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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 Fort Bend, Harris, Montgomery Counties. 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 $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 has an enhanced alternative drug benefit. There is no deductible for prescription drugs. During the initial coverage phase, you'll pay a $2.00 copay for preferred generic drugs at preferred pharmacies. For standard mail order drugs, you will have no copay for preferred generic drugs. Once your total drug costs reach $2,000, you enter the catastrophic coverage phase, where you pay nothing for covered drugs.
Additional Benefits
The Wellpoint Select (HMO-POS) plan offers comprehensive coverage with varying costs. Inpatient hospital stays have a copay for the first few days, and then no copay for the rest of the stay. Emergency services and ambulance services have copays, and outpatient services have copays that vary by service. The plan includes no copay for many services, such as primary care, preventive services, routine hearing and vision exams, home health, and dental services. Other services, such as hearing aids, prescription drugs, and durable medical equipment, may have coinsurance or limitations on coverage.
Inpatient Hospital See details
Inpatient Hospital services are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric. For days 1-3, the copay is $120, and for days 4-90, there is no copay; there is no coinsurance. Additional days for both Inpatient Hospital-Acute and Inpatient Hospital Psychiatric have no copay or coinsurance. Non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute and Non-Medicare-covered stays for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient services include coverage for outpatient hospital services with a copay between $0 and $50, observation services with a $50 copay, ambulatory surgical center services with no copay, outpatient substance abuse services with a $25 copay for both individual and group sessions, and outpatient blood services with no copay. Outpatient hospital services, observation services, ambulatory surgical center services, and outpatient substance abuse services require prior authorization and a doctor referral.
Partial Hospitalization See details
Partial Hospitalization is covered by the Wellpoint Select (HMO-POS) plan, but requires prior authorization. You will have a $25 copay for this benefit.
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 $210 copay, and Transportation Services to a plan-approved health-related location are covered with no copay for up to 84 one-way trips per year. 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 by the Wellpoint Select (HMO-POS) plan. Emergency Services and Worldwide Emergency Coverage, Urgent Coverage, and Emergency Transportation each have a $120 copay, while Urgently Needed Services has a $25 copay; there is no coinsurance for any of these services.
Primary Care See details
Primary Care Physician Services, and Additional Telehealth benefits are covered with no copay, while Chiropractic Services, Physician Specialist Services, Physical Therapy and Speech-Language Pathology Services, and Opioid Treatment Program Services have a $20 or $25 copay. Occupational Therapy Services, and both Individual and Group Sessions for Mental Health and Psychiatric Services have a $25 copay, and Podiatry Services may have a copay between $0 and $25. Other Health Care Professional services may have a copay between $0 and $20. Routine Chiropractic Care is not covered.
Preventive Services See details
The Wellpoint Select (HMO-POS) plan covers preventive services, including an annual physical exam with no copay. Additional preventive services are covered, and may include a copay.
Hearing Services See details
The Wellpoint Select (HMO-POS) plan covers hearing exams with a $25 copay, routine hearing exams with no copay, and fitting/evaluation for hearing aids with no copay. Prescription hearing aids are covered up to a maximum of $3000 annually, and OTC hearing aids are covered with no copay up to a maximum of $300 per year.
Vision Services See details
Wellpoint Select (HMO-POS) covers vision services, including eye exams with a copay between $0 and $25, and eyewear with a 20% coinsurance. Routine eye exams, contact lenses, eyeglasses (lenses and frames), eyeglass lenses, and eyeglass frames have no copay.
Dental Services See details
Dental Services are covered, with a $25 copay for Medicare Dental Services, and a $2,500 annual maximum for Other Dental Services. Oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatment, other preventive dental services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable & fixed), maxillofacial prosthetics, implant services, oral and maxillofacial surgery, and orthodontics are covered with no copay.
Home Infusion bundled Services See details
Home Infusion bundled Services, including Medicare Part B Insulin Drugs, are covered by the Wellpoint Select (HMO-POS) plan. Medicare Part B Insulin Drugs have a $35 copay, and Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the Wellpoint Select (HMO-POS) plan. You will pay a coinsurance of 20% for this service.
Medical Equipment See details
Medical Equipment, including Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment, is covered. Durable Medical Equipment has a coinsurance of 0% to 20%, while Prosthetics and Medical Supplies have a 20% coinsurance; Diabetic Supplies and Diabetic Therapeutic Shoes/Inserts have no copay.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, with a doctor referral and prior authorization required. Diagnostic Procedures/Tests have a copay between $0 and $70, while Lab Services have no copay; Diagnostic Radiological Services have a copay between $10 and $70, Therapeutic Radiological Services have a 20% coinsurance, and Outpatient X-Ray Services have a $10 copay.
Home Health Services See details
Home Health Services are covered by the Wellpoint Select (HMO-POS) plan with no copay and no coinsurance. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered under the Wellpoint Select (HMO-POS) plan, but none of the sub-services are covered. The plan requires prior authorization for these services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered under the Wellpoint Select (HMO-POS) plan, but require prior authorization. For days 1-20, there is no copay, and for days 21-100, the copay is $140. Additional days beyond Medicare-covered for SNF, and non-Medicare-covered stays for SNF are not covered.
Other Services See details
Under the Wellpoint Select (HMO-POS) plan, Over-the-Counter (OTC) Items are covered with no copay, and a maximum plan benefit coverage amount of $215 every three months. Acupuncture, Meal Benefit, Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, and Self-Directed Personal Assistance Services are not covered.
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