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2018 Medicare Advantage Plan Benefit Details for the WellCare Access (HMO SNP) - H1416-034-0
This is archive material for research purposes. Please see PDPFinder.com or MAFinder.com for current plans.

2018 Medicare Advantage Plan Details
Medicare Plan Name:WellCare Access (HMO SNP)
Location:Claiborne, Mississippi     Click to see other locations
Plan ID:H1416 - 034 - 0     Click to see other plans
Member Services:1-855-292-0237 TTY users 1-877-247-6272
— This plan information is for research purposes only. —
Click here to see plans for the current plan year
Medicare Contact Information:Please go to Medicare.gov or call 1-800-MEDICARE (1-800-633-4227) to get information on all of your options.
TTY users 1-877-486-2048
or contact your local SHIP for assistance
Email a copy of the WellCare Access (HMO SNP) benefit details
— Medicare Plan Features —
Monthly Premium:$0.00 for people who qualify for both Medicare and Medicaid. (see Plan Premium Details below)
Annual Deductible:$0 for people who qualify for both Medicare and Medicaid.
Annual Initial Coverage Limit (ICL):$3,750
Health Plan Type:Local HMO
Special Needs Plan (SNP)
Eligibility Requirement:		Dual-Eligible
Additional Gap Coverage?No additional gap coverage, only the Donut Hole Discount
Total Number of Formulary Drugs:3,280 drugsBrowse the WellCare Access (HMO SNP) Formulary
This plan has 5 drug tiers. See cost-sharing for all pharmacies and tiers. 
Formulary Drug Details:Tier 1Tier 2Tier 3Tier 4Tier 5
• Preferred Pharmacy
  Cost-Sharing during
  initial coverage phase:		$0.00$18.00$47.0050%25%
• Number of Drugs per
  Tier:		360450917918635
Plan's Pharmacy Search:http://www.wellcare.com/medicare
Plan Offers Mail Order?Yes
Number of Members enrolled in this plan in Claiborne, Mississippi:81 members
Number of Members enrolled in this plan in Mississippi:6,765 members
Number of Members enrolled in this plan in (H1416 - 034):11,050 members
Plan’s Summary Star Rating: 3 out of 5 Stars.
• Customer Service Rating: 5 out of 5 Stars.
• Member Experience Rating: 3 out of 5 Stars.
• Drug Cost Accuracy Rating: 3 out of 5 Stars.
— Plan Premium Details —
The Monthly Premium is Split as Follows: ❔
Total
Premium		Part C
Premium		Part D Base
Premium		Part D Supplemental
Premium
$25.80$0.00$25.80$0.00
Monthly Premium with Extra Help Low-Income Subsidy (LIS): ❔100%
Subsidy		75%
Subsidy		50%
Subsidy		25%
Subsidy
Monthly Part D Premium with LIS:$0.00$6.40$12.90$19.30
Total Monthly Premium with LIS (Parts C & D):$0.00$6.40$12.90$19.30
— Plan Health Benefits —
** Benefit Highlights **
Health plan deductible
• $0
Maximum out-of-pocket enrollee responsibility (does not include prescription drugs)
• $6,700 In-network
Optional supplemental benefits
• No
Inpatient hospital coverage
• $0 copay
Outpatient hospital coverage
• $0 copay
Preventive care
• $0 copay
Other health plan deductibles?
• In-Network:  No
Doctor visits
• Primary:  $0 copay
• Specialist:  $0 copay
Emergency care/Urgent care
• Emergency:  $0 copay
• Urgent care:  $0 copay
Diagnostic procedures/lab services/imaging
• Diagnostic tests and procedures:  $0 copay
• Lab services:  $0 copay
• Diagnostic radiology services (e.g., MRI):  $0 copay
• Outpatient x-rays:  $0 copay
Mental health services
• $0 copay
Skilled Nursing Facility
• $0 copay
Ambulance
• $0 copay
Transportation
• $0 copay
Wellness programs (e.g., fitness, nursing hotline)
• Covered
Mental health services
• Outpatient group therapy visit with a psychiatrist:  $0 copay
• Outpatient individual therapy visit with a psychiatrist:  $0 copay
• Outpatient group therapy visit:  $0 copay
• Outpatient individual therapy visit:  $0 copay
Rehabilitation services
• Occupational therapy visit:  $0 copay
• Physical therapy and speech and language therapy visit:  $0 copay
Foot care (podiatry services)
• Foot exams and treatment:  $0 copay
• Routine foot care:  $5
Medical equipment/supplies
• Durable medical equipment (e.g., wheelchairs, oxygen):  $0 copay
• Prosthetics (e.g., braces, artificial limbs):  $0 copay
• Diabetes supplies:  $0 copay
Medicare Part B drugs
• Chemotherapy:  $0 copay
• Other Part B drugs:  $0 copay
** Benefits Services **
Hearing
• Hearing exam:  $0 copay
• Fitting/evaluation:  $0
• Hearing aids:  $0 copay
Preventive dental
• Oral exam:  $0 copay
• Cleaning:  $0 copay
• Fluoride treatment:  $0 copay
• Dental x-ray(s):  $0 copay
Comprehensive dental
• Non-routine services:  Not covered
• Diagnostic services:  Not covered
• Restorative services:  $0
• Endodontics:  Not covered
• Periodontics:  $0
• Extractions:  $0
• Prosthodontics, other oral/maxillofacial surgery, other services:  $0
Vision
• Routine eye exam:  $0
• Other:  Not covered
• Contact lenses:  $0 copay
• Eyeglasses (frames and lenses):  $0 copay
• Eyeglass frames:  $0 copay
• Eyeglass lenses:  $0 copay
• Upgrades:  Not covered




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