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Wellcare Mutual of Omaha No Premium Open (PPO)
Missouri Medicare Advantage Plan (2024 Plan)
Monthly Premium
Your Cost
$0
by Wellcare
Additional Coverage
HearingVisionDental
Overall Government Star Rating
3.0
out of 5 stars
Ready to Enroll Online?
Plan Overview
Plan Name
Wellcare Mutual of Omaha No Premium Open (PPO)
Insurance Carrier
Wellcare
Plan Type
Medicare Advantage Plan With Part D Prescription Drug Coverage
Network Type
PPO
Wellcare Mutual of Omaha No Premium Open (PPO) is a Medicare Advantage Plan With Part D Prescription Drug Coverage, which is available in Missouri and offered by the health insurance company Wellcare. This plan’s network type is PPO which determines in-network doctors who accept the health plan and whether a referral is needed.
Cost Summary
Monthly Premium
$0
Annual Deductible
$0
Max Out-of-Pocket
$4,900
Primary doctor visit
$0 copay
Specialist visit
$20 copay per visit
ER visit
$120 copay per visit (always covered)
Ambulance
$300 copay
Wellcare Mutual of Omaha No Premium Open (PPO) has a monthly premium cost of $0 per month, with an annual deductible of $0 and a maximum out of pocket cost sharing of $7,900 In and Out-of-network
$4,900 In-network. The most common benefit costs which people evaluate when choosing a plan are costs for a primary doctor visit, specialist doctor visit, emergency room visit, and ambulance. These costs are listed in this summary section and a full list of benefit costs for Wellcare Mutual of Omaha No Premium Open (PPO) are defined below.
Additional Benefits and Coverage
Yes
Part D Prescription Drug Coverage
Yes
Dental
Yes
Vision
Yes
Hearing
Wellcare Mutual of Omaha No Premium Open (PPO) is a Medicare Advantage plan which does include Medicare Part D Prescription Drug coverage. Other common benefits included with Medicare Advantage plans are coverage for dental, vision, and hearing. Wellcare Mutual of Omaha No Premium Open (PPO) includes coverage for hearing, vision, dental.
Medicare Advantage health plans can offer even more additional benefits. Wellcare Mutual of Omaha No Premium Open (PPO) includes coverage for the following additional benefits:
Other benefits
Fitness benefit
Limited coverage
Over the counter drug benefits
Limited coverage
In-home support services
Not covered
Home and bathroom safety devices
Not covered
Meals for short duration
Limited coverage
Annual physical exams
Limited coverage
Telehealth
Limited coverage
Comparing the Quality Score of Wellcare Mutual of Omaha No Premium Open (PPO) to Other Plans in Missouri
Each year the federal government evaluates the quality of Medicare Advantage and Part D Prescription Drug plans based on a 5-star scoring system. For 2024, Wellcare Mutual of Omaha No Premium Open (PPO) received an overall government quality rating of 3.0 stars out of 5 stars.
Wellcare Mutual of Omaha No Premium Open (PPO) performed worse than Missouri’s State average overall quality score of 3.9 stars.
This Plan’s 5-star Gov’t Quality Score
Missouri State Average Score
Overall Government 5 Star Quality Rating
3.0
3.9
Summary rating of health plan quality
2.5
3.8
Staying healthy: screenings, tests, & vaccines
2
3.5
Managing chronic (long term) conditions
2
3.3
Member experience with health plan
3
3.9
Member complaints & changes in the health plan's performance
1
3.8
Health plan customer service
No Rating (new plan)
4.4
Summary rating of drug plan quality
3
3.9
Drug plan customer service
5
4.1
Member complaints & changes in the drug plan's performance
2
3.9
Member experience with the drug plan
3
3.9
Drug safety & accuracy of drug pricing
3
3.4
The government calculates an “Overall star rating” based on ratings for sub components including “Health plan star rating” and “Drug plan star rating”, which includes further subcomponents of each.
Wellcare Mutual of Omaha No Premium Open (PPO) received 2.5 stars for its health plan quality score which is worse than the Missouri State average health plan quality score of 3.8 stars.
Wellcare Mutual of Omaha No Premium Open (PPO) received 3 stars for its drug plan quality score which is worse than the Missouri State average drug plan quality score of 3.9 stars.
In-network: $300 per day for days 1 through 5
$0 per day for days 6 through 90
Out-of-network: 30% per day for days 1 through 90
Outpatient hospital coverage
In-network: $0-300 copay per visit
Out-of-network: 40% coinsurance per visit
Skilled nursing facility
Skilled nursing facility
In-network: $0 per day for days 1 through 20
$203 per day for days 21 through 45
$0 per day for days 46 through 100
Out-of-network: 30% per day for days 1 through 100
In this article we rank Missouri Medicare Advantage plans based on our evaluation of government 5-star quality scores. Each year the government rates the quality of Medicare Advantage health insurance plans with a 5-star quality score. An overall quality score is assigned to each plan which is based on the scores of various quality metrics.
The Medicare landscape in Missouri is constantly changing. In this article we show a summary of new and returning health insurance companies offering Medicare Advantage Plans (Part C) and Medicare Prescription Drug Plans (Part D) in Missouri.