Wellcare No Premium (HMO) - 2024 Wellcare (2024)

Go Back

H6975 - 005 - 0

Wellcare No Premium (HMO) - 2024 Wellcare (1) (2.5 / 5)

Wellcare No Premium (HMO) - 2024 Wellcare (2)

Wellcare No Premium (HMO)is a Medicare Advantage (Part C) Plan by Wellcare.

This page features plan details for 2024 Wellcare No Premium (HMO)H6975 – 005 – 0 available in Select counties in AL.

IMPORTANT: This page has been updated with plan and premium data for 2024.

Wellcare No Premium (HMO)is offered in the following locations.

Alabama

Autauga County, Alabama

Baldwin County, Alabama

Click to see more locations

Wellcare No Premium (HMO)offers the following coverage and cost-sharing.

Insurer:Wellcare
Health Plan Deductible:$0.00
MOOP:$4,500 In-network
Drugs Covered:Yes

Ready to sign up for Wellcare No Premium (HMO)?

Get help from a licensed insurance agent.

Call 1-877-354-4611 TTY 711.

8am – 11pm EST. 7 days a week

Premium Breakdown

Wellcare No Premium (HMO)has a monthly premium of $0.00. This amount includes your Part C and D premiums but does not include your Part B premium.The following is a breakdown of your monthly premium with Part B costs included.

Part BPart CPart DPart B Give BackTotal
$174.70$0.00$0.00$0.00$174.70

Please Note:

  • Your Part B premium may differ based on factors including late enrollment, income, and disability status.
  • You may also qualify for “Extra Help” on drug costs. See the Part D Premium Reduction section below for more details.

Drug Info

Wellcare No Premium (HMO)provides the following cost-sharing on drugs. Please check the plan’s formulary for specific drugs covered.

Drug Deductible:$0.00
Initial Coverage Limit:$5,030.00
Catastrophic Coverage Limit:$8,000.00
Drug Benefit Type:Enhanced Alternative
Additional Gap Coverage:
Formulary Link:Formulary Link

Part D Premium Reduction

The Low-Income Subsidy (also known as LIS or “Extra Help”) helps people with Medicare lower the cost of prescription drugs.

The table below shows how the LIS impacts the Part D premium of this plan.

Part DLIS Full
$0.00$

NOTE: The Inflation Reduction Act of 2022 has expanded full subsidy eligibility under the LIS program to individuals with incomes up to 150% of the Federal Poverty Level. People who qualify for Extra Help generally will pay no more than $4.50 for each generic drug and $11.20 for each brand-name drug.

Initial Coverage Phase

After you pay your $0.00 drug deductible, you will pay the following costs for drugs in each tier until your total drug costs (including what this plan has paid and what you have paid) reach $5,030.00. Once you reach that amount, you will enter the next coverage phase.

30 Day

60 Day

90 Day

30 Day

60 Day

90 Day

Gap Coverage Phase

After your total drug costs (including what this plan has paid and what you have paid) reach $5,030.00, you will pay no more than the amounts below for any drug tier until you reach $8,000.00.

30 Day

90 Day

30 Day

90 Day

Tier Cost
All other tiers (Generic)25%
All other tiers (Brand-name)25%

Catastrophic Coverage Phase

After your yearly out-of-pocket drug costs (including drugs purchased through your retail pharmacy and through mail order) reach $8,000.00, you pay nothing for Medicare Part D covered drugs. However, you may still pay a share of the costs for excluded drugs covered under any enhanced benefit. Please note, that this plan has a Enhanced Alternative benefit type.

Additional Benefits

Wellcare No Premium (HMO)also provides the following benefits.

Health plan deductible

$0

Other health plan deductibles?

In-network No

Maximum out-of-pocket enrollee responsibility (does not include prescription drugs)

$4,500 In-network

Optional supplemental benefits

No

Additional benefits and/or reduced cost-sharing for enrollees with certain health conditions?

In-network No

Outpatient hospital coverage

$0-250 copay per visit (Authorization is required.) (Referral is not required.)

Doctor visits

Primary$0 copay (Not applicable.) (Not applicable.)
Specialist$15 copay per visit (Authorization is required.) (Referral is not required.)

Preventive care

$0 copay (Authorization is not required.) (Referral is not required.)

Emergency care/Urgent care

Emergency$120 copay per visit (always covered) (Not applicable.) (Not applicable.)
Urgent care$25 copay per visit (always covered) (Not applicable.) (Not applicable.)

Diagnostic procedures/lab services/imaging

Diagnostic tests and procedures$0-20 copay (Authorization is required.) (Referral is not required.)
Lab services$0-50 copay (Authorization is required.) (Referral is not required.)
Diagnostic radiology services (e.g., MRI)$0-250 copay (Authorization is required.) (Referral is not required.)
Outpatient x-rays$0 copay (Authorization is required.) (Referral is not required.)

Hearing

Hearing exam$15 copay (Authorization is required.) (Referral is not required.)
Fitting/evaluation$0 copay (Limits may apply.) (Authorization is required.) (Referral is not required.)
Hearing aids$0 copay (Limits may apply.) (Authorization is required.) (Referral is not required.)

Preventive dental

Oral exam$0 copay (Limits may apply.) (Authorization is required.) (Referral is not required.)
Cleaning$0 copay (Limits may apply.) (Authorization is required.) (Referral is not required.)
Fluoride treatment$0 copay (Limits may apply.) (Authorization is required.) (Referral is not required.)
Dental x-ray(s)$0 copay (Limits may apply.) (Authorization is required.) (Referral is not required.)

Comprehensive dental

Non-routine services$0 copay (Limits may apply.) (Authorization is required.) (Referral is not required.)
Diagnostic services$0 copay (Limits may apply.) (Authorization is required.) (Referral is not required.)
Restorative services$0 copay (Limits may apply.) (Authorization is required.) (Referral is not required.)
Endodontics$0 copay (Limits may apply.) (Authorization is required.) (Referral is not required.)
Periodontics$0 copay (Limits may apply.) (Authorization is required.) (Referral is not required.)
Extractions$0 copay (Limits may apply.) (Authorization is required.) (Referral is not required.)
Prosthodontics, other oral/maxillofacial surgery, other services$0 copay (Limits may apply.) (Authorization is required.) (Referral is not required.)

Vision

Routine eye exam$0 copay (Limits may apply.) (Authorization is required.) (Referral is not required.)
OtherNot covered (There are no limits.) (Not applicable.) (Not applicable.)
Contact lenses$0 copay (Limits may apply.) (Authorization is required.) (Referral is not required.)
Eyeglasses (frames and lenses)$0 copay (Limits may apply.) (Authorization is required.) (Referral is not required.)
Eyeglass frames$0 copay (Limits may apply.) (Authorization is required.) (Referral is not required.)
Eyeglass lenses$0 copay (Limits may apply.) (Authorization is required.) (Referral is not required.)
Upgrades$0 copay (Limits may apply.) (Authorization is required.) (Referral is not required.)

Rehabilitation services

Occupational therapy visit$15 copay (Authorization is required.) (Referral is not required.)
Physical therapy and speech and language therapy visit$15 copay (Authorization is required.) (Referral is not required.)

Ground ambulance

$300 copay (Not applicable.) (Not applicable.)

Transportation

$0 copay (Limits may apply.) (Authorization is required.) (Referral is not required.)

Foot care (podiatry services)

Foot exams and treatment$15 copay (Authorization is required.) (Referral is not required.)
Routine foot careNot covered (Not applicable.) (Not applicable.)

Medical equipment/supplies

Durable medical equipment (e.g., wheelchairs, oxygen)20% coinsurance per item (Authorization is required.) (Not applicable.)
Prosthetics (e.g., braces, artificial limbs)20% coinsurance per item (Authorization is required.) (Not applicable.)
Diabetes supplies$0 copay per item (Authorization is required.) (Not applicable.)

Wellness programs (e.g., fitness, nursing hotline)

Covered (Authorization is not required.) (Referral is not required.)

Medicare Part B drugs

Chemotherapy0-20% coinsurance (Authorization is required.) (Not applicable.)
Other Part B drugs0-20% coinsurance (Authorization is required.) (Not applicable.)
Part B Insulin drugs$35 copay (Authorization is required.) (Not applicable.)

Inpatient hospital coverage

$300 per day for days 1 through 7
$0 per day for days 8 through 90 (Authorization is required.) (Referral is not required.)

Mental health services

Inpatient hospital – psychiatric$265 per day for days 1 through 7
$0 per day for days 8 through 90 (Authorization is required.) (Referral is not required.)
Outpatient group therapy visit with a psychiatrist$40 copay (Authorization is required.) (Referral is not required.)
Outpatient individual therapy visit with a psychiatrist$40 copay (Authorization is required.) (Referral is not required.)
Outpatient group therapy visit$40 copay (Authorization is required.) (Referral is not required.)
Outpatient individual therapy visit$40 copay (Authorization is required.) (Referral is not required.)

Skilled Nursing Facility

$0 per day for days 1 through 20
$203 per day for days 21 through 50
$0 per day for days 51 through 100 (Authorization is required.) (Referral is not required.)

Ready to sign up for Wellcare No Premium (HMO)?

Get help from a licensed insurance agent.

Call 1-877-354-4611 TTY 711.

8am – 11pm EST. 7 days a week

Table of Contents

Get Help Enrolling

Get help enrolling in a Medicare Advantage or Medicare Prescription Drug Plan by calling a licensed insurance agent today.

Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross Blue Shield, Anthem Blue Cross, Aspire Health Plan, Cigna Healthcare, Dean Health Plan, Devoted Health, Florida Blue Medicare, GlobalHealth, Health Care Service Corporation, Healthy Blue, Humana, Molina Healthcare, Mutual of Omaha, Premera Blue Cross, Medica Central Health Plan, SCAN Health Plan, Baylor Scott & White Health Plan, Simply, UnitedHealthcare(R), Wellcare, WellPoint.

SMID: MULTIPLAN_HCIHNDOGMED01_M

Factsonmedicare.com is a free-to-use informational website by Dog Media Solutions LLC. All insurance agents and enrollment platforms linked to this site have their own terms and conditions.

This is a promotional communication.

Every year, Medicare evaluates plans based on a 5-star rating system.

Part B Premium give-back is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.

All plan-related information on this site is from CMS.gov and Medicare.gov.We only use data released publicly each year. While our goal is always to provide fact-based, accurate information, information is subject to change, and some data may be inaccurate. Contact a plan for a Summary of Benefits.

Enrollment in Medicare/Medicare Advantage may be limited to certain times of the year unless you qualify for a Special Enrollment Period

We do not feature every plan available in your area. Any information we provide is limited to those plans we do feature in your area. Enrollment is offered through our partners including HealthCompare Insurance Services.

HealthCompare Insurance Services does not offer every plan available in your area. Currently, HealthCompare Insurance Services represents 18 organizations, which offer 52,101 products in your area.

HealthCompare Insurance Services represents Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan’s contract renewal.

Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.

Please contactMedicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.

Medicare has neither approved nor endorsed any information on this site.

© All rights reserved | About | Contact | Legal and Privacy

Wellcare No Premium (HMO) - 2024 Wellcare (2024)

References

Top Articles
Latest Posts
Article information

Author: Chrissy Homenick

Last Updated:

Views: 6703

Rating: 4.3 / 5 (74 voted)

Reviews: 81% of readers found this page helpful

Author information

Name: Chrissy Homenick

Birthday: 2001-10-22

Address: 611 Kuhn Oval, Feltonbury, NY 02783-3818

Phone: +96619177651654

Job: Mining Representative

Hobby: amateur radio, Sculling, Knife making, Gardening, Watching movies, Gunsmithing, Video gaming

Introduction: My name is Chrissy Homenick, I am a tender, funny, determined, tender, glorious, fancy, enthusiastic person who loves writing and wants to share my knowledge and understanding with you.