Wellcare Advantage No Premium (PFFS)

Medicare Plan Details (2022 Plan)


Monthly Premium

 

by Wellcare
Additional Coverage
HearingVision
Overall Government Star Rating
 4.0
out of 5 stars

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Plan Type

Medicare Advantage (Part C)

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

 

$0
$0
$0
$0
$6,700 In and Out-of-network
No
Yes
Yes
No

Doctor Services

In-network: $10 copay per visit
Out-of-network: $20 copay per visit
In-network: $35 copay per visit
Out-of-network: $50 copay per visit

Tests, labs, & imaging

In-network: $0 copay
Out-of-network: 30% coinsurance
In-network: $0 copay
Out-of-network: 30% coinsurance
In-network: $0-250 copay
Out-of-network: 30% coinsurance
In-network: $0 copay
Out-of-network: 30% coinsurance
$90 copay per visit (always covered)
$35 copay per visit (always covered)

Hospital Services

In-network: $300 per day for days 1 through 6
$0 per day for days 7 through 90
Out-of-network: $350 per day for days 1 through 7
$0 per day for days 8 and beyond
In-network: $250-300 copay per visit
Out-of-network: 30% coinsurance per visit

Skilled nursing facility

In-network: $0 per day for days 1 through 20
$184 per day for days 21 through 100
Out-of-network: $0 per day for days 1 through 20
$184 per day for days 21 through 100

Preventive services

In-network: $0 copay
Out-of-network: $0 copay

Ambulance

In-network: $300 copay
Out-of-network: $300 copay

Therapy services

In-network: $35 copay
Out-of-network: 30% coinsurance
In-network: $35 copay
Out-of-network: 30% coinsurance

Mental health services

In-network: $25 copay
Out-of-network: 30% coinsurance
In-network: $25 copay
Out-of-network: 30% coinsurance
In-network: $25 copay
Out-of-network: 30% coinsurance
In-network: $25 copay
Out-of-network: 30% coinsurance

Opioid treatment services

Covered

Other services

In-network: 20% coinsurance per item
Out-of-network: 20% coinsurance per item
In-network: 20% coinsurance per item
Out-of-network: 20% coinsurance per item
In-network: $0 copay per item
Out-of-network: 20% coinsurance per item

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

Part B Drugs

In-network: 20% coinsurance
Out-of-network: 30% coinsurance
In-network: 20% coinsurance
Out-of-network: 30% coinsurance

Hearing

In-network: $35 copay
Out-of-network: $50 copay
In-network: $0 copay
Out-of-network: $0 copay
Not covered
Not covered
Not covered

Preventive Dental

Not covered
Not covered
Not covered
Not covered

Comprehensive dental

Not covered
Not covered
Not covered
Not covered
Not covered
Not covered
Not covered

Vision

In-network: $0 copay
Out-of-network: $0 copay
Not covered
Not covered
Not covered
Not covered
Not covered

Other benefits

Limited coverage
Not covered
Not covered
Not covered
Not covered
Limited coverage
Limited coverage
 3.5
 3
 3
 4
 4
No Rating

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