WellCare Value (HMO) is a HMO Medicare Advantage (Medicare Part C) plan offered by WellCare Health Plans, Inc.
Plan ID: H1353-001-000
Washington 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 Washington Medicare Advantage plans like the one below and find a plan that offers the benefits you want at an affordable price.
Coverage | Details |
---|---|
Monthly plan premium | $0.00 |
Vision coverage | |
Dental coverage | |
Hearing coverage | |
Prescription drugs | |
Medical deductible | $0.00 |
Out-of-pocket maximum | $5,900.00 |
Initial drug coverage limit | $0.00 |
Catastrophic drug coverage limit | $6,550.00 |
Primary care doctor visit | $0 |
Specialty doctor visit | $25 |
Inpatient hospital care | $350 co-pay per day for days 1-5 and a $0 co-pay per day for days 6-90 |
Urgent care | $35 |
Emergency room visit | $90 |
Ambulance transportation | $220 |
WellCare Value (HMO) covers a range of additional benefits. Learn more about WellCare Value (HMO) 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 / Routine Chiropractic Services: $20 for 12 visits every year |
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. For other services, please refer to your Evidence of Coverage for more information. |
Home health care | $0 |
Mental health inpatient care | $350 co-pay per day for days 1-4 and a $0 co-pay per day for days 5-90 |
Mental health outpatient care | $40 for individual or group |
Outpatient services/surgery | Outpatient Hospital Non-Surgery: $250 / Outpatient Hospital Surgery: $250 Ambulatory Surgery Center: $200 |
Outpatient substance abuse care | $40 for individual or group |
Over-the-counter items | $100 every quarter OTC Retail/Catalog. Unused amounts do not carry over to the next quarter. |
Podiatry services | Medicare Covered Podiatry Services: $25 per visit / Routine Podiatry Services: $25 per visit for 6 visits every year |
Skilled Nursing Facility (SNF) care | $0 co-pay per day for days 1-20 and a $178.00 co-pay per day for days 21-100 |
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 and comprehensive services up to $2,000, including but not limited to: cleanings, x-ray(s), oral exams, fluoride treatments, fillings, dentures or a bridge or a crown and a root canal. |
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 $200 for unlimited contacts, glasses, lenses, and/or frames per year. |
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 cover, but are not limited to: routine hearing exams, hearing aid fittings and evaluations, and up to $2,000 for 2 hearing aids per year with a maximum of $1,000 per ear. |
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 Washington 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 Washington 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.
Links to plan documents | |
We represent carriers such as Humana, UnitedHealthcare®, Anthem Blue Cross and Blue Shield, Aetna, Cigna Healthcare, Wellcare, or Kaiser Permanente.
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