Wellcare Dual Access (HMO-POS D-SNP)

Benefits Summary and Overview

This page is a benefits summary and overview of key plan information for Wellcare Dual Access (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 (HMO-POS D-SNP) in 2026, please refer to our full plan details page.

This summary reflects 2026 plan information. Where this plan continues in 2027, the full plan details page links to its 2027 benefits and costs.

Wellcare Dual Access (HMO-POS D-SNP) is a HMO-POS D-SNP plan offered by Arkansas Health & Wellness Health Plan, Inc. available for the 2026 plan year to people living in Statewide in AR. This plan received an overall rating of 3.5 out of 5 stars in 2026.

It's important to know that Wellcare Dual Access (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 (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.

Overview IconKey Plan Facts

Below are a few key facts and commonly-asked questions about Wellcare Dual Access (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 (HMO-POS D-SNP), the main costs are as follows:

Monthly Premium

The Monthly Premium for this plan is $8.90. 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

Health deductible: information not available.

This plan has a $615.00 drug deductible that applies only to drugs in certain tiers. You pay this amount toward covered prescriptions in those tiers before the plan's cost sharing begins; drugs in the other tiers are not subject to the deductible. See the full plan details page for the tier table.

Out-of-Pocket Maximums

This plan has a Maximum Out-Of-Pocket cost of $9250.00 for in-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your out-of-pocket costs reach $9250.00 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:

Regular visits to your primary care doctor are covered and will have a coinsurance of 20%.

Specialist Visits:

Visits to specialists are covered and will have a coinsurance of 20%. Specialist visits may require a referral from your primary care doctor or prior authorization.

Emergency Room:

Trips to the Emergency Room are covered, and will have a coinsurance of 0% (no coinsurance). Coverage may vary for in-network and out-of-network hospitals.

Urgent Care:

Trips to Urgent Care are covered and will have a coinsurance of 0% (no coinsurance). Coverage may vary for in-network and out-of-network hospitals.

Sign up for Wellcare Dual Access (HMO-POS D-SNP)

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Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. Call-center hours (ET): Mon-Fri 8am-10pm; Sat 9am-8pm; Sun closed.

Drug Coverage IconDrug Coverage

The Wellcare Dual Access (HMO-POS D-SNP) prescription drug plan features a $615.00 annual deductible before entering the initial coverage phase. During this phase, Tier 1 preferred generics cost a $19.00 copay at preferred pharmacies ($20.00 at standard), while Tier 3 preferred brands carry a $100.00 copay. Tier 2 standard generics require a 20% coinsurance, Tier 4 non-preferred drugs require a 25% coinsurance, and Tier 5 specialty drugs have no copay. For individuals who qualify for the low-income subsidy (LIS), the Part D premium may be reduced to $8.90. Once your yearly out-of-pocket costs reach $2,100.00, you enter the catastrophic coverage phase and pay nothing for covered Part D drugs. This Medicare plan provides clear drug tiers and cost-sharing options to help you manage your healthcare expenses.

Additional Benefits IconAdditional Benefits

The Wellcare Dual Access (HMO-POS D-SNP) plan offers comprehensive medical coverage with predictable out-of-pocket costs, including an inpatient hospital stay copay of $1,875 and no coinsurance. For outpatient services, primary care, and specialist visits, members generally pay a 20% coinsurance and no copay. Emergency room visits require a $115 copay, which is waived if you are admitted, while home health services are available with no copay and no coinsurance. This plan also features valuable supplemental benefits, such as preventive and comprehensive dental care with no copay and no coinsurance up to a $3,000 annual limit. Members can also access routine eye and hearing exams with no copay and 20% coinsurance, alongside up to 24 one-way transportation trips per year at no cost. Additionally, over-the-counter items are provided with no copay and no coinsurance, though cardiac rehabilitation and acupuncture are not covered.

Inpatient Hospital See details

Inpatient hospital benefits are partially covered under Wellcare Dual Access (HMO-POS D-SNP), requiring a $1,875 copay per stay and no coinsurance for acute and psychiatric admissions. Prior authorization is required, and additional days, non-Medicare-covered stays, and acute care upgrades are not covered.

Outpatient Services See details

Wellcare Dual Access (HMO-POS D-SNP) covers outpatient services, including outpatient hospital, observation, ambulatory surgical center, substance abuse, and blood services, with a 20% coinsurance and no copay. Prior authorization is required for several of these services, and there is no deductible for blood services.

Partial Hospitalization See details

Partial hospitalization benefits are covered by Wellcare Dual Access (HMO-POS D-SNP) with a 20% coinsurance and no copay. Prior authorization is required for these services.

Ambulance and Transportation Services See details

Ambulance and transportation services are partially covered by Wellcare Dual Access (HMO-POS D-SNP), as transportation to any health-related location is not covered. Covered ground and air ambulance services require a 20% coinsurance and no copay, while up to 24 one-way trips per year to plan-approved locations are provided with no copay and no coinsurance.

Emergency Services See details

Wellcare Dual Access (HMO-POS D-SNP) covers emergency services with a $115 copay and no coinsurance, and urgent care 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 $50,000 with a $115 copay, though worldwide emergency transportation is not covered.

Primary Care See details

Wellcare Dual Access (HMO-POS D-SNP) covers primary care, specialist, and mental health services with a 20% coinsurance and no copay, while telehealth services require a 20% coinsurance and a copay ranging from no copay to $40. Podiatry services are covered with no copay and no coinsurance, but chiropractic services are only partially covered since routine chiropractic care is not covered.

Preventive Services See details

Preventive services are covered by Wellcare Dual Access (HMO-POS D-SNP), featuring annual physicals and select supplemental benefits like fitness and PERS with no copay and no coinsurance. Kidney disease education and other services like glaucoma screenings are covered with a 20% coinsurance and no copay. Additional preventive services are partially covered; excluded sub-services include health education, weight management, therapeutic massage, counseling, in-home safety assessments, medical nutrition therapy, medication reconciliation, readmission prevention, wigs, adult day health, nutritional/dietary benefits, palliative care, caregiver support, smoking cessation, disease management, telemonitoring, and home safety modifications.

Hearing Services See details

Hearing services are partially covered by Wellcare Dual Access (HMO-POS D-SNP), offering annual routine exams with no copay and a 20% coinsurance, and fitting evaluations with no copay. Prescription hearing aids are covered with no copay up to $750 per ear annually, though OTC hearing aids and prescription aids for the inner ear, outer ear, and over the ear are not covered. Prior authorization is required for exams and prescription hearing aids.

Vision Services See details

Wellcare Dual Access (HMO-POS D-SNP) covers one routine eye exam per year with no copay and a 20% coinsurance. Eyewear is also covered with no copay up to a $200 annual limit, though contact lenses are subject to a 20% coinsurance.

Dental Services See details

Wellcare Dual Access (HMO-POS D-SNP) dental services are partially covered, as maxillofacial prosthetics, implant services, and orthodontics are not covered. Medicare-covered dental services require a 20% coinsurance and no copay, while other covered preventive and comprehensive services have no copay and no coinsurance up to a $3,000 annual maximum.

Home Infusion bundled Services See details

Home infusion bundled services are covered by Wellcare Dual Access (HMO-POS D-SNP), though prior authorization and step therapy are required. Medicare Part B insulin drugs carry a $35 copay and no coinsurance, while chemotherapy and other Part B drugs have no copay and coinsurance ranging from no coinsurance up to 20%.

Dialysis Services See details

Wellcare Dual Access (HMO-POS D-SNP) covers dialysis services with no copay and a 20% coinsurance. This benefit ensures you have affordable access to vital kidney dialysis treatments with clear, predictable out-of-pocket costs.

Medical Equipment See details

Medical equipment is covered by Wellcare Dual Access (HMO-POS D-SNP) with a 20% coinsurance and no copay for durable medical equipment, prosthetics, and diabetic supplies. Prior authorization is required for these covered services, and diabetic supplies are limited to specified manufacturers.

Diagnostic and Radiological Services See details

Wellcare Dual Access (HMO-POS D-SNP) covers diagnostic and radiological services, including lab work, diagnostic tests, x-rays, and therapeutic radiological services. These covered services require prior authorization and feature no copay, but they are subject to a 20% coinsurance.

Home Health Services See details

Wellcare Dual Access (HMO-POS D-SNP) covers Home Health Services with no copay and no coinsurance. Prior authorization is required to receive these covered services.

Cardiac Rehabilitation Services See details

Cardiac Rehabilitation Services are not covered under the Wellcare Dual Access (HMO-POS D-SNP) plan. This lack of coverage applies to all related sub-services, including intensive cardiac, pulmonary, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD).

Skilled Nursing Facility (SNF) See details

Skilled Nursing Facility (SNF) services are partially covered by Wellcare Dual Access (HMO-POS D-SNP) with no coinsurance, requiring no copay for days 1 to 20 and days 71 to 100, and a $218 daily copay for days 21 to 70. Prior authorization is required, and additional days beyond the Medicare-covered limit are not covered.

Other Services See details

Wellcare Dual Access (HMO-POS D-SNP) partially covers Other Services, offering over-the-counter (OTC) items with no copay and no coinsurance. Acupuncture, meal benefits, and dual-eligible SNPs with highly integrated services are not covered under this plan.

Plan Providers IconPlan Providers

Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross and Blue Shield, Aspire Health Plan, Dean Health Plan, Devoted Health, Florida Blue Medicare, Freedom Health, Health Care Service Corporation, HealthSpringSM, HealthSun, Healthy Blue, Humana, Molina Healthcare, Mutual of Omaha, Medica Central Health Plan, Optimum HealthCare, Premera Blue Cross, SCAN Health Plan, Simply, UnitedHealthcare(R), Wellcare, WellPoint.

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Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.

* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.

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