WellCare Essential (HMO)


Medicare Plan Details

2021 Plan
Monthly Premium
(select county for price)

 

by WellCare
Additional Coverage
Hearing Vision Dental
Overall Government Star Rating
No Rating
out of 5 stars

State: Alabama

Select your county to view the price for this plan

 


Plan Type

Medicare Advantage (Part C) with Prescription Drug (Part D)

Medicare Advantage combines Part A and Part B. This plan = Part A + Part B + Part D

 

$0
$0
$0
$0
$4,900 In-network
No
Yes
Yes
Yes

Medical Benefits

Doctor Services

$0 copay
$30 copay per visit

Tests, labs, & imaging

$0-20 copay
$0 copay
$0-250 copay
$0 copay
$90 copay per visit (always covered)
$40 copay per visit (always covered)

Hospital Services

$250 per day for days 1 through 7
$0 per day for days 8 through 90
$250 copay per visit

Skilled nursing facility

$0 per day for days 1 through 20
$184 per day for days 21 through 100

Preventive services

$0 copay

Ambulance

$225 copay

Therapy services

$40 copay
$40 copay

Mental health services

$40 copay
$40 copay
$40 copay
$40 copay

Opioid treatment services

Covered

Other services

20% coinsurance per item
20% coinsurance per item
$0 copay per item

Prescription Drug Benefits

Tier drug costs for: Standard retail pharmacy drug cost for 1-month

TiersInitial coverage phaseGap coverage phaseCatastrophic coverage phase
Preferred Generic$0.00 copay


Generic drugs :
25%

Brand-name drugs :
25%


Generic drugs :
$3.70 copay or 5% (whichever costs more)

Brand-name drugs :
$9.20 copay or 5% (whichever costs more)

Generic$5.00 copay
Preferred Brand$47.00 copay
Non-Preferred Drug$99.00 copay
Specialty Tier33%

Part B Drugs

20% coinsurance
20% coinsurance

Extra Benefits

Hearing

$30 copay
$0 copay
$0 copay

Preventive Dental

$0 copay
$0 copay
$0 copay
$0 copay

Comprehensive dental

$0 copay
$0 copay
$0 copay
$0 copay
$0 copay
$0 copay
$0 copay

Vision

$0 copay
$0 copay
$0 copay
$0 copay
$0 copay
$0 copay

Other benefits

Limited coverage
Limited coverage
Not covered
Not covered
Limited coverage
Limited coverage
Limited coverage
No Rating
No Rating
No Rating
No Rating
No Rating
No Rating
No Rating
No Rating
No Rating
No Rating
No Rating

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