Medicare Advantage · HMO
WellSense Health Plan
Plan year 2026

WellSense Added Value H6851-001 (HMO)

3.0 · 2026 Star Rating · source: CMS · Ratings are updated annually
Monthly premium
$21.70
+ your Part B premium
Max out-of-pocket
$8,750
in-network annual cap
Primary care
20%
per visit copay
Specialist
20%
per visit

Your costs at a glanceIn-network, for the 2026 plan year

Rx deductible
$615
Inpatient hospital
Days 1-4: $610/day, Days 5-90: $0/day
Inpatient mental health
Days 1-5: $415/day, Days 6-90: $0/day
Outpatient surgery
20%
Emergency room
$115
Urgent care
$40

What's included, and what it's actually worth3 benefits included. Tap any card for the detail

OTC allowance

$250/quarter OTC allowance
Prepaid card$250/quarter OTC allowance
See more details about this plan
Doctor Visits: PCP20%
In-network20% per visit
Doctor Visits: Specialist20%
In-network20% per visit
Inpatient Hospital$610/day, days 1–4
In-networkDays 1-4: $610/day, Days 5-90: $0/day
Outpatient Surgery20%
In-network20% per procedure
Mental HealthDays 1-5: $415/day, Days 6-90: $0/day
Inpatient psychiatricDays 1-5: $415/day, Days 6-90: $0/day
VisionRoutine vision benefit
DetailsRoutine vision benefit
This is a supplemental benefit with plan-specific limits. See plan documents for details.
MealsMeal benefit

Your coverageCheck your coverageFrom the doctors and prescriptions you added

Your plan's drug tiers30-day retail · after any applicable deductible

Tier 1
25%
Preferred Generic

Our take

Things to know before you enroll

This plan’s out-of-pocket maximum is above the national median.
Network restriction — you’ll need to use in-network providers except in emergencies.
Limited coverage while traveling outside the plan’s service area.
Questions? Talk to a licensed agent at1-866-764-3312 (TTY: 711)

Plan documents

Plan questions

Common questions about WellSense Added Value (HMO)

What does WellSense Added Value (HMO) cover?

WellSense Added Value (HMO) is a Medicare Advantage plan that the current plan record identifies as including Part D prescription drug coverage. The plan record also identifies Part D prescription drug coverage. Its published drug benefit lists 1 formulary tiers. Published supplemental benefits include vision (Routine vision benefit), over-the-counter (OTC) ($250/quarter OTC allowance), and meals (Meal benefit). Review the plan documents for covered services, limits, and rules. Coverage can change each plan year.

Learn about Medicare Advantage

How much does WellSense Added Value (HMO) cost in 2026?

The published 2026 monthly plan premium for WellSense Added Value (HMO) is $21.70. The standard Part B premium is $202.90/month in 2026 for most people; assistance may pay it for some members. The listed Part D deductible is $615. The in-network medical out-of-pocket maximum is $8,750; it does not include Part D drug spending. Published visit costs include primary care 20% and specialist visits 20%. These figures are plan data, not a personal yearly-cost estimate.

Understand Medicare drug-cost limits

Can I use my current doctors with WellSense Added Value (HMO)?

CMS lists WellSense Added Value (HMO) as a HMO plan. 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

Does WellSense Added Value (HMO) cover my prescriptions?

WellSense Added Value (HMO) has 1 published formulary tiers in the current plan record. Published preferred-pharmacy 30-day retail costs include Tier 1 at 25%. The listed Part D deductible is $615. A tier listing does not confirm that a specific prescription is covered. Check each medication against the plan's current formulary, restrictions, pharmacy network, and costs before enrolling.

Check your prescriptions

What dental, vision, and hearing benefits does WellSense Added Value (HMO) include?

The current plan record for WellSense Added Value (HMO) lists vision (Routine vision benefit). It also lists over-the-counter (OTC) ($250/quarter OTC allowance). The current data does not list dental and hearing as offered benefits. Benefit allowances, frequency, eligibility, and participating providers can have additional limits, so review the Summary of Benefits or Evidence of Coverage for the complete rules.

When can I enroll in WellSense Added Value (HMO)?

WellSense Added Value (HMO) is a 2026 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. A qualifying circumstance may create a Special Enrollment Period outside those dates. Confirm the enrollment window and effective date that apply to you before changing coverage.

Review Medicare enrollment periods

More plan options

Browse the full 2026 Medicare Advantage with drug coverage directory. This plan is offered in New Hampshire. Plan availability can vary by county.

Helpful next steps

WellSense Added Value H6851-001 (HMO) — 2026 Costs & Benefits