Wellcare Specialty Simple (HMO-POS C-SNP) Costs & Coverage, Clark County, Nevada

CMS Rating: (3.0 out of 5 stars^*)

Uncover the tailored benefits and costs of Wellcare Specialty Simple (HMO-POS C-SNP), a 2025 Medicare Special Needs Plan crafted to support your specific healthcare requirements. Review this plan to understand how it aligns with your health and financial goals.

This Wellcare HMO-POS C-SNP plan is required to provide all of the same benefits as Original Medicare, but out-of-pocket costs are different. Available to qualified individual living in Clark County, NV, Wellcare Specialty Simple may include extra benefits not covered by Medicare Part A or Part B.

• Doctor Visits
• Foot Care
• Chiropractic
• Urgent & Emergency
• Mental Health
• Rehab Services
• Equipment & Supplies
• Diag, Lab, Imaging
• Part B Drugs
• Dental
• Hearing Aids
• Vision
• Prescriptions

Health Plan Cost Sharing & Benefits

Wellcare Specialty Simple is an HMO-POS (Point-of-Service) plan. While HMO-POS {plan_type_2} plans share many features with traditional Health Maintenance Organization (HMO) plans, they offer greater flexibility by allowing members to access healthcare providers outside the network for certain services. Typically, a referral from your physician is required to go out of network. Additionally, there are separate deductibles for in-network and out-of-network services.

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Prescription Drug Plan Costs & Benefits

Prescription Drug Plan Premium

The following table outlines the prescription drug plan premium details of this plan.

Prescription Drug Plan Deductible

The Medicare Part D annual deductible with this plan is $420.00. This is the amount you must pay at the pharmacy before Wellcare begins paying its share.

Prescription Drug Plan Out-of-Pocket Costs

In addition to the plan's monthly premium and deductible, Wellcare Specialty Simple has out-of-pocket costs that you must pay when you pick up your prescriptions. The following table shows you those costs.

CMS 5-Star Rating Marks

Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates Medicare Advantage {plan_type_2}s across nine broad categories using a 5-star rating system. These star ratings provide insight into the quality of care and service you can expect from this Wellcare plan.

Eligibility Criteria for Enrolling in Wellcare Specialty Simple

To enroll in Wellcare Specialty Simple , you must meet the following criteria:

1. You are eligible for Medicare;
2. You reside within the plan’s service area; and
3. You have been diagnosed with one or more severe or disabling chronic conditions.

This plan is for individuals with cardiovascular disorders, chronic heart failure, and/or diabetes.

Medicare Special Needs Plan Enrollment Periods

After determining your eligibility for Wellcare Specialty Simple , it’s important to be aware of the Medicare Enrollment Periods, which determine when you can enroll in or change your plan. Depending on your circumstances, one of the following periods will apply:

• Initial Enrollment Period (IEP): Your first opportunity to enroll when you become eligible for Medicare.
• Annual Enrollment Period (AEP): The time each year when you can change your Medicare plan or enroll in a new one.
• Special Enrollment Periods (SEPs): Times outside of AEP when you can make changes due to specific circumstances, such as moving to a new area or losing other insurance coverage.

To get a deeper understanding of these enrollment periods, click here to learn more and stay informed about your Medicare choices.

Contact Wellcare

If you qualify for Medicare benefits but have not yet enrolled or verified your enrollment status, you can do so on the Social Security Administration website. You can learn more about the Medicare Advantage program on www.medicare.gov.

Plans Offered through Medicare.org

Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, 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(R), Wellcare, WellPoint.