Wellcare Dual Access
Wellcare Dual Access bridges the gap between Medicare and Medicaid, providing an integrated healthcare solution for those eligible for both programs. It’s designed to enhance benefits while curtailing costs.
This guide explains the plan’s eligibility criteria, services, and how it compares to Original Medicare.
Key Takeaways
- The Wellcare Dual Access Plan is a comprehensive healthcare plan for individuals eligible for both Medicare and Medicaid, offering broader coverage than Original Medicare, including Part A, Part B, and prescription drug services, as well as supplemental benefits.
- Members of the Wellcare Dual Access Plan have access to resources such as the 24-Hour Nurse Advice Line, the Krames Health Library, and enhanced support for managing their health plan online with personal support, enabling them to make informed healthcare decisions and manage their health efficiently.
- Wellcare Dual Access coordinates Medicare and Medicaid benefits, offering seamless coverage with reduced out-of-pocket expenses, and comes with additional member perks like dental, hearing, vision, fitness, and more without extra costs, promoting a simplified and comprehensive healthcare experience.
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Unveiling Wellcare Dual Access: A Comprehensive Medicare Advantage Plan
The Wellcare Dual Access Medicare Advantage Plan is an inclusive healthcare solution that provides Medicare coverage for all Medicare-covered Part A and Part B services, including prescription drugs.
It also offers supplemental non-Medicare services such as routine dental, vision, and hearing care, ensuring you have all the enhanced benefits you need.
The Wellcare Dual Access Plan is designed for individuals eligible for both Medicare and Medicaid. As a result, it offers more extensive coverage than Original Medicare, serving as a comprehensive solution for healthcare needs.
Essential Documents for Your Plan Management
Upon joining the Wellcare Dual Access Plan, you will receive vital documents such as the Summary of Benefits and the Evidence of Coverage.
The Summary of Benefits provides a broad view of the plan’s costs and coverage, while the Evidence of Coverage delves into the specifics of the plan’s coverage, costs, and benefits, including any additional coverage.
These documents are crucial for understanding your healthcare benefits and cost assistance.
To access these documents, you just need to visit the Wellcare website. They can be found in the Wellcare Dual Access Essential Plan Document, which provides insights into your plan’s benefits, rights, and additional support.
This method provides a convenient way to access all the information you need.
How to Access Your Health Plan Resources Online
Managing your health plan is made easy with Wellcare’s Member Account Login feature. This feature on the Wellcare website allows you to manage your health plan online, offering personal support and easy access to your plan information.
To access your health plan online, you’ll need:
- Your Member ID Card
- A selected Primary Care Provider (PCP)
- Reviewed Plan Benefits
- Scheduled Preventive Screenings and Annual check-ups
By following these steps, you can maximize the benefits of your Wellcare Dual Access health plan.
Enhanced Support with 24-Hour Nurse Advice Line
One of the benefits of the Wellcare Dual Access Plan is the 24-Hour Nurse Advice Line. This service provides medical guidance and support for urgent decision-making at no additional cost.
Whether you’re facing a health emergency or just need some advice, you can count on this service for helpful answers.
The 24-Hour Nurse Advice Line is staffed by unrestricted, licensed RNs who have at least three recent years of clinical experience. These nurses boast an average of over 15 years of clinical and five years of telehealth experience, covering both adult and pediatric health.
To get in touch with the Wellcare 24-Hour Nurse Advice Line, you can call 1-800-581-9952 (TTY: 711) at any hour.
Tailored Health Education through Krames Health Library
The Krames Health Library is an extensive patient education resource that features over 4,000 topics covering health and medication.
It includes:
- Patient education materials
- Handouts
- Booklets
- Over 6,000 images
- 4,000 HealthSheets®
These resources are designed to provide you with comprehensive health information that caters to your individual health needs.
The Krames Health Library offers:
- Customized content catering to individual health needs
- Educational materials across various specialties
- Personalized learning opportunities
- Enhanced patient engagement
Krames Online provides easy access to these resources, offering an abundance of information at your convenience.
Additional Wellness Tools in the Krames/StayWell Library
In addition to the Krames Health Library, you also have access to the wellness tools in the Krames/StayWell Library. Accessing these tools is a breeze through Krames Online, which offers access to over 4,000 topics on health and medication.
The Krames/StayWell Library offers a variety of resources designed to promote understanding and management of health conditions, and lifestyle improvements.
These resources include:
- Tools
- Assessments
- Educational materials
- Specialized health content
- Information on a wide range of health conditions
Thus, the Krames/StayWell Library provides reliable and effective resources for enhancing your health.
Seamless Coordination of Medicare and Medicaid Benefits
The Wellcare Dual Access Plan offers the following benefits:
- Simplified coordination of Medicare and Medicaid benefits
- Reduced out-of-pocket expenses and no extra cost
- Enhanced healthcare benefits compared to Original Medicare
- Access to supplementary support and cost support benefits at no additional cost
By enrolling in a Dual Eligible Special Needs Plan (D-SNP), you can take advantage of these benefits.
The plan addresses the complexity of coordinating Medicare and Medicaid benefits by enrolling dual-eligible individuals in Dual Eligible Special Needs Plans (D-SNPs).
These plans have contracts with Medicare and state Medicaid agencies to coordinate the various benefits from both programs, providing you with comprehensive coverage for all your healthcare needs.
The Advantages of Dual Eligible Special Needs Plans (D-SNP)
D-SNPs are specialized HMO D SNP plans aimed at providing enhanced benefits and reduced out-of-pocket expenses compared to Original Medicare, in collaboration with Medicaid coverage.
Wellcare integrates D-SNPs as a Medicare Advantage plan, offering supplementary assistance and benefits without additional charges for individuals eligible for both Medicaid and Medicare.
To be eligible for a D-SNP, you must qualify for both Medicare and Medicaid. Consequently, you can choose a plan without waiting for the Annual Enrollment Period.
But bear in mind, you cannot opt for a separate Part D plan while enrolled in a Medicare Advantage D-SNP as it already includes prescription drug coverage within its network.
Simplifying Prescription Drug Coverage
Wellcare simplifies Medicare and Medicaid prescription drug coverage by providing plans that offer prescription drug coverage for individuals with both Medicare and full Medicaid.
The Medicare Advantage plans encompass outpatient prescription drug coverage under Medicare Part D and include both brand name and generic drugs.
Acquiring prescription drug coverage through Wellcare is straightforward. You can enroll through a meeting with a Licensed Representative, visit www.wellcare.com/PDP, or call 1-877-MY-WELLCARE (TTY: 711).
Additionally, coverage determination can be requested by phone at 1-888-550-5252. This ensures that your prescription drug coverage is as comprehensive as your healthcare coverage.
Partnering with Your Primary Care Provider (PCP)
In the Wellcare Dual Access D-SNP plan, having a Primary Care Provider (PCP) is of paramount importance. Your PCP ensures a smooth delivery of care through routine healthcare and coordination with other benefits and services.
When selecting a PCP within the Wellcare D-SNP plan, make sure they are part of Wellcare’s network for better understanding of your health needs and a well-coordinated care with other providers.
Wellcare enhances the collaboration with your PCP by promoting effective communication and trust. They do this by offering a community advocacy team, a Care Management program for referrals, and by providing your PCP with essential health information.
This ensures that you have a strong partnership with your PCP, enhancing your healthcare experience.
Exclusive Member Perks and Assistance Services
As a Wellcare Dual Access member, you have access to a variety of exclusive benefits, as well as additional benefits. These include:
- Dental
- Hearing
- Vision
- Fitness
- Over the counter benefits
- Telehealth
- Transportation
- Member discounts
- Medical alert system discounts
- Healthy lifestyle rewards
- $0 prescription
- Healthy foods benefits
- Preventive services
- My Wellcare Rewards Program
Wellcare Dual Access facilitates healthcare communication by offering multi-language interpreter services. You can even authorize the direct withdrawal of your monthly premiums from your bank accounts using a form provided by Wellcare, making the payment process easier.
These perks and assistance services aim to make your healthcare journey as seamless as possible.
Summary
In conclusion, the Wellcare Dual Access Medicare Advantage Plan provides a comprehensive solution to your healthcare needs. It offers enhanced benefits, seamless coordination with Medicaid, a 24-Hour Nurse Advice Line, tailored health education through the Krames Health Library, and exclusive member perks and assistance services.
With Wellcare Dual Access, you can be assured of a healthcare plan that caters to your every need.
Frequently Asked Questions
→ Which Wellcare plan is best for dual eligible members?
For dual eligible members, the best Wellcare plan is a Dual Special Needs Plan (D-SNP), which coordinates Medicare and Medicaid benefits.
The Wellcare D-SNP provides additional support and benefits at no extra cost for those who qualify for both Medicaid and Medicare coverage.
→ How does Wellcare differ from Medicare?
Wellcare differs from Medicare as it is a private insurance company that contracts with Medicare to offer Medicare Advantage plans, Part D coverage, and additional benefits such as vision, dental, and hearing care. Medicare, on the other hand, is administered by the federal government.
This allows Wellcare to provide broader coverage and additional benefits compared to Original Medicare.
→ In what states does Wellcare have new all dual DSNP products?
Wellcare has new All-Dual D-SNP products in AL, AR, FL, GA, KY, LA, MI, MS, NC, NM, OH, OK, TX, and WI, offering 23 newly designed plans.
→ Which standalone prescription drug plan is best for a dual eligible chooser?
The Medicare Prescription Drug Plan (Part D) is often considered the best standalone prescription drug plan for dual-eligible members due to its flexibility in coverage and potential for additional assistance.
→ What is the Wellcare Dual Access Medicare Advantage Plan?
The Wellcare Dual Access Medicare Advantage Plan is a comprehensive healthcare solution exclusively available to individuals who qualify for both Medicare and Medicaid, offering coverage for all Medicare-covered services, routine dental, vision, and hearing care, and prescription drugs.
ZRN Health & Financial Services, LLC, a Texas limited liability company
Russell Noga is the CEO of ZRN Health & Financial Services, and head content editor of several Medicare insurance online publications. He has over 15 years of experience as a licensed Medicare insurance broker helping Medicare beneficiaries learn about Medicare, Medicare Advantage Plans, Medigap insurance, and Medicare Part D prescription drug plans.