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Wellcare Dual Access Sync (HMO-POS D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Wellcare Dual Access Sync (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 Sync (HMO-POS D-SNP) in 2026, please refer to our full plan details page.
Wellcare Dual Access Sync (HMO-POS D-SNP) is a HMO-POS D-SNP plan offered by Centene Corporation available for enrollment in 2025 to people living in All counties in KY. This plan received an overall rating of 3.5 out of 5 stars in 2026.
It's important to know that Wellcare Dual Access Sync (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 Sync (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 Sync (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 Sync (HMO-POS D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $38.40. 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 $510.00 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 Sync (HMO-POS D-SNP) prescription drug plan features an annual drug deductible of $510. For Tier 1 preferred generics, copays start as low as $18 for a one-month supply at preferred pharmacies, while Tier 2 generics start at $19. Notably, there is no copay for Tier 6 select care drugs, and three-month supplies of Tier 1 and Tier 2 drugs also have no copay when filled through preferred mail order. For higher-tier medications, Tier 3 preferred brands require a 20% coinsurance, and Tier 5 specialty drugs carry a 25% coinsurance for a one-month supply. Tier 4 non-preferred drugs have a flat $100 copay for a one-month supply at both preferred and standard pharmacies. These detailed copay and coinsurance structures help you estimate your out-of-pocket costs when choosing this Medicare plan.
Additional Benefits
The Wellcare Dual Access Sync (HMO-POS D-SNP) plan offers comprehensive medical coverage, featuring an inpatient hospital copayment of $2,065 per admission and no copay with a 20% coinsurance for most outpatient, specialist, and diagnostic services. Emergency room visits require a $115 copay, while urgent care has a $40 copay, both of which are waived if you are admitted to the hospital within 24 hours. Additionally, primary care, routine annual physicals, and home health services are available to members with no copay. This plan also provides valuable supplemental benefits, including routine dental care, eyeglasses and frames up to a $300 annual limit, and prescription hearing aids up to $1,000 per ear with no copay. Members can access over-the-counter items and up to 36 one-way transportation trips per year to approved locations with no copay or coinsurance. Skilled nursing facility stays are covered with no coinsurance, requiring no copay for days 1 through 20 and a $218 daily copay for days 21 through 70.
Inpatient Hospital See details
Wellcare Dual Access Sync (HMO-POS D-SNP) partially covers inpatient acute and psychiatric hospital stays with a $2,065.00 copayment per admission and no coinsurance. Prior authorization is required, and additional days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Wellcare Dual Access Sync (HMO-POS D-SNP) covers outpatient services with no copay, although a 20% coinsurance applies to outpatient hospital, ambulatory surgical center, outpatient substance abuse, and outpatient blood services. Prior authorization is required for several of these services, and there is no deductible for outpatient blood services.
Partial Hospitalization See details
Partial hospitalization is covered by Wellcare Dual Access Sync (HMO-POS D-SNP) with no copay and a 20% coinsurance. Prior authorization is required for these services.
Ambulance and Transportation Services See details
Wellcare Dual Access Sync (HMO-POS D-SNP) covers ground and air ambulance services with a 20% coinsurance and no copay. Transportation services are partially covered with no copay and no coinsurance for up to 36 one-way trips per year to plan-approved locations, but transportation to any health-related location is not covered.
Emergency Services See details
Emergency services are covered by Wellcare Dual Access Sync (HMO-POS D-SNP) with a $115 copay and no coinsurance, while urgent care requires a $40 copay and no coinsurance, with both copays waived if you are admitted to the hospital within 24 hours. Worldwide emergency and urgent care are partially covered up to a $50,000 maximum limit with a $115 copay and no coinsurance, although worldwide emergency transportation is not covered.
Primary Care See details
Wellcare Dual Access Sync (HMO-POS D-SNP) covers primary, specialist, therapy, and mental health services with no copay and 20% coinsurance, while podiatry services require no copay and no coinsurance. Chiropractic services are partially covered, offering up to 12 routine visits per year with no copay or coinsurance, though other chiropractic services are not covered. Additional telehealth benefits are also available with a $0 to $40 copay and 20% coinsurance.
Preventive Services See details
Preventive services are covered by Wellcare Dual Access Sync (HMO-POS D-SNP) with no copay and no coinsurance for annual physicals, fitness, and PERS, while kidney disease education and other screenings require no copay and a 20% coinsurance. This benefit is partially covered, as health education, in-home safety assessments, medical nutrition therapy, medication reconciliation, re-admission prevention, wigs, weight management, therapeutic massage, adult day health, nutritional/dietary benefits, palliative care, in-home support, caregiver support, smoking cessation, disease management, telemonitoring, home modifications, and counseling are not covered.
Hearing Services See details
Wellcare Dual Access Sync (HMO-POS D-SNP) hearing services are partially covered, excluding OTC hearing aids as well as inner ear, outer ear, and over the ear prescription hearing aids. Covered services require no deductible and include annual routine exams for a 20% coinsurance and no copay, fitting evaluations for no copay or coinsurance, and eligible prescription hearing aids up to $1,000 per ear annually with no copay or coinsurance.
Vision Services See details
Wellcare Dual Access Sync (HMO-POS D-SNP) covers one routine eye exam per year and contact lenses with no copay and 20% coinsurance, though other eye exam services are not covered. Eyeglasses, lenses, frames, and upgrades are covered with no copay and no coinsurance up to a $300 combined annual limit, with prior authorization required and no deductibles.
Dental Services See details
Wellcare Dual Access Sync (HMO-POS D-SNP) offers partially covered dental services with no copay and 20% coinsurance for Medicare-covered dental, and no copay or coinsurance for most preventive and comprehensive services. Prior authorization is required for most treatments, and maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Wellcare Dual Access Sync (HMO-POS D-SNP) covers home infusion bundled services with no copay, although prior authorization is required. Under this benefit, Medicare Part B insulin has a $35 copay and no coinsurance, while chemotherapy and other Part B drugs require a 0% to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered by Wellcare Dual Access Sync (HMO-POS D-SNP) with no copay and a 20% coinsurance.
Medical Equipment See details
Wellcare Dual Access Sync (HMO-POS D-SNP) covers medical equipment, including durable medical equipment, prosthetics, medical supplies, and diabetic equipment, with no copay and a 20% coinsurance. Prior authorization is required for these benefits, and diabetic supplies are limited to specified manufacturers.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Wellcare Dual Access Sync (HMO-POS D-SNP) with no copay and a 20% coinsurance, subject to prior authorization. This coverage applies to Medicare-covered diagnostic procedures, lab services, outpatient X-rays, and both diagnostic and therapeutic radiological services.
Home Health Services See details
Wellcare Dual Access Sync (HMO-POS D-SNP) covers home health services with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Wellcare Dual Access Sync (HMO-POS D-SNP) covers some cardiac rehabilitation services with no copay, but in practice, cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and SET for PAD services are not covered and require a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is covered by Wellcare Dual Access Sync (HMO-POS D-SNP) with no coinsurance, requiring prior authorization and no prior three-day inpatient hospital stay. There is no copay for days 1 through 20 and days 71 through 100, but a $218 daily copay applies for days 21 through 70, with no coverage provided for additional days beyond the standard 100 days.
Other Services See details
Wellcare Dual Access Sync (HMO-POS D-SNP) partially covers other services, providing over-the-counter (OTC) items with no copay and no coinsurance. Acupuncture and meal benefits are not covered under this plan.
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