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Wellcare Dual Reserve (HMO-POS D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Wellcare Dual Reserve (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 Reserve (HMO-POS D-SNP) in 2025, please refer to our full plan details page.
Wellcare Dual Reserve (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 Reserve (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 Reserve (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 Reserve (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 Reserve (HMO-POS D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $17.90. 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 $3850.00 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 Reserve (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. Once your total drug costs reach $2000, you enter the catastrophic coverage phase, where you will pay nothing for your Part D covered drugs. If you qualify for the low-income subsidy, your monthly premium will be $17.90.
Additional Benefits
The Wellcare Dual Reserve (HMO-POS D-SNP) plan offers a range of benefits with varying costs. Hospital stays have a copay, and outpatient services have copays depending on the service. Emergency and urgent care services have copays, while primary care and many preventive services have no copay. The plan covers vision, hearing, and dental services, with some services having no copay. It also includes coverage for home health and skilled nursing facility services, with specific copay structures. Medical equipment and some diagnostic services have coinsurance, and the plan also includes transportation benefits and other services like over-the-counter items with no copay.
Inpatient Hospital See details
Inpatient Hospital services are covered, including acute and psychiatric care. For days 1-5, there is a $350 copay, and for days 6-90, there is no copay.
Outpatient Services See details
Outpatient Services, including all outpatient hospital services and outpatient blood services, are covered. Outpatient hospital services have a copay between $0 and $275, while observation services have a copay between $140 and $275. Ambulatory surgical center services have a $225 copay, and outpatient substance abuse services have a $40 copay for both individual and group sessions.
Partial Hospitalization See details
Partial Hospitalization is covered under the Wellcare Dual Reserve (HMO-POS D-SNP) plan, but requires prior authorization. You will have a $130 copay for this service.
Ambulance and Transportation Services See details
The Wellcare Dual Reserve (HMO-POS D-SNP) plan covers ambulance services with a $275 copay for both ground and air ambulance services, and transportation services to a plan-approved health-related location with no copay, up to 36 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 Coverage are covered under the Wellcare Dual Reserve (HMO-POS D-SNP) plan. Emergency Services and Worldwide Emergency Coverage have a $140 copay, and Urgently Needed Services have a $40 copay; all have no coinsurance. Worldwide Emergency Transportation is not covered.
Primary Care See details
Primary Care Physician Services are covered with no copay. Chiropractic Services, Physician Specialist Services, and Physical Therapy and Speech-Language Pathology Services each have a $15 copay. Mental Health Specialty Services and Psychiatric Services have a $40 copay for individual and group sessions. Other Health Care Professional services have a copay between $0 and $15. Additional Telehealth Benefits have a copay between $0 and $40. Opioid Treatment Program Services have a $15 copay. Occupational Therapy Services have a $15 copay. Routine Chiropractic Care and Podiatry Services are not covered.
Preventive Services See details
Preventive services include an annual physical exam with no copay, while additional preventive services, including fitness benefits, are covered with no copay. Kidney disease education services have a 20% coinsurance.
Hearing Services See details
Hearing exams are covered with a $15 copay, and routine hearing exams and fitting/evaluation for hearing aids have no copay. Prescription Hearing Aids are covered, but specific types such as Inner Ear, Outer Ear, and Over the Ear are not covered. OTC Hearing Aids are not covered.
Vision Services See details
Vision services include eye exams and eyewear. Eye exams have a copay of $0-$15, and routine eye exams are covered with no copay. Eyewear, including contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades, are covered with no copay, and have a combined maximum benefit of $200 per year.
Dental Services See details
The Wellcare Dual Reserve (HMO-POS D-SNP) plan covers Medicare and other dental services. Oral exams, dental x-rays, other diagnostic dental services, cleanings, and fluoride treatments have no copay, but the plan has a $15 copay for Medicare dental services and a 20% coinsurance for restorative, adjunctive general, endodontic, periodontic, prosthodontic (removable and fixed), and oral/maxillofacial surgery services. Orthodontic services are covered up to a maximum of $2,000 per year, but maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by the Wellcare Dual Reserve (HMO-POS D-SNP) plan, with prior authorization required. Medicare Part B Insulin Drugs have a $35 copay, while 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 by the Wellcare Dual Reserve (HMO-POS D-SNP) plan. The plan has a coinsurance of 20% for dialysis services.
Medical Equipment See details
Medical Equipment is covered by the Wellcare Dual Reserve (HMO-POS D-SNP) plan. Durable Medical Equipment (DME) has a 20% coinsurance and requires authorization, while Prosthetic Devices and Medical Supplies have a 20% coinsurance, and Diabetic Supplies have no copay.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered. Diagnostic Procedures/Tests and Lab Services have no copay, while Diagnostic Radiological Services have a copay up to $275 and Outpatient X-Ray Services have a $75 copay; Therapeutic Radiological Services have 20% coinsurance and Medicare-covered X-Ray Services have coinsurance.
Home Health Services See details
Home Health Services are covered by the Wellcare Dual Reserve (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 Reserve (HMO-POS D-SNP) plan. Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services are also not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Wellcare Dual Reserve (HMO-POS D-SNP) plan, but require prior authorization. For days 1-20, there is no copay, for days 21-40, the copay is $214, and for days 41-100, there is no copay.
Other Services See details
The Wellcare Dual Reserve (HMO-POS D-SNP) plan offers Other Services, including Over-the-Counter (OTC) Items with no copay, and a Meal Benefit with no copay that requires a doctor's referral. Acupuncture, 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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