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Wellpoint Kidney Care (HMO-POS C-SNP)

Medicare Advantage Health Plan Details

Chronic Condition (C-SNP)

Health insurance company offering plan: Wellpoint

Wellpoint
$0 /mo
monthly premium
Wellpoint Kidney Care (HMO-POS C-SNP)
Additional Coverage
Overall Star Rating (2026)
  • Rx
  • Dental
  • Vision
  • Hearing
3.5
out of 5 stars

General Plan Details

Medical Deductible
$0
Out-of-Pocket Maximum
$9250
Rx Drug Coverage
Yes
Rx Deductible
$350
Primary Doctor Office Visit
$0 copay
Specialist Office Visit
$0 copay

Additional Benefits

Dental Coverage
Yes
Vision Coverage
Yes
Mental Health Coverage
Yes
Transportation for non-emergency
Yes
Fitness Benefits
Yes
Worldwide emergency
No
Telehealth
Yes
Part B Premium Reduction
No

We're Here to Help You Enroll

Or Call for Live Support from Licensed Insurance Agents

(888) 311-4264
TTY 711

Mon-Fri: 8am-10pm, Sat-Sun: 8am-9pm ETNo Obligation to Enroll

Doctor & Hospital Coverage

Primary Doctor Office Visit
In-network: $0 copay
Out-of-network: $0 copay
Specialist Office Visit
In-network: $0 copay
Out-of-network: $0 copay
Periodic Exam Coverage
In-network: $0 copay
Out-of-network: 20% coinsurance

Emergency Room

$115 copay

Ambulance Coverage

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

Lab, X-Ray, Radiology Coverage

Diagnostic tests & procedures:
In-network: 20% coinsurance
Out-of-network: 20% coinsurance
Lab services:
In-network: 20% coinsurance
Out-of-network: 20% coinsurance
Diagnostic radiology services (e.g., CT, MRI, etc):
In-network: 20% coinsurance
Out-of-network: 20% coinsurance
Outpatient x-rays:
In-network: 20% coinsurance
Out-of-network: 20% coinsurance

Hospital Services

Inpatient hospital coverage:
In-network:
  Tier 1
  $0 per day for days 1-60
  $419 per day for days 61-90
  $838 per day for days 91-150
Out-of-network:
  $0 per day for days 1-60
  $419 per day for days 61-90
  $838 per day for days 91-150
Outpatient hospital coverage:
In-network: 20% coinsurance
Out-of-network: 20% coinsurance

Rehabilitation Coverage

Occupational therapy services:
In-network: 20% coinsurance
Out-of-network: 20% coinsurance

Urgent Care Coverage

$115 copay

Skilled Nursing Facility (SNF)


Out-of-network:
  $ per stay

Mental Health Coverage

Outpatient group therapy with a psychiatrist:
In-network: 20% coinsurance
Out-of-network: 20% coinsurance
Outpatient individual therapy with a psychiatrist:
In-network: 20% coinsurance
Out-of-network: 20% coinsurance
Outpatient group therapy visits:
In-network: 20% coinsurance
Out-of-network: 20% coinsurance
Outpatient individual therapy visit:
In-network: 20% coinsurance
Out-of-network: 20% coinsurance

Dental, Vision, Hearing Benefits

Dental Services

Oral exams:
In-network: $0 copay
Out-of-network: 20%-50% coinsurance
Prophylaxis (cleaning):
In-network: $0 copay
Out-of-network: 20%-50% coinsurance
Dental x-rays:
In-network: $0 copay
Out-of-network: 20%-50% coinsurance

Vision Benefits

Routine eye exams:
In-network: $0 copay
Out-of-network: $0 copay
Contact Lenses:
In-network: $0 copay
Out-of-network: $0 copay
Eyeglasses:
In-network: $0 copay
Out-of-network: $0 copay

Hearing Benefits

Hearing exam:
In-network: $0 copay
Out-of-network: $0 copay
Fitting/evaluation:
In-network: $0 copay
Out-of-network: $0 copay
Hearing aids - prescription:
In-network: $0 copay
Out-of-network: $0 copay
Hearing aids - over the counter:
In-network: $0 copay
Out-of-network: $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

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

Tier 3: Preferred Brand

10% coinsurance (30-day supply)
10% coinsurance (90-day supply)

Tier 4: Non-Preferred Drug

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

Tier 5: Specialty Tier

29% coinsurance (30-day supply)

Rx Drug Coverage - Standard Retail Cost

Tier 1: Preferred Generic

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

Tier 2: Generic

$10.00 copay (30-day supply)
$30.00 copay (90-day supply)

Tier 3: Preferred Brand

15% coinsurance (30-day supply)
15% coinsurance (90-day supply)

Tier 4: Non-Preferred Drug

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

Tier 5: Specialty Tier

29% coinsurance (30-day supply)

Tier 1: Preferred Generic

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

Tier 2: Generic

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

Tier 3: Preferred Brand

10% coinsurance (30-day supply)
10% coinsurance (90-day supply)

Tier 4: Non-Preferred Drug

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

Tier 5: Specialty Tier

29% coinsurance (30-day supply)

Additional Added Benefits

Annual physical exams
Yes
Chiropractic Coverage
No
Acupuncture
No
Massage Therapy
No
Health Education
No
Counseling Services
No
Support for Caregivers of Enrollees
No
Personal Emergency Response System (PERS)
Yes
In-home support services
No
Home and bathroom safety devices
No
Meals for short duration
Yes

Plan Links

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Mon-Fri: 8am-10pm, Sat-Sun: 8am-9pm ET
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Where This Plan is Available

State:
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Additional Plan Info

Plan Year:
2026
Insurance Company Website:
Wellpoint

Health Insurance Companies Offering Plans

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

  • Aetna Medicare
  • Anthem Blue Cross Blue Shield
  • Anthem Blue Cross
  • Anthem Blue Cross and Blue Shield
  • Aspire Health Plan
  • Baylor Scott & White Health Plan
  • Capital Blue Cross
  • Cigna Healthcare
  • Dean Health Plan
  • Devoted Health
  • Florida Blue Medicare
  • Freedom Health
  • GlobalHealth
  • Health Care Service Corporation
  • Healthy Blue
  • HealthSun
  • Humana
  • Molina Healthcare
  • Mutual of Omaha
  • Medica Central Health Plan
  • Optimum HealthCare
  • Premera Blue Cross
  • SCAN Health Plan
  • Simply
  • UnitedHealthcareⓇ
  • Wellcare
  • WellPoint