Wellcare Fidelis Patriot No Premium (HMO-POS)
Wellcare Fidelis Patriot No Premium (HMO-POS) is a HMO-POS Medicare Advantage (Medicare Part C) plan offered by WellCare Health Plans, Inc.
Plan ID: H5599-005-000
New York Medicare beneficiaries may want to consider reviewing their Medicare Advantage (Medicare Part C) plan options. A Medicare Advantage plan combines your Original Medicare (Part A and Part B) benefits into a single plan.
Most Medicare Advantage plans cover prescription drugs, and many plans may offer other extra benefits Original Medicare doesn’t cover.
Learn more about New York Medicare Advantage plans like the one below and find a plan that offers the benefits you want at an affordable price.
Basic Costs and Coverage
| Coverage | Details |
|---|---|
| Monthly plan premium | $0.00 |
| Vision coverage | |
| Dental coverage | |
| Hearing coverage | |
| Prescription drugs | |
| Medical deductible | ($1.00) |
| Out-of-pocket maximum | $7,550.00 |
| Initial drug coverage limit | $0.00 |
| Catastrophic drug coverage limit | $7,050.00 |
| Primary care doctor visit | $0 copay |
| Specialty doctor visit | $30 |
| Inpatient hospital care | $390 copay per day for days 1-5 and a $0 copay per day for days 6-90 |
| Urgent care | $30 |
| Emergency room visit | $90 |
| Ambulance transportation | $350 |
Health Care Services and Medical Supplies
Wellcare Fidelis Patriot No Premium (HMO-POS) covers a range of additional benefits. Learn more about Wellcare Fidelis Patriot No Premium (HMO-POS) benefits, some of which may not be covered by Original Medicare (Part A and Part B).
| Coverage | Details |
|---|---|
| Chiropractic services | Medicare Covered Chiropractic Services: $20 per visit |
| Diabetes supplies, training, nutrition therapy and monitoring | Diabetes Supplies: $0 / Diabetes Self-Management Training: $0 / Diabetic Therapeutic Shoes or Inserts: 20% |
| Durable medical equipment (DME) | 20% |
| Diagnostic tests, lab and radiology services, and X-rays | X-Ray Services: $0 / Lab Services: $0. $0 for COVID-related testing. For other services, please refer to the Evidence of Coverage for more information. |
| Home health care | $0 copay |
| Mental health inpatient care | $350 copay per day for days 1-5 and a $0 copay per day for days 6-90 |
| Mental health outpatient care | $25 for individual or group |
| Outpatient services/surgery | POS (Out-of-Network): Outpatient Hospital and ASC Services: Coinsurance for Medicare Covered Outpatient Hospital Services 50% Coinsurance for Medicare Covered Ambulatory Surgical Center Services 50% |
| Outpatient substance abuse care | $25 for individual or group |
| Podiatry services | Medicare Covered Podiatry Services: $30 |
| Skilled Nursing Facility (SNF) care | $0 copay per day for days 1-20 and a $184 copay per day for days 21-100 |
Dental Benefits
The following dental services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage.
| Coverage | Details |
|---|---|
| Dental care | The dental benefits on this plan include coverage of preventive, diagnostic and non-routine services up to $500, including but not limited to cleanings, x-ray(s), oral exams, and fluoride treatments offered at a $0 co-pay. |
Vision Benefits
The following vision services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage.
| Coverage | Details |
|---|---|
| Vision benefits | The vision benefits on this plan cover routine eye exams and up to $50 for unlimited contacts, glasses, lenses, and/or frames per plan year |
Hearing Benefits
The following hearing services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage.
| Coverage | Details |
|---|---|
| Hearing benefits | The hearing benefits on this plan include, but are not limited to, an annual exam, hearing aid fitting and evaluation, and up to $700 a year towards hearing aids A maximum of one hearing aid per ear will apply |
Preventive Services and Health/Wellness Education Programs
The following services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage.
| Coverage | Details |
|---|---|
| Preventive services and health/wellness education programs | Most services offered at $0 cost share, please refer to your Evidence of Coverage for more information. |
When reviewing New York Medicare plans, be sure to find out if your doctors are part of the plan network. If a Medicare Advantage plan covers prescription drugs, make sure the plan formulary (list of drugs covered by the plan) includes your drugs.
You may be able to find plans in your part of New York that offer similar benefits at similar or lower prices than the plan above. Call 1-800-557-6059 TTY 711, 24/7 to speak with a licensed insurance agent who can help you compare plans.
Plan Documents
| Links to plan documents |
New York Counties Served
We represent carriers such as Humana, UnitedHealthcare®, Anthem Blue Cross and Blue Shield, Aetna, Cigna Healthcare, Wellcare, or Kaiser Permanente.
