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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 2025, 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 2025.
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) plan has a $0 deductible for prescription drugs. During the initial coverage phase, you'll pay a copay or coinsurance depending on the drug tier and pharmacy. For example, preferred generic drugs have a $5 copay at a preferred pharmacy, while standard mail order has no copay. Once your total drug costs reach $2,000, you enter the catastrophic coverage phase where you pay nothing for covered Part D drugs. This plan offers an enhanced alternative drug benefit.
Additional Benefits
The Wellpoint Select (HMO-POS) plan offers a range of healthcare benefits with varying cost-sharing arrangements. The plan covers inpatient hospital stays with a copay, and outpatient services with copays that vary depending on the service. Emergency, primary care, and preventive services often have no copay, while other services such as vision and dental have copays or coinsurance. Additional benefits include coverage for hearing aids, vision care, and dental services, with specific copays and maximum benefit amounts. The plan also covers home health services, home infusion, and durable medical equipment with either no copay or a coinsurance. Transportation and ambulance services are covered, and the plan also includes coverage for over-the-counter items.
Inpatient Hospital See details
Inpatient Hospital services are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric. For Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, there is a $150 copay for days 1-5, and no copay for days 6-90. Additional days for both are covered with no copay. Non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute are not covered, and Non-Medicare-covered stays for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services, including Outpatient Hospital Services and Observation Services, have a copay between $0 and $95, while Ambulatory Surgical Center (ASC) Services and Outpatient Blood Services have no copay. Outpatient Substance Abuse Services, including both individual and group sessions, have a $20 copay.
Partial Hospitalization See details
Partial Hospitalization is covered under the Wellpoint Select (HMO-POS) plan, but requires prior authorization. You will have a $20 copay for this service.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Wellpoint Select (HMO-POS) plan. Ground and air ambulance services have a $260 copay, and transportation services to a plan-approved health-related location have no copay for up to 84 one-way trips per year, while transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered. Emergency Services have a $90 copay with no coinsurance, while Urgently Needed Services have a $20 copay with no coinsurance. Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation each have a $90 copay with no coinsurance.
Primary Care See details
The Wellpoint Select (HMO-POS) plan offers primary care services with no copay, and chiropractic services with a $20 copay, but routine care is not covered. Occupational therapy has a $20 copay, and physician specialist services, mental health specialty services, and psychiatric services have a $20 copay for individual and group sessions. The plan also covers podiatry services with copays ranging from $0 to $20, other health care professional services with copays from $0 to $20, physical therapy and speech-language pathology services with a $20 copay, telehealth benefits with no copay, and opioid treatment program services with a $20 copay.
Preventive Services See details
The Wellpoint Select (HMO-POS) plan covers preventive services, including an annual physical exam with no copay, and several other preventive services with varying copays depending on the service. Additional benefits such as Fitness Benefits, Remote Access Technologies, and Home and Bathroom Safety Devices and Modifications have a $0 copay. Other benefits such as Health Education, In-Home Safety Assessment, Medical Nutrition Therapy (MNT), Post discharge In-Home Medication Reconciliation, Re-admission Prevention, Wigs for Hair Loss Related to Chemotherapy, Weight Management Programs, Alternative Therapies, Therapeutic Massage, Adult Day Health Services, Nutritional/Dietary Benefit, Home-Based Palliative Care, In-Home Support Services, Support for Caregivers of Enrollees, Additional Sessions of Smoking and Tobacco Cessation Counseling, Enhanced Disease Management, Telemonitoring Services, and Counseling Services are not covered.
Hearing Services See details
Hearing services include hearing exams with a $20 copay, routine hearing exams with no copay, and fitting/evaluation for hearing aids with no copay. Prescription hearing aids are covered with a plan-specified amount per period of $3,000, and OTC hearing aids are covered with no copay and a maximum benefit of $300 every year for both ears combined. Prescription hearing aids - inner ear, outer ear, and over the ear are not covered.
Vision Services See details
The Wellpoint Select (HMO-POS) plan covers vision services, including eye exams with a copay of $0-$20, and eyewear. Eyewear has a 20% coinsurance for contact lenses and a copay for eyeglasses (lenses and frames), eyeglass lenses, and eyeglass frames, with a combined maximum plan benefit of $250 every year.
Dental Services See details
Wellpoint Select (HMO-POS) covers dental services, including Medicare Dental Services with a $20 copay, and other services with Oral Exams, Dental X-Rays, Other Diagnostic Dental Services, Prophylaxis (Cleaning), Fluoride Treatment, and Other Preventive Dental Services covered with no copay. The plan also covers Orthodontic Services with a maximum benefit of $1200 per year, and other services like Restorative Services, Endodontics, Periodontics, and more with no copay.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs with a $35 copay, and Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs with 0-20% coinsurance. Prior authorization is required for these services.
Dialysis Services See details
Dialysis Services are covered by the Wellpoint Select (HMO-POS) plan, with a coinsurance between 20% and 20%.
Medical Equipment See details
Medical Equipment is covered by Wellpoint Select (HMO-POS), including Durable Medical Equipment (DME) with 0% - 20% coinsurance, and Prosthetics/Medical Supplies and Diabetic Equipment with 20% coinsurance. Diabetic Supplies and Diabetic Therapeutic Shoes/Inserts have no copay. Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including diagnostic procedures, lab services, and radiological services. Diagnostic Procedures/Tests have no copay, while Lab Services have no copay. Diagnostic Radiological Services have a copay of up to $100, and Therapeutic Radiological Services have a coinsurance of at most 20%. Outpatient X-Ray Services have no copay.
Home Health Services See details
Home Health Services are covered by the Wellpoint Select (HMO-POS) plan with no copay and no coinsurance. However, additional hours of care and personal care services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the Wellpoint Select (HMO-POS) plan. This includes Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, and Additional Cardiac Rehabilitation Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Wellpoint Select (HMO-POS) plan, but require prior authorization. The plan does not provide Skilled Nursing Facility Services as a supplemental benefit under Part C, and additional days beyond Medicare-covered for SNF and Non-Medicare-covered stays are not covered.
Other Services See details
The Wellpoint Select (HMO-POS) plan covers Over-the-Counter (OTC) Items with no copay, and a maximum benefit coverage amount of $155 every three months. Other services such as Acupuncture, Meal Benefit, Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, and more are not covered.
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