D-SNP Plan Costs & Benefits

Wellcare 'Ohana Dual Liberty is a Health Maintenance Organization (HMO) plan. HMO plan members usually receive health care services through the plan’s local network of providers. Referrals are almost always required to see a specialist and other providers. However, Wellcare 'Ohana Dual Liberty does allow out-of-network care for emergencies and out-of-area dialysis.

Costs vary widely from plan to plan. It is beneficial to compare costs, including premiums, deductibles, and copays, and apply them to your personal situation.

Healthcare Service	Member Cost
Health plan deductible	$0
Maximum out-of-pocket enrollee responsibility (does not include prescription drugs)	$8,300 In-network
Doctor Visits
Primary	$0 copay
Wellness programs (e.g., fitness, nursing hotline)	Covered
Preventive care	$0 copay
Mental Health Services
Outpatient group therapy visit	$0 copay (authorization required)
Outpatient group therapy visit with a psychiatrist	$0 copay (authorization required)
Outpatient individual therapy visit	$0 copay (authorization required)
Outpatient individual therapy visit with a psychiatrist	$0 copay (authorization required)
Rehabilitation Services
Physical therapy and speech and language therapy visit	$0 copay (authorization required)
Medical Equipment / Supplies
Diabetes supplies	$0 copay (authorization required)
Prosthetics (e.g., braces, artificial limbs)	$0 copay (authorization required)
Diagnostic Procedures / Lab Services / Imaging
Diagnostic tests and procedures	$0 copay (authorization required)
Diagnostic radiology services (e.g., MRI)	$0 copay (authorization required)
Outpatient x-rays	$0 copay (authorization required)
Medicare Part B Drugs
Other Part B drugs	$0 copay (authorization required)
Foot Care (podiatry Services)
Routine foot care	Not covered
Hearing
Fitting/evaluation	$0 copay (referral required, authorization required, limits may apply)
Hearing exam	$0 copay (referral required, authorization required)
Preventive Dental
Dental x-ray(s)	Not covered
Cleaning	Not covered
Oral exam	Not covered
Comprehensive Dental
Prosthodontics, other oral/maxillofacial surgery, other services	$0 copay (authorization required, limits may apply)
Extractions	$0 copay (authorization required, limits may apply)
Restorative services	$0 copay (authorization required, limits may apply)
Endodontics	$0 copay (authorization required, limits may apply)
Non-routine services	$0 copay (authorization required, limits may apply)
Periodontics	$0 copay (authorization required, limits may apply)
Vision
Eyeglass frames	$0 copay (referral required, authorization required, limits may apply)
Upgrades	$0 copay (referral required, authorization required, limits may apply)
Other	Not covered
Contact lenses	$0 copay (referral required, authorization required, limits may apply)
Eyeglasses (frames and lenses)	$0 copay (referral required, authorization required, limits may apply)
Eyeglass lenses	$0 copay (referral required, authorization required, limits may apply)
Emergency Care / Urgent Care
Emergency	$0 copay
Ground ambulance	$0 copay
Inpatient hospital coverage	$0 copay
Outpatient hospital coverage	$0 copay
Skilled Nursing Facility	$0 copay
Optional supplemental benefits	No

Prescription Costs & Benefits

A basic benefit Part D plan is bundled with this health plan. This simply means that Wellcare 'Ohana Dual Liberty covers the minimum amount required by Medicare, whereas enhanced benefit plans cover more of the overall costs and may include more benefits.

Prescription Drug Plan Premium

Although the prescription drug plan (Part D) premium is bundled with the total plan cost, some plans have supplemental costs and/or offer low-income subsidy (LIS) assistance. 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 $505.00. 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 'Ohana Dual Liberty has copayments (a fixed dollar amount) and/or coinsurances (a percentage amount) that you must pay when you pick up your prescriptions. The following table shows you those costs.

CMS 5-Star Rating

Each year Medicare rates D-SNP plans, like Wellcare 'Ohana Dual Liberty, in nine categories. Medicare's plan ratings help consumers understand the quality of care and service they can expect if they qualify and choose to enroll.

Do You Qualify to Join Wellcare 'Ohana Dual Liberty?

Unfortunately, not everyone on Medicare will qualify to join Wellcare 'Ohana Dual Liberty. To join a 2023 Medicare Special Needs Plan in Hawaii County, Hawaii you must be eligible for both Medicare and Medicaid. To qualify for Medicare, you must be age 65 or older. People with SSDI benefits for a disability qualify after 24 months.

Hawaii Medicaid eligibility is based on your income and assets. Here are Hawaii's Medicaid thresholds.

People with Medicare that do not qualify to join Wellcare 'Ohana Dual Liberty, or another SNP plan, are encouraged to explore Medicare Advantage plans in Hawaii County.

Contact Wellcare

The Medicare SNP Plans for Hawaii County, Hawaii information on this page originates from Medicare.gov and was last updated by All Medicare on February 2, 2023.