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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 2026, 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 2026.
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 $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 $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) prescription drug plan features an annual drug deductible of $615.00. During the initial coverage phase, you will pay a $19.00 copay for preferred generics at preferred pharmacies, a $100.00 copay for preferred brands, and coinsurance of 21% for standard generics and 25% for non-preferred drugs. Notably, there is no copay for specialty tier drugs under this plan during this phase. For beneficiaries qualifying for the low-income subsidy (LIS), the Part D premium is reduced to $8.90. Once your yearly out-of-pocket drug costs reach $2,100.00, you enter the catastrophic coverage phase and will pay nothing for your covered Part D prescription drugs. This plan provides structured cost-sharing to help manage your ongoing medication expenses.
Additional Benefits
The Wellcare Dual Reserve (HMO-POS D-SNP) plan offers comprehensive medical coverage with no copay and no coinsurance for primary care visits, home health services, and preventive care. For emergency situations, members pay a $150 copay for emergency room visits and a $275 copay for ambulance services, both with no coinsurance. Inpatient hospital stays require a $350 daily copay for the first few days, after which there is no copay for the remainder of a 90-day stay. This plan also features robust supplemental benefits, including routine dental, vision, and hearing exams with no copay or coinsurance. Members receive up to $200 annually for eyewear and $500 per ear for prescription hearing aids with no copay, while comprehensive dental services require a 20% coinsurance and no copay up to a $2,000 yearly limit. Additionally, diagnostic lab tests, diabetic supplies, and over-the-counter items are fully covered with no copay or coinsurance.
Inpatient Hospital See details
Inpatient hospital benefits are partially covered by Wellcare Dual Reserve (HMO-POS D-SNP), with acute care requiring a $350 copay per day for days 1 to 6 and psychiatric care requiring a $350 copay per day for days 1 to 5, both with no copay for subsequent days up to day 90 and no coinsurance. Prior authorization is required, and specific sub-services such as additional days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Outpatient services are covered by Wellcare Dual Reserve (HMO-POS D-SNP) with no coinsurance, featuring a copay ranging from no copay to $275 for outpatient hospital services and $150 to $275 per stay for observation services. Patients will also pay a $225 copay for ambulatory surgical center services, a $40 copay for outpatient substance abuse sessions, and no copay or deductible for outpatient blood services.
Partial Hospitalization See details
Wellcare Dual Reserve (HMO-POS D-SNP) covers partial hospitalization services with a $175.00 copay and no coinsurance. Prior authorization is required to access this benefit.
Ambulance and Transportation Services See details
Wellcare Dual Reserve (HMO-POS D-SNP) covers ground and air ambulance services with a $275 copay and no coinsurance. Transportation benefits are partially covered with no copay or coinsurance for up to 12 one-way trips per year to plan-approved health-related locations, while transportation to any health-related location is not covered.
Emergency Services See details
Wellcare Dual Reserve (HMO-POS D-SNP) partially covers emergency services with no coinsurance, requiring a $150 copay for emergency care and a $40 copay for urgent care. Worldwide emergency and urgent services are covered up to a $50,000 limit with a $150 copay and no coinsurance, though worldwide emergency transportation is not covered.
Primary Care See details
Wellcare Dual Reserve (HMO-POS D-SNP) covers primary care physician services with no copay and no coinsurance, while other specialist, therapy, and mental health services require copays between $0 and $40 with no coinsurance. This benefit is partially covered, as podiatry services and routine chiropractic care are not covered by the plan.
Preventive Services See details
Preventive services are partially covered by Wellcare Dual Reserve (HMO-POS D-SNP), with most covered benefits like annual physicals and fitness programs requiring no copay and no coinsurance. Kidney disease education requires a 20% coinsurance and no copay, while various sub-services, including health education, therapeutic massage, and counseling, are not covered.
Hearing Services See details
Wellcare Dual Reserve (HMO-POS D-SNP) offers partially covered hearing services, featuring routine exams and fittings with no copay or coinsurance, and Medicare-covered exams for a $15 copay and no coinsurance. The plan provides up to $500 per ear annually for prescription hearing aids with no copay or coinsurance, though OTC hearing aids and inner ear, outer ear, and over the ear prescription hearing aids are not covered.
Vision Services See details
Vision services are covered by Wellcare Dual Reserve (HMO-POS D-SNP) with no coinsurance, featuring a $0 to $15 copay for eye exams, which includes one routine annual exam with no copay. Eyewear is also covered with no copay and no coinsurance, up to a $200 annual combined maximum.
Dental Services See details
Dental services are partially covered by Wellcare Dual Reserve (HMO-POS D-SNP), as maxillofacial prosthetics, implant services, and orthodontics are not covered. Medicare dental services require a $15 copay and no coinsurance, preventive services have no copay and no coinsurance, and covered comprehensive services require a 20% coinsurance and no copay up to a $2,000 annual maximum.
Home Infusion bundled Services See details
Wellcare Dual Reserve (HMO-POS D-SNP) covers home infusion bundled services, which require prior authorization. Under this plan, Medicare Part B insulin drugs have a $35 copay and no coinsurance, while chemotherapy, radiation, and other Part B drugs require no copay and a 0% to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered by the Wellcare Dual Reserve (HMO-POS D-SNP) plan with no copay and a 20% coinsurance.
Medical Equipment See details
Wellcare Dual Reserve (HMO-POS D-SNP) covers durable medical equipment, prosthetics, and diabetic therapeutic shoes with a 20% coinsurance and no copay. Diabetic supplies are covered with no copay and no coinsurance, and prior authorization is required for these medical equipment services.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Wellcare Dual Reserve (HMO-POS D-SNP), with prior authorization required. Members pay no copay or coinsurance for lab services and diagnostic tests, a $50 copay and no coinsurance for outpatient x-rays, up to a $275 copay and no coinsurance for diagnostic radiology, and a 20% coinsurance with no copay for therapeutic radiology.
Home Health Services See details
Wellcare Dual Reserve (HMO-POS D-SNP) covers home health services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are technically covered under Wellcare Dual Reserve (HMO-POS D-SNP), and while some services are covered, in practice Cardiac Rehabilitation, Intensive Cardiac Rehabilitation, Pulmonary Rehabilitation, and SET for PAD Services are not covered.
Skilled Nursing Facility (SNF) See details
Wellcare Dual Reserve (HMO-POS D-SNP) partially covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring no copay for days 1-20 and 41-100, and a $218 copay per day for days 21-40. Prior authorization is required, and additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Other Services are partially covered under the Wellcare Dual Reserve (HMO-POS D-SNP) plan, providing Over-the-Counter (OTC) items with no copay and no coinsurance. However, acupuncture, meal benefits, and Dual Eligible SNPs with Highly Integrated Services are not covered under this benefit.
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