Wellcare Assist Compass (HMO)

Health Insurance Company: Wellcare

Medicare Advantage Plan Details

Wellcare
$24 /mo
monthly premium
Wellcare Assist Compass (HMO)
Additional Coverage
Overall Star Rating (2024)
  • Rx
  • Dental
  • Vision
  • Hearing
3
out of 5 stars

General Plan Details

Medical Deductible
$0
Out-of-Pocket Maximum
$3850
Rx Drug Coverage
Yes
Rx Deductible
$160

Additional Benefits

Dental Coverage
Yes
Vision Coverage
Yes
Mental Health Coverage
Yes
Chiropractic Coverage
No
Optional Supplemental Benefits
No
Part B Give Back
No

Doctor & Hospital Coverage

Primary Doctor Office Visit
$0 copay
Specialist Office Visit
$35 copay per visit
Periodic Exam Coverage
$0 copay

Emergency Room

$135 copay per visit (always covered)

Ambulance Coverage

$275 copay

Lab, X-Ray, Radiology Coverage

Outpatient diag procs/tests/lab services:
Medicare-covered diagnostic procedures/tests: $0-20 copay
Medicare-covered lab services: $0-50 copay
Outpatient diag/therapeutic rad services:
Medicare-covered diagnostic radiological services (e.g., CT, MRI, etc): $0-275 copay
Medicare-covered x-ray services: $0 copay

Outpatient Surgery Coverage

Outpatient hospital:
Medicare-covered outpatient hospital services: $0-275 copay per visit

Hospitalization Coverage

Inpatient hospital-acute:
$325 per day for days 1 through 5
$0 per day for days 6 through 90
Inpatient hospital psychiatric:
$325 per day for days 1 through 5
$0 per day for days 6 through 90

Rehabilitation Coverage

Occupational therapy services:
$35 copay
Physical therapy and speech and language therapy services:
$35 copay

Urgent Care Coverage

$30 copay per visit (always covered)

Skilled Nursing Facility (SNF)

$0 per day for days 1 through 20
$203 per day for days 21 through 40
$0 per day for days 41 through 100

Mental Health Coverage

Medicare-covered individual sessions: $40 copay
Medicare-covered group sessions: $40 copay

Dental, Vision, Hearing Benefits

Dental Services

Oral exams: $0 copay
Prophylaxis (cleaning): $0 copay
Dental x-rays: $0 copay

Vision Benefits

Eye exams:
Routine eye exams: $0 copay
Eyewear:
Contact Lenses: $0 copay
Eyeglasses: $0 copay

Hearing Benefits

Hearing exams:
Routine hearing exams: $35 copay
Hearing aids:
Hearing aids (all types): $0 copay

Rx Drug Coverage - Preferred Retail Cost

Tier 1: Preferred Generic

$0.00 copay (30-day supply)
$0.00 copay (90-day supply)

Tier 2: Generic

$20.00 copay (30-day supply)
$60.00 copay (90-day supply)

Tier 3: Preferred Brand

$47.00 copay (30-day supply)
$141.00 copay (90-day supply)

Tier 4: Non-Preferred Drug

50% coinsurance (30-day supply)
50% coinsurance (90-day supply)

Tier 5: Specialty Tier

25% coinsurance (30-day supply)

Rx Drug Coverage - Standard Retail Cost

Tier 1: Preferred Generic

$19.00 copay (30-day supply)
$57.00 copay (90-day supply)

Tier 2: Generic

$20.00 copay (30-day supply)
$60.00 copay (90-day supply)

Tier 3: Preferred Brand

$47.00 copay (30-day supply)
$141.00 copay (90-day supply)

Tier 4: Non-Preferred Drug

50% coinsurance (30-day supply)
50% coinsurance (90-day supply)

Tier 5: Specialty Tier

25% coinsurance (30-day supply)

Rx Drug Coverage - Standard Mail Order Cost

Tier 1: Preferred Generic

$19.00 copay (30-day supply)
$57.00 copay (90-day supply)

Tier 2: Generic

$20.00 copay (30-day supply)
$60.00 copay (90-day supply)

Tier 3: Preferred Brand

$47.00 copay (30-day supply)
$141.00 copay (90-day supply)

Tier 4: Non-Preferred Drug

50% coinsurance (30-day supply)
50% coinsurance (90-day supply)

Tier 5: Specialty Tier

25% coinsurance (30-day supply)

Rx Drug Coverage - Preferred Mail Order Cost

Tier 1: Preferred Generic

$0.00 copay (30-day supply)
$0.00 copay (90-day supply)

Tier 2: Generic

$20.00 copay (30-day supply)
$0.00 copay (90-day supply)

Tier 3: Preferred Brand

$47.00 copay (30-day supply)
$94.00 copay (90-day supply)

Tier 4: Non-Preferred Drug

50% coinsurance (30-day supply)
50% coinsurance (90-day supply)

Tier 5: Specialty Tier

25% coinsurance (30-day supply)

Plan Links

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Where This Plan is Available

Additional Plan Info

Year:
2024
Plan ID:
H1416-041-0
Insurance Company Website:
Wellcare

Health Insurance Companies Offering Plans

Medicare Advantage and Part D plans and benefits offered by the following carriers:

  • Aetna Medicare
  • Anthem Blue Cross Blue Shield
  • Aspire Health Plan
  • Dean Health Plan
  • Devoted Health
  • GlobalHealth
  • Health Care Service Corporation
  • Cigna Healthcare
  • Humana
  • Medica Central Health Plan
  • Molina Healthcare
  • Mutual of Omaha
  • Premera Blue Cross
  • SCAN Health Plan
  • Scott and White Health Plan now part of Baylor Scott & White Health
  • UnitedHealthcareⓇ
  • Wellcare