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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 Select Counties in OK. This plan received an overall rating of 2.5 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 $42.80. 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 $520.00 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 $3700.00 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 $520 deductible for prescription drugs. After the deductible, you'll pay a copay or coinsurance depending on the drug tier and pharmacy. For preferred generic drugs, you'll pay a $19 copay at preferred pharmacies and $20 at standard pharmacies. Specialty tier drugs have no copay.
Additional Benefits
The Wellcare Dual Reserve (HMO-POS D-SNP) plan offers a wide array of benefits with varying cost-sharing. Inpatient hospital stays have copays, while outpatient services have a range of copays depending on the service. Primary care, preventive services, and many dental services are covered with no copay. The plan includes coverage for hearing, vision, and dental services, with specific copays or no copays for exams and services. Ambulance services have a copay, and transportation to health-related locations is covered up to a limit. The plan also covers home health services and skilled nursing facility stays with specific cost-sharing arrangements.
Inpatient Hospital See details
Inpatient Hospital benefits, including acute and psychiatric, are covered by the Wellcare Dual Reserve (HMO-POS D-SNP) plan. For Inpatient Hospital-Acute, you pay a $300 copay for days 1-7, and no copay for days 8-90, with no coinsurance; for Inpatient Hospital Psychiatric, you pay a $250 copay for days 1-7, and no copay for days 8-90, with no coinsurance.
Outpatient Services See details
Outpatient services, including outpatient hospital services, observation services, outpatient substance abuse services, and outpatient blood services, are covered. Outpatient hospital services have a copay between $0 and $500, observation services have a copay between $140 and $500, ambulatory surgical center services have a $200 copay, and outpatient blood services have no copay. Individual and group sessions for outpatient substance abuse have a copay of $25.
Partial Hospitalization See details
Partial Hospitalization is covered under the Wellcare Dual Reserve (HMO-POS D-SNP) plan, with a $130 copay. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Ambulance services are covered with a $250 copay for both ground and air ambulance services, with no coinsurance. Transportation services to a plan-approved health-related location are covered with no copay, up to 24 one-way trips per year using rideshare services, bus/subway, or medical transport, while transportation to any other health-related location is 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 have a $140 copay, and Urgently Needed Services have a $35 copay. Worldwide Emergency Coverage and Worldwide Urgent Coverage have a $140 copay, while 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, chiropractic services with a $20 copay, and occupational therapy with a $25 copay. The plan also covers physician specialist services and physical therapy with a $25 copay, mental health specialty services with a $25 copay, podiatry services with a $25 copay, other health care professional services with a copay between $0 and $25, psychiatric services with a $25 copay, additional telehealth benefits with a copay between $0 and $35, and opioid treatment program services with a $25 copay.
Preventive Services See details
Preventive services include coverage for annual physical exams with no copay. Additional preventive services, including fitness benefits, remote access technologies, and alternative therapies, are covered with no copay. Kidney Disease Education Services are covered with 20% coinsurance. Other preventive services, including glaucoma screenings, diabetes self-management training, barium enemas, digital rectal exams, and EKG following a welcome visit, are covered with no copay. Health education, in-home safety assessments, medical nutrition therapy, post-discharge in-home medication reconciliation, re-admission prevention, wigs for hair loss, weight management programs, therapeutic massage, adult day health services, nutritional/dietary benefits, home-based palliative care, in-home support services, support for caregivers of enrollees, additional sessions of smoking and tobacco cessation counseling, enhanced disease management, telemonitoring services, home and bathroom safety devices and modifications, and counseling services are not covered.
Hearing Services See details
Hearing Services include hearing exams, routine hearing exams, fitting/evaluation for hearing aids, prescription hearing aids, and OTC hearing aids. Hearing exams have a $25 copay, while routine hearing exams and fitting/evaluation for hearing aids have no copay. Prescription Hearing Aids (all types) have no copay, and are covered up to $750 per year. OTC hearing aids are not covered.
Vision Services See details
The Wellcare Dual Reserve (HMO-POS D-SNP) plan covers vision services, including eye exams and eyewear. Eye exams have a copay between $0 and $25, while eyewear, including contact lenses, eyeglasses, eyeglass lenses, eyeglass frames, and upgrades, have no copay, with a combined maximum of $200 per year.
Dental Services See details
The Wellcare Dual Reserve (HMO-POS D-SNP) plan covers Medicare Dental Services with a $25 copay, and other dental services with no copay for oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatment, other preventive dental services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), and oral and maxillofacial surgery, but not maxillofacial prosthetics, implant services, and orthodontics. Orthodontic services are covered up to a maximum of $2000 per year.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by the Wellcare Dual Reserve (HMO-POS D-SNP) plan. 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 coinsurance for dialysis services is 20%.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with 20% coinsurance and Prosthetics/Medical Supplies, with no copay, and 20% coinsurance for Medicare-covered Prosthetic Devices and Medical Supplies. Diabetic Equipment is also covered, with 20% coinsurance for Medicare-covered Diabetic Therapeutic Shoes or Inserts, and no copay for Diabetic Supplies.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including diagnostic procedures and tests with a copay between $0 and $30, lab services with no copay, diagnostic radiological services with a copay of up to $250, therapeutic radiological services with 20% coinsurance, and outpatient X-ray services with a $50 copay.
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 covered, but the specific services of Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, and Additional Cardiac Rehabilitation Services are not covered. The plan has a copay for some cardiac and pulmonary rehabilitation services, but the specific amount is not detailed in the provided information.
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
Other Services for the Wellcare Dual Reserve (HMO-POS D-SNP) plan covers over-the-counter items with no copay. Acupuncture, meal benefit, and several other services are not covered.
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