Wellcare Dual Access Open (PPO D-SNP)

Oklahoma Medicare-Medicaid Dual Eligible D-SNP Plan (2025 Plan)

Monthly Premium

Your Cost

$42

by Wellcare

Additional Coverage

HearingVisionDental

Overall Government Star Rating

(coming soon)

Ready to Enroll Online?

Plan Name

Wellcare Dual Access Open (PPO D-SNP)

Insurance Carrier

Wellcare

Plan Type

Medicare-Medicaid Dual Eligible Medicare Advantage Plan (D-SNP)

Network Type

PPO

Wellcare Dual Access Open (PPO D-SNP) is a Medicare-Medicaid Dual Eligible Medicare Advantage Plan (D-SNP), which is available in Oklahoma 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.

Monthly Premium

$42

Annual Deductible

Coming soon

Max Out-of-Pocket

$9,350

Primary doctor visit

0% or 20% coinsurance per visit

Specialist visit

0% or 20% coinsurance per visit

ER visit

$0 or $110 copay per visit (always covered)

Ambulance

0% or 20% coinsurance

Wellcare Dual Access Open (PPO D-SNP) has a monthly premium cost of $42 per month, with an annual deductible of Coming soon and a maximum out of pocket cost sharing of $13,300 In and Out-of-network $9,350 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 Dual Access Open (PPO D-SNP) are defined below.

Yes

Part D Prescription Drug Coverage

Yes

Dental

Yes

Vision

Yes

Hearing

Wellcare Dual Access Open (PPO D-SNP) 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 Dual Access Open (PPO D-SNP) includes coverage for hearing, vision, dental.

Medicare Advantage health plans can offer even more additional benefits. Wellcare Dual Access Open (PPO D-SNP) 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

Limited coverage

Meals for short duration

Not covered

Annual physical exams

Limited coverage

Telehealth

Limited coverage

Monthly Premium

$42

Health Portion of Premium

Drug Portion of Premium

$42

Health Plan Deductible

Coming soon

Health Plan Max Out-of-Pocket

$13,300 In and Out-of-network
$9,350 In-network

Nationwide Coverage included

Hearing Coverage included

Yes

Vision Coverage included

Yes

Dental Coverage included

Yes

Doctor Lookup Link

http://www.wellcare.com/OK

Plan Link

http://www.wellcare.com/OK

Doctor Services

Primary doctor visit

In-network: 0% or 20% coinsurance per visit
Out-of-network: 20% coinsurance per visit

Specialist visit

In-network: 0% or 20% coinsurance per visit
Out-of-network: 20% coinsurance per visit

Tests, labs, & imaging

Diagnostic tests & procedures

In-network: 0% or 20% coinsurance
Out-of-network: 20% coinsurance

Lab services

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

Diagnostic radiology services (like MRI)

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

Outpatient x-rays

In-network: 0% or 20% coinsurance
Out-of-network: 20% coinsurance

Emergency care

$0 or $110 copay per visit (always covered)

Urgent care

$0 or $45 copay per visit (always covered)

Hospital Services

Inpatient hospital coverage

In-network: $0 or $1,870 per stay
Out-of-network: 20% per day for days 1 through 90

Outpatient hospital coverage

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

Skilled nursing facility

In-network: $0 per day for days 1 through 20
$0 or $214 per day for days 21 through 100
Out-of-network: 20% per day for days 1 through 100

Preventive services

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

Ambulance

Ground ambulance

In-network: 0% or 20% coinsurance
Out-of-network: 20% coinsurance

Therapy services

Occupational therapy visit

In-network: 0% or 20% coinsurance
Out-of-network: 20% coinsurance

Physical therapy & speech & language therapy visit

In-network: 0% or 20% coinsurance
Out-of-network: 20% coinsurance

Mental health services

Outpatient group therapy with a psychiatrist

In-network: 0% or 20% coinsurance
Out-of-network: 20% coinsurance

Outpatient individual therapy with a psychiatrist

In-network: 0% or 20% coinsurance
Out-of-network: 20% coinsurance

Outpatient group therapy visit

In-network: 0% or 20% coinsurance
Out-of-network: 20% coinsurance

Outpatient individual therapy visit

In-network: 0% or 20% coinsurance
Out-of-network: 20% coinsurance

Opioid treatment services

Covered

Other services

Durable medical equipment (like wheelchairs & oxygen)

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

Prosthetics (like braces, artificial limbs)

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

Diabetes supplies

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

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

Tiers	Initial coverage phase	Catastrophic coverage phase
Preferred Generic	Generic drugs : 25% coinsurance Brand-name drugs : 25% coinsurance	Generic drugs : 0% coinsurance Brand-name drugs : 0% coinsurance
Generic
Preferred Brand
Non-Preferred Drug
Specialty Tier

Part B Drugs

Chemotherapy drugs

In-network: 0% or 0-20% coinsurance
Out-of-network: 0-20% coinsurance

Other Part B drugs

In-network: 0% or 0-20% coinsurance
Out-of-network: 0-20% coinsurance

Hearing

Hearing exam

In-network: 0% or 20% coinsurance
Out-of-network: 20% coinsurance

Fitting/evaluation

In-network: $0 copay
Out-of-network: 40% coinsurance

Hearing aids - All types

In-network: $0 copay
Out-of-network: 40% coinsurance