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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 2025, please refer to our full plan details page.
Wellcare Dual Access (HMO-POS D-SNP) is a HMO-POS D-SNP plan offered by Centene Corporation available for enrollment in 2025 to people living in Statewide in AR. This plan received an overall rating of 3.5 out of 5 stars in 2025.
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.
Key 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 $20.90. 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
This plan does not have a health deductible. Your insurance coverage on covered health services will start immediately.
This plan has a $590.00 drug deductible. You will need to pay this amount towards covered prescriptions before your insurance coverage for prescription medications kicks in.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $9350.00 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 Wellcare Dual Access (HMO-POS D-SNP) plan has a $590 deductible for prescription drugs. After the deductible, you will pay the costs for your drugs based on the tier and pharmacy type until your total drug costs reach $2000. If you qualify for the low-income subsidy, your monthly Part D premium will be $20.90. Once your yearly out-of-pocket drug costs reach $2000, you will pay nothing for your covered Part D drugs.
Additional Benefits
The Wellcare Dual Access (HMO-POS D-SNP) plan offers a range of benefits. Inpatient hospital stays have copays, while outpatient services generally have a 20% coinsurance. The plan also covers ambulance services with 20% coinsurance and transportation services with no copay for up to 24 one-way trips per year. Other benefits include coverage for primary care, preventive, hearing, vision, dental, and home health services, with varying copays and coinsurance.
Inpatient Hospital See details
Inpatient Hospital benefits are covered under the Wellcare Dual Access (HMO-POS D-SNP) plan. For Inpatient Hospital-Acute, you will pay a copay of $1445 per admission or stay, and for Inpatient Hospital Psychiatric, you will pay a copay of $1590 per admission or stay. Additional Days, Non-Medicare-covered Stays, and Upgrades for Inpatient Hospital-Acute, and Additional Days 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 20% coinsurance and no copay, Observation Services with a 20% coinsurance, Ambulatory Surgical Center (ASC) Services with a 20% coinsurance, Outpatient Substance Abuse Services with a 20% coinsurance, and Outpatient Blood Services with a 20% coinsurance. The plan also waives the deductible for three pints of blood.
Partial Hospitalization See details
Partial Hospitalization is covered, but requires prior authorization. You will pay 20% coinsurance for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services, including those not usually covered by Medicare, are covered by the Wellcare Dual Access (HMO-POS D-SNP) plan. Ground and air ambulance services have a 20% coinsurance, while transportation services to a plan-approved health-related location have no copay and are limited to 24 one-way trips per year using rideshare services, bus/subway, or medical transport. Transportation services to any other health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Coverage are covered under the Wellcare Dual Access (HMO-POS D-SNP) plan. Emergency Services and Worldwide Emergency Coverage have a $110 copay, while Urgently Needed Services have a $45 copay; there is no coinsurance for any of these services.
Primary Care See details
The Wellcare Dual Access (HMO-POS D-SNP) plan covers primary care physician services, chiropractic services, occupational therapy, physician specialist services, mental health specialty services, podiatry services, other health care professional services, psychiatric services, physical therapy, speech-language pathology services, additional telehealth benefits, and opioid treatment program services. Primary care physician services, chiropractic services, physician specialist services, physical therapy and speech-language pathology services, and additional telehealth benefits have a 20% coinsurance; chiropractic services do not cover routine care, and podiatry services cover routine foot care with a 20% coinsurance and no copay.
Preventive Services See details
Preventive services include an annual physical exam with no copay, and additional preventive services, including Fitness Benefit, Personal Emergency Response System (PERS), Alternative Therapies, In-Home Support Services, Remote Access Technologies, and Home and Bathroom Safety Devices and Modifications. Kidney Disease Education Services, Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit have a 20% coinsurance. Some services, such as Health Education, are not covered.
Hearing Services See details
Hearing Services include hearing exams, with a coinsurance of at most 20% for routine hearing exams, and fitting/evaluation for hearing aids with no copay. Prescription hearing aids are covered, with a maximum benefit of $750 per year, and no copay.
Vision Services See details
The Wellcare Dual Access (HMO-POS D-SNP) plan covers vision services, including eye exams with a 20% coinsurance and no copay, and eyewear with a 20% coinsurance. Eyewear has a combined maximum benefit of $200 per year, while routine eye exams have no copay, contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades have no copay.
Dental Services See details
Wellcare Dual Access (HMO-POS D-SNP) covers Medicare Dental Services with 20% coinsurance. Other dental services include oral exams, dental x-rays, and other diagnostic dental services with no copay, but are limited to a certain number of visits, as well as prophylaxis (cleaning), fluoride treatment, other preventive dental services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), and oral and maxillofacial surgery, all with no copay and a limit on the number of visits. Orthodontics is not covered, but the plan does cover orthodontics services with a maximum plan benefit of $4000.00 per year.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs with a $35 copay, and other Medicare Part B drugs with 0-20% coinsurance. Medicare Part B Chemotherapy/Radiation Drugs are covered with 0-20% coinsurance.
Dialysis Services See details
Dialysis Services are covered by the Wellcare Dual Access (HMO-POS D-SNP) plan. The plan has a coinsurance of 20% for dialysis services.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with a 20% coinsurance, Prosthetics/Medical Supplies with a 20% coinsurance, and Diabetic Equipment. Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered by the Wellcare Dual Access (HMO-POS D-SNP) plan. Diagnostic Procedures/Tests and Radiological Services have a coinsurance of at most 20%, while Lab Services have a 20% coinsurance and no copay.
Home Health Services See details
Home Health Services are covered by the Wellcare Dual Access (HMO-POS D-SNP) 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 not covered by the Wellcare Dual Access (HMO-POS D-SNP) plan. The plan does not cover Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, or Additional Cardiac Rehabilitation Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Wellcare Dual Access (HMO-POS D-SNP) plan. There is no copay for days 1-20, but the copay is $214 per day for days 21-100; additional days beyond Medicare-covered for SNF and non-Medicare-covered stays for SNF are not covered.
Other Services See details
The Wellcare Dual Access (HMO-POS D-SNP) plan covers Over-the-Counter (OTC) Items with no copay, but does not cover 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.
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