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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 Fort Bend, Harris, Montgomery Counties. 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 $3400.00 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 features a $0 drug deductible, allowing your prescription coverage to begin immediately with no deductible to meet. Beneficiaries will pay no copay for Tier 1 preferred generic, Tier 2 generic, and Tier 6 select care drugs. This savings applies to one-month, two-month, and three-month fills at preferred pharmacies, standard pharmacies, and standard mail order. For brand-name and specialty medications, costs are determined by coinsurance rather than flat copays. Tier 3 preferred brand drugs require a 20% coinsurance at preferred pharmacies and standard mail order, or 25% at standard pharmacies, 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 available pharmacy types.
Additional Benefits
The Wellpoint Select (HMO-POS) plan offers comprehensive medical coverage featuring no copayments for primary care visits, routine annual physicals, and home health services. For hospital care, inpatient stays require a $120 daily copayment for the first three days followed by no copay, while emergency room visits carry a $120 copay that is waived upon admission. Additionally, members can access routine dental, vision, and hearing exams with no copays, alongside generous annual allowances for eyewear and hearing aids. Specialist visits and mental health therapies require a low $20 copay, while diagnostic lab tests and routine transportation for up to 84 one-way trips are available with no copay. The plan also provides a quarterly $75 over-the-counter item allowance with no copay, though certain services like dialysis and durable medical equipment require up to a 20% coinsurance. Overall, this plan minimizes out-of-pocket costs by eliminating deductibles for key services and offering robust preventive care.
Inpatient Hospital See details
Wellpoint Select (HMO-POS) covers inpatient acute and psychiatric hospital stays with no coinsurance, requiring a $120 daily copay for days 1 through 3 and no copay for day 4 and beyond. This partially covered benefit requires prior authorization and does not cover upgrades or non-Medicare-covered stays.
Outpatient Services See details
Wellpoint Select (HMO-POS) covers outpatient services with no coinsurance, featuring a $0 to $50 copay for outpatient hospital services and a $50 copay per stay for observation services. Ambulatory surgical center and outpatient blood services are covered with no copay and no coinsurance, while outpatient substance abuse sessions require a $20 copay.
Partial Hospitalization See details
Partial hospitalization services are covered by Wellpoint Select (HMO-POS) with a $25.00 copay and no coinsurance, though prior authorization is required.
Ambulance and Transportation Services See details
Wellpoint Select (HMO-POS) covers ambulance and transportation services, featuring a $210 copay and no coinsurance for both ground and air ambulance trips. Transportation services are partially covered, offering up to 84 one-way trips per year to plan-approved 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 $120 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services require a $25 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered up to a $100,000 maximum limit with a $120 copay and no coinsurance per service.
Primary Care See details
Wellpoint Select (HMO-POS) provides primary care and telehealth services with no copay and no coinsurance. Specialist visits, therapy, mental health, and opioid treatment require a $20 copay and no coinsurance, while chiropractic services are not covered. Podiatry services are covered with no coinsurance and a copay ranging from $0 to $20.
Preventive Services See details
Preventive Services are partially covered by Wellpoint Select (HMO-POS) with no copay and no coinsurance for covered services such as annual physical exams, home safety devices, and kidney disease education. However, fitness benefits, health education, in-home safety assessments, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, chemotherapy wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, caregiver support, telemonitoring, and counseling services are not covered.
Hearing Services See details
Hearing services are covered by Wellpoint Select (HMO-POS), offering Medicare-covered exams for a $20 copay and no coinsurance, and annual routine exams and fitting evaluations with no copay or coinsurance. Prescription hearing aids are partially covered with no copay or coinsurance up to a $3,000 annual limit, but inner ear, outer ear, and over the ear models are not covered, while OTC hearing aids are covered with no copay or coinsurance up to $300 annually.
Vision Services See details
Wellpoint Select (HMO-POS) covers vision services with no deductibles, including one annual routine eye exam with no copay or coinsurance. Eyewear is covered up to $300 annually with no copays, though contact lenses require a 20% coinsurance, and upgrades and other eye exams are not covered.
Dental Services See details
Dental Services under Wellpoint Select (HMO-POS) are partially covered up to a $3,250 annual maximum, offering preventive and diagnostic care with no copay and no coinsurance. Medicare-covered dental services require a $20 copay and no coinsurance, while covered comprehensive services have no copay and a 25% coinsurance; however, 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, though prior authorization and step therapy are required. Under this benefit, Medicare Part B insulin is covered with a $35 copay and no coinsurance, while chemotherapy, radiation, and other Part B drugs require a 0% to 20% coinsurance.
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 with no copay and 0% to 20% coinsurance, and prosthetics or medical supplies with no copay and 20% coinsurance. Diabetic supplies and therapeutic shoes or inserts are covered with no copay and no coinsurance, though selection is limited to specified manufacturers.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered under Wellpoint Select (HMO-POS), requiring referrals and prior authorization for care. Members pay no copay or coinsurance for lab services, $0 to $70 copays with no coinsurance for diagnostic tests, a $10 copay for X-rays, and a minimum 20% coinsurance for therapeutic radiological services.
Home Health Services See details
Home Health Services are covered under the Wellpoint Select (HMO-POS) plan with no copay and no coinsurance, though prior authorization and a referral are required.
Cardiac Rehabilitation Services See details
Wellpoint Select (HMO-POS) does not cover Cardiac Rehabilitation Services, as all associated sub-services—including intensive cardiac, pulmonary, and supervised exercise therapies—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 allowing admission without a prior three-day hospital stay. There is no copay for days 1 through 20, a $140 daily copay for days 21 through 100, and additional days beyond the Medicare-covered period are not covered.
Other Services See details
Other services are partially covered by Wellpoint Select (HMO-POS), featuring no copays and no coinsurance for a meal benefit, Medicare Community Resource Support (referral required), and up to $75 every three months for over-the-counter items, while acupuncture is not covered.
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