Wellcare Patriot No Premium (HMO) - 2023 Wellcare (2024)

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

This page features plan details for 2023 Wellcare Patriot No Premium (HMO)H6975 – 006 – 0 available in Select counties in AL.

IMPORTANT: This page features the 2023 version of this plan. See the 2024 version using the link below:

No 2024 version found. You can use the location links below to find 2024 plans in your area.

Locations

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

Autauga County, Alabama

Baldwin County, Alabama

Click to see more locations

Plan Overview

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

Insurer:Wellcare
Health Plan Deductible:$0.00
MOOP:$3,450 In-network
Drugs Covered:No

Ready to sign up for Wellcare Patriot 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 Patriot No Premium (HMO)has a monthly premium of $0.00. This amount includes your Part C premium but does not include your Part B premium.

Part BPart CPart B Give BackTotal
$164.90$0.00$0.00$164.90

Please Note:

  • Your Part B premium may differ based on factors including late enrollment, income, and disability status.

Additional Benefits

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

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

In-Network: No

Dental (comprehensive)

Diagnostic services: $0 copay (limits may apply) (authorization required) (referral not required)
Endodontics: $0 copay (limits may apply) (authorization required) (referral not required)
Extractions: $0 copay (limits may apply) (authorization required) (referral not required)
Non-routine services: $0 copay (limits may apply) (authorization required) (referral not required)
Periodontics: $0 copay (limits may apply) (authorization required) (referral not required)
Prosthodontics, other oral/maxillofacial surgery, other services: $0 copay (limits may apply) (authorization required) (referral not required)
Restorative services: $0 copay (limits may apply) (authorization required) (referral not required)

Dental (preventive)

Cleaning: $0 copay (limits may apply) (authorization required) (referral not required)
Dental x-ray(s): $0 copay (limits may apply) (authorization required) (referral not required)
Fluoride treatment: $0 copay (limits may apply) (authorization required) (referral not required)
Oral exam: $0 copay (limits may apply) (authorization required) (referral not required)

Diagnostic procedures/lab services/imaging

Diagnostic radiology services (e.g., MRI): $0-150 copay (authorization required) (referral not required)
Diagnostic tests and procedures: $0-20 copay (authorization required) (referral not required)
Lab services: $0 copay (authorization required) (referral not required)
Outpatient x-rays: $0 copay (authorization required) (referral not required)

Doctor visits

Primary: $0 copay
Specialist: $0 copay (authorization required) (referral not required)

Emergency care/Urgent care

Emergency: $125 copay per visit (always covered)
Urgent care: $35 copay per visit (always covered)

Foot care (podiatry services)

Foot exams and treatment: $0 copay (authorization required) (referral not required)
Routine foot care: Not covered

Ground ambulance

$200 copay

Health plan deductible

$0.00

Health plan deductibles (other)

In-Network: No

Hearing

Fitting/evaluation: $0 copay (limits may apply) (authorization required) (referral required)
Hearing aids: $0 copay (limits may apply) (authorization required) (referral required)
Hearing exam: $0 copay (authorization required) (referral required)

Hospital coverage (inpatient)

$325 per day for days 1 through 5
$0 per day for days 6 through 90 (authorization required) (referral not required)

Hospital coverage (outpatient)

$150 copay per visit (authorization required) (referral not required)

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

$3,450 In-network

Medical equipment/supplies

Diabetes supplies: $0 copay per item (authorization required)
Durable medical equipment (e.g., wheelchairs, oxygen): 20% coinsurance per item (authorization required)
Prosthetics (e.g., braces, artificial limbs): 20% coinsurance per item (authorization required)

Medicare Part B drugs

Chemotherapy: 20% coinsurance (authorization required)
Other Part B drugs: 20% coinsurance (authorization required)

Mental health services

Inpatient hospital – psychiatric: $325 per day for days 1 through 4
$0 per day for days 5 through 90 (authorization required) (referral not required)
Outpatient group therapy visit: $15 copay (authorization required) (referral not required)
Outpatient group therapy visit with a psychiatrist: $15 copay (authorization required) (referral not required)
Outpatient individual therapy visit: $15 copay (authorization required) (referral not required)
Outpatient individual therapy visit with a psychiatrist: $15 copay (authorization required) (referral not required)

Optional supplemental benefits

No

Preventive care

$0 copay (authorization not required) (referral not required)

Rehabilitation services

Occupational therapy visit: $35 copay (authorization required) (referral not required)
Physical therapy and speech and language therapy visit: $35 copay (authorization required) (referral not required)

Skilled Nursing Facility

$0 per day for days 1 through 20
$196 per day for days 21 through 40
$0 per day for days 41 through 100 (authorization required) (referral not required)

Transportation

$0 copay (limits may apply) (authorization required) (referral not required)

Vision

Contact lenses: $0 copay (limits may apply) (authorization required) (referral required)
Eyeglass frames: $0 copay (limits may apply) (authorization required) (referral required)
Eyeglass lenses: $0 copay (limits may apply) (authorization required) (referral required)
Eyeglasses (frames and lenses): $0 copay (limits may apply) (authorization required) (referral required)
Other: Not covered (no limits)
Routine eye exam: $0 copay (limits may apply) (authorization required) (referral required)
Upgrades: $0 copay (limits may apply) (authorization required) (referral required)

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

Covered (authorization not required) (referral not required)

Ready to sign up for Wellcare Patriot 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.

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Wellcare Patriot No Premium (HMO) - 2023 Wellcare (2024)

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