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Medicare Advantage · D-SNP · HMOPOS · 2027

Wellcare Home State Health Dual Reserve (HMO-POS D-SNP)

Wellcare H1664-0123.0 CMS rating for 2027
Is it offered where you live?

At a glance: $18.40 monthly premium and $0 primary care visits.

Eligibility required for this D-SNP. You must be entitled to Medicare Part A, enrolled in Part B, and have a Medicaid category this plan accepts. See who can enroll

Monthly premium
$18.40
Part B premium separate
Yearly limit
$3,600
Most you’d pay for in-network care
Vision
$300/yr
Vision eyewear allowance
Doctor visits
$0
Primary care · specialists $25

Check this plan for you

Referral needed to see a specialist

Add your doctors and prescriptions to see how they work with this plan.

Your doctors
Not checked yetSee if they’re in this plan’s network
Your prescriptions
Not checked yetSee your drug tier and monthly cost
Extra benefits
3 includedVision · Dental · Fitness

Enter your ZIP code to see how you can enroll

Enrollment options depend on where you live. Enter your ZIP code so we can show the right ways to enroll in this plan.

Who can enroll

Eligibility for this Special Needs Plan

Eligibility required for this D-SNP

You must be entitled to Medicare Part A, enrolled in Part B, and have a Medicaid category this plan accepts. The plan must verify your Medicaid status. Eligibility alone does not create a year-round right to enroll.

Integration status
CO

Common dual-eligibility labels

These definitions are educational. They do not confirm which Medicaid categories this specific plan accepts.

FBDE
Full Medicaid benefits in addition to Medicare.
QMB+
QMB help with Medicare costs plus full Medicaid benefits.
SLMB+
SLMB help with the Part B premium plus full Medicaid benefits.
QMB
Help with Medicare premiums and Medicare-covered cost sharing.

Check the Summary of Benefits or Evidence of Coverage for the exact Medicaid levels this plan accepts.

Could a Medicare Savings Program help?

Medicare Savings Programs are run by each state. The 2026 federal baseline monthly income limits are:

  • QMB: $1,350 for one person or $1,824 for a married couple
  • SLMB: $1,616 for one person or $2,184 for a married couple
  • QI: $1,816 for one person or $2,455 for a married couple

Alaska, Hawaii, and some states use different limits or resource rules. Qualifying for an MSP does not by itself confirm eligibility for this D-SNP. Apply through your state Medicaid office.

Learn about QMB, SLMB, and QI

Costs and copays

Deductibles, yearly limit, visits, hospital stays and drug tiers
DeductiblesMedical · $700 for drugs
$0
Yearly limitIn-network care, not counting drugs
$3,600
Primary doctorPer visit
$0
SpecialistPer visit · referral needed
$25
Hospital stayPer stay
Days 1-8: $290/day, Days 9-90: $0/day
Inpatient mental healthHospital stay
Days 1-8: $250/day, Days 9-90: $0/day
Outpatient surgeryPer procedure
$0–$500
Emergency roomPer visit
$150
Urgent carePer visit
$35
Tier 1 · Preferred Generic30-day supply at a retail pharmacy
$0
Tier 2 · Generic30-day supply at a retail pharmacy
25%
Tier 3 · Preferred Brand30-day supply at a retail pharmacy, after deductible
28%
Tier 4 · Non-Pref Brand30-day supply at a retail pharmacy, after deductible
25%
Tier 5 · Specialty30-day supply at a retail pharmacy, after deductible
25%
Tier 6 · Drugs30-day supply at a retail pharmacy, after deductible
$0

This plan is for people with Medicaid. What you pay depends on your Medicaid level: with QMB, your share of Medicare-covered services is covered; with full Medicaid benefits, your state may also cover Medicaid-covered services. Your state Medicaid office can confirm your level — or call us at 1-866-764-3312 (TTY 711) and a Licensed Medicare Advisor will help confirm it and discuss this plan's details with you. If you lose Medicaid eligibility, you may be billed the plan's cost sharing.

Our take

Where this plan shines, and what to know

Where this plan shines

  • This plan’s out-of-pocket maximum ($3,600) is among the lowest available.
  • See your primary doctor for $0.
  • The specialist copay ($25) is among the more affordable options.
  • No separate medical deductible.
  • Some out-of-network care is covered (HMO-POS).

Things to know before you enroll

  • Limited coverage while traveling outside the plan’s service area.

Similar plans

Other Medicare Advantage plans offered in Missouri

Common questions

6 answers about this plan

What does Wellcare Home State Health Dual Reserve (HMO-POS D-SNP) (HMOPOS) cover?

Wellcare Home State Health Dual Reserve (HMO-POS D-SNP) (HMOPOS) is a Dual Eligible Special Needs Plan, a Medicare Advantage plan for people who have Medicare and a Medicaid category the plan accepts. The plan record also identifies Part D prescription drug coverage. Its published drug benefit lists 6 formulary tiers. Published supplemental benefits include dental (Preventive & comprehensive dental ($0 copay)), vision ($300/yr eyewear allowance), and fitness ($0 fitness benefit). Review the plan documents for covered services, limits, and rules. Coverage can change each plan year.

Learn about Medicare Advantage

How much does Wellcare Home State Health Dual Reserve (HMO-POS D-SNP) (HMOPOS) cost in 2027?

The published 2027 monthly plan premium for Wellcare Home State Health Dual Reserve (HMO-POS D-SNP) (HMOPOS) is $18.40. Any Medicare premiums you owe are separate from the listed plan premium. The listed medical deductible is $0. The listed Part D deductible is $700. The in-network medical out-of-pocket maximum is $3,600; it does not include Part D drug spending. Published visit costs include primary care $0 and specialist visits $25. Member costs can depend on the Medicaid category the plan accepts and verifies. These figures are plan data, not a personal yearly-cost estimate.

Understand Medicare drug-cost limits

Can I use my current doctors with Wellcare Home State Health Dual Reserve (HMO-POS D-SNP) (HMOPOS)?

CMS lists Wellcare Home State Health Dual Reserve (HMO-POS D-SNP) (HMOPOS) as a HMOPOS plan. The plan record says specialist referrals are required. The record also identifies point-of-service flexibility, but exact out-of-network rules can vary. A network label alone does not confirm that a specific doctor participates. Use the doctor lookup tool, then confirm with the doctor's office and the plan before receiving care. Provider networks and member costs can change. Emergency care and travel coverage can follow different network rules.

Check your doctors

Do I qualify for Wellcare Home State Health Dual Reserve (HMO-POS D-SNP) (HMOPOS)?

Wellcare Home State Health Dual Reserve (HMO-POS D-SNP) (HMOPOS) is listed in the current plan record as a D-SNP. You must be entitled to Medicare Part A, enrolled in Part B, and have a Medicaid category this plan accepts. The plan must verify your Medicaid status. Eligibility alone does not create a year-round right to enroll.

Learn about Medicare Savings Programs

What extra benefits does Wellcare Home State Health Dual Reserve (HMO-POS D-SNP) (HMOPOS) offer for dual-eligible members?

The current plan record for Wellcare Home State Health Dual Reserve (HMO-POS D-SNP) (HMOPOS) lists dental (Preventive & comprehensive dental ($0 copay)), vision ($300/yr eyewear allowance), and fitness ($0 fitness benefit). Member costs can depend on the Medicaid category the plan accepts and verifies. The record identifies Part D prescription drug coverage. Review the plan documents for benefit limits, eligibility rules, and how Medicare and Medicaid coverage work together.

When can I enroll in Wellcare Home State Health Dual Reserve (HMO-POS D-SNP) (HMOPOS)?

Wellcare Home State Health Dual Reserve (HMO-POS D-SNP) (HMOPOS) is a 2027 Medicare Advantage plan. The Annual Enrollment Period runs from October 15 through December 7, with changes taking effect January 1. The Medicare Advantage Open Enrollment Period runs from January 1 through March 31 for people already enrolled in Medicare Advantage. Because this is a D-SNP, the plan must also verify its eligibility requirements. A qualifying circumstance may create a Special Enrollment Period, but eligibility alone does not guarantee a year-round right to enroll. Confirm the enrollment window and effective date that apply to you before changing coverage.

Review Medicare enrollment periods

Plan documents

Evidence of Coverage

Enter your ZIP code to see how you can enroll

Enrollment options depend on where you live. Enter your ZIP code so we can show the right ways to enroll in this plan.

Wellcare Home State Health Dual Reserve H1664-012 — 2027