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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 2026, 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 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.
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 $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
This plan does not have a health deductible. Your insurance coverage on covered health services will start immediately.
This plan has a $615.00 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 $9250.00 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) 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
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.
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