Select (HMO-POS) hearing services include Medicare-covered exams for a $20 copay and no coinsurance, alongside routine exams, fitting evaluations, and OTC hearing aids up to $300 annually with no copay and no coinsurance. Prescription hearing aids are partially covered with no copay or coinsurance up to a $3,000 annual limit, though inner ear, outer ear, and over-the-ear prescription hearing aids are not covered.
Vision Services See details
Wellpoint Select (HMO-POS) provides partially covered vision services, featuring no copay and no coinsurance for one routine annual eye exam, though other eye exam services are not covered. Covered eyewear has a $250 annual limit with no copay for eyeglasses, lenses, and frames, and no copay with a 20% coinsurance for contact lenses, while upgrades are not covered.
Dental Services See details
Dental services are partially covered by Wellpoint Select (HMO-POS) up to a $1,500 yearly maximum, offering preventive care with no copay and no coinsurance, and comprehensive services with no copay and 25% coinsurance. Medicare-covered dental services have a $20 copay and no coinsurance, while maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Wellpoint Select (HMO-POS) covers home infusion bundled services with no copay and no coinsurance, subject to prior authorization. Under this benefit, Medicare Part B insulin is covered with a $35 copay and no coinsurance, while chemotherapy, radiation, and other Part B drugs have no copay and coinsurance ranging from no coinsurance to 20%.
Dialysis Services See details
Dialysis Services are covered by Wellpoint Select (HMO-POS) with no copay and a 20% coinsurance.
Medical Equipment See details
Wellpoint Select (HMO-POS) covers durable medical equipment and prosthetics with no copays, requiring a 0% to 20% coinsurance for durable medical equipment and a 20% coinsurance for prosthetics and medical supplies. Diabetic supplies and therapeutic shoes are fully covered with no copays and no coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Wellpoint Select (HMO-POS) with no copays and no coinsurance for lab services, diagnostic procedures, and diagnostic radiological services. Outpatient X-rays also feature no copay, while therapeutic radiological services require a 20% coinsurance, with referrals and prior authorizations required for all services.
Home Health Services See details
Home health services are covered by Wellpoint Select (HMO-POS) with no copay and no coinsurance, though prior authorization and a referral are required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by Wellpoint Select (HMO-POS) with no coinsurance and require prior authorization. While some services are covered, specific programs such as cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered in practice.
Skilled Nursing Facility (SNF) See details
Wellpoint Select (HMO-POS) covers skilled nursing facility (SNF) services with no coinsurance, requiring prior authorization and no prior three-day hospital stay. There is no copay for days 1 through 20, a $90 daily copay for days 21 through 100, and additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Wellpoint Select (HMO-POS) partially covers other services with no copay and no coinsurance, providing a meal benefit, Medicare Community Resource Support (referral required), and up to $62 every three months for over-the-counter items. Acupuncture is not covered under this benefit.
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