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Wellcare Assist (HMO) is a HMO Medicare Advantage (Medicare Part C) plan offered by Wellcare Health Plans, Inc.
Plan ID: H1416-042
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$21.70
Monthly Premium
Wellcare Assist (HMO) is a HMO Medicare Advantage (Medicare Part C) plan offered by Wellcare Health Plans, Inc.
Plan ID: H1416-042
Have Medicare questions?
Talk to a licensed agent today to find a plan that fits your needs.
Get Medicare Help
2.5 out of 5 stars
Wellcare Assist (HMO) is a HMO Medicare Advantage (Medicare Part C) plan offered by Wellcare Health Plans, Inc.
Plan ID: H1416-042
Have Medicare questions?
Talk to a licensed agent today to find a plan that fits your needs.
Get Medicare Help
$21.70
Monthly Premium
Tennessee Counties Served
Fayette Shelby Loudon Grainger Blount Monroe Rhea Hamblen Sevier Union Claiborne Meigs Morgan Campbell Hanco*ck Anderson co*cke Scott Jefferson Knox Jackson Robertson Hamilton Cannon Houston Clay Carter Dekalb Benton Bedford Polk Weakley Haywood Marion Wilson Perry Mcnairy Montgomery Hickman Greene Moore Sullivan Gibson Roane Warren Carroll Tipton Giles Dickson Smith Lake Trousdale Bradley Lewis Lincoln Hawkins Henry Davidson Sequatchie Williamson Hardeman Putnam Hardin Bledsoe Dyer Mcminn Lauderdale Johnson Chester Stewart Pickett Madison White Grundy Van Buren Rutherford Obion Decatur Washington Wayne Coffee Humphreys Crockett Marshall Unicoi Overton Henderson Macon Sumner Maury Lawrence Cheatham Fentress Cumberland Franklin
Basic Costs and Coverage
Coverage | Cost |
---|---|
Monthly Deductible | $365 |
Out of Pocket Max | In-Network: $4900 Out-of-Network: N/A |
Initial Coverage Limit | $5030 |
Catastrophic Coverage Limit | $8,000 |
Primary Care Doctor Visit | In-Network: Doctor Office Visit: |
Specialty Doctor Visit | In-Network: Doctor Specialty Visit: |
Inpatient Hospital Care | In-Network: Acute Hospital Services: |
Urgent Care | Copayment for Urgent Care $30.00 Worldwide Coverage: |
Emergency Room Visit | Copayment for Emergency Care $120.00 Worldwide Coverage: |
Ambulance Transportation | In-Network: Ground Ambulance: Air Ambulance: Please see Evidence of Coverage for Prior Authorization rules |
Health Care Services and Medical Supplies
Wellcare Assist (HMO) covers additional benefits and services, some of which may not be covered by Original Medicare (Medicare Part A and Part B).
Coverage | Cost |
---|---|
Chiropractic Services | In-Network: |
Diabetes Supplies, Training, Nutrition Therapy and Monitoring | In-Network: |
Durable Medical Eqipment (DME) | In-Network: |
Diagnostic Tests, Lab and Radiology Services, and X-Rays | In-Network: Outpatient Diag Procs/Tests/Lab Services: Outpatient Diag/Therapeutic Rad Services: |
Home Health Care | In-Network: |
Mental Health Inpatient Care | In-Network: Psychiatric Hospital Services: |
Mental Health Outpatient Care | In-Network: |
Outpatient Services / Surgery | In-Network: Outpatient Hospital Services: Outpatient Observation Services: Ambulatory Surgical Center Services: |
Outpatient Substance Abuse Care | In-Network: |
Over-the-counter (OTC) Items | In-Network: Over-The-Counter (OTC) Items: |
Podiatry Services | In-Network: |
Skilled Nursing Facility Care | In-Network: Skilled Nursing Facility Services: |
Dental Benefits
The following dental services are covered from in-network providers.
Coverage | Cost |
---|---|
Dental Care | In-Network: Preventive Dental:
Copayment for Prophylaxis (Cleaning) $0.00
Copayment for Fluoride Treatment $0.00
Copayment for Dental X-Rays $0.00
Referral Required for Preventive Dental Comprehensive Dental:
Copayment for Diagnostic Services $0.00
Copayment for Restorative Services $0.00
Copayment for Endodontics $0.00
Copayment for Periodontics $0.00
Copayment for Extractions $0.00
Copayment for Prosthodontics, Other Oral/Maxillofacial Surgery, Other Services $0.00
Maximum Plan Benefit of $3000.00 every year for Non-Medicare Covered Comprehensive |
Vision Benefits
The following vision services are covered from in-network providers.
Coverage | Cost |
---|---|
Vision Benefits | In-Network: Eye Exams:
Prior Authorization Required for Eye Exams Eyewear: |
Hearing Benefits
The following hearing services are covered from in-network providers.
Coverage | Cost |
---|---|
Hearing Benefits | In-Network: Hearing Exams:
Copayment for Fitting/Evaluation for Hearing Aid $0.00
Prior Authorization Required for Hearing Exams Hearing Aids:
Maximum Plan Benefit of $1500.00 every year per ear |
Preventive Services and Health/Wellness Education Programs
The following services are covered from in-network providers.
Coverage | Cost |
---|---|
Preventive Services and Health/Wellness Education Programs | In-Network: Abdominal aortic aneurysm screening
Tobacco use cessation |
Prescription Drug Costs and Coverage
The Wellcare Assist (HMO) plan offers the following prescription drug coverage, with an annual drug deductible of $365 (excludes Tiers 1 and 6) per year.
Coverage | Cost |
---|---|
Coverage & Cost | |
Annual Drug Deductible | $365 (excludes Tiers 1 and 6) |
Preferred Generic |
|
Select Care Drugs |
|
Annual Drug Deductible | $365 (excludes Tiers 1 and 6) |
Preferred Generic |
|
Select Care Drugs |
|
Annual Drug Deductible | $365 (excludes Tiers 1 and 6) |
Preferred Generic |
|
Select Care Drugs |
|
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