Wellcare Home State Health Dual Reserve (HMO-POS D-SNP)

HOME STATE HEALTH PLAN, INC. · 2027 plan year

Plan ID H1664-012-000

HMOPOS★ 3 CMS StarsDual-Eligible SNP
MOOP (in-network)
$3,600
MOOP (combined)
—
Monthly premium
$18.40/mo
Part C $0 + Part D $18.40, before Extra Help
Prescription drugs
Included

This plan in 2026

Plan information

Contract / Plan / Segment
H1664-012-000
Medical deductible
$0 — no deductible
Part D premium
$18.40/mo (part of the monthly premium above)Before Extra Help, which can lower or remove it for people with limited income.
Part D deductible
$700/yr
Also owed
Your Medicare Part B premium, paid separately

More HOME STATE HEALTH PLAN, INC. plans in MO

Benefits & cost sharing

Hospital

BenefitIn-network
Inpatient Hospital — Acute$290/day for days 1–8, $0 after
Inpatient Hospital — Psychiatric$250/day for days 1–8, $0 after
Worldwide Urgent Care Coverage$150

Pharmacy

BenefitIn-network
Part B DrugsSee plan details
Chemotherapy & Radiation Drugs (Part B)0%-20% coinsurance
Other Part B Drugs0%-20% coinsurance

Mental Health

BenefitIn-network
Mental Health Specialty ServicesSee plan details
Mental Health — Individual Sessions$25
Mental Health — Group Sessions$25
Supplemental Health BenefitsSee plan details

Other

BenefitIn-network
Podiatry Services$25
Other Health Care Professional Services$0-$25
Psychiatric ServicesSee plan details
Psychiatric Services — Individual Sessions$25
Psychiatric Services — Group Sessions$25
Outpatient Blood ServicesNo charge
Air Ambulance$250
Durable Medical Equipment (DME)20% coinsurance
Prosthetics & OrthoticsSee plan details
Prosthetic Devices20% coinsurance
Medical Supplies20% coinsurance
Diabetic Supplies & ServicesSee plan details
Diabetic SuppliesNo charge
Diabetic Therapeutic Shoes & Inserts20% coinsurance
Diabetic MonitorsNo charge
Dialysis Services20% coinsurance
Medicare-Covered Preventive ServicesSee plan details
Annual Physical ExamNo charge
Vision — EyewearSee plan details
Vision — Contact LensesNo charge
Vision — Eyeglasses (Lenses & Frames)No charge
Vision — Eyeglass FramesNo charge
Partial Hospitalization Program$190
Intensive Outpatient Program (IOP)$200
Home Health ServicesNo charge
Primary Care Physician ServicesNo charge
Chiropractic Services$20
Occupational Therapy Services$25
Physician Specialist Services$25
Podiatry Services$25
Physical Therapy & Speech-Language Pathology$25
Ambulance ServicesSee plan details
Ground Ambulance$250
Vision — Eyeglass LensesNo charge
Vision — Eyewear UpgradesNo charge
Hearing — Exams$25
Skilled Nursing Facility (SNF)$0/day for days 1–20, $221/day for days 21–40, $0 after
Cardiac & Pulmonary RehabilitationSee plan details
Cardiac Rehabilitation — Additional Sessions$55
Intensive Cardiac Rehabilitation — Additional Sessions$70
Pulmonary Rehabilitation — Additional Sessions$40
Supervised Exercise Therapy (SET)$30
Emergency Services$150
Urgently Needed Services$35
Worldwide Emergency & Urgent CoverageSee plan details
Worldwide Emergency Coverage$150
Additional Telehealth Services (Part B)$0-$35
Opioid Treatment Program Services$25
Diagnostic Tests & Lab ServicesSee plan details
Diagnostic Procedures & Tests$0-$30
Laboratory Services$0-$50
Radiological ServicesSee plan details
Diagnostic Radiology$0-$400
Therapeutic Radiology20% coinsurance
X-Ray Services$50
Outpatient Hospital Services$0-$500
Hospital Observation Services$150-$500 per stay
Ambulatory Surgical Center (ASC)$200
Outpatient Substance Abuse ServicesSee plan details
Substance Abuse — Individual Sessions$25
Substance Abuse — Group Sessions$25
Fitness BenefitNo charge
Remote Access TechnologiesNo charge
Alternative TherapiesNo charge
Kidney Disease Education Services20% coinsurance
Glaucoma ScreeningNo charge
Diabetes Self-Management TrainingNo charge
Digital Rectal ExamsNo charge
Welcome to Medicare EKGNo charge
Insulin (Part B)$35
Dental — Medicare-Covered Services$25
Vision — EyewearNo charge
Dental — PreventiveSee plan details
Dental — Oral ExamsNo charge
Dental — X-RaysNo charge
Dental — Diagnostic ServicesNo charge
Dental — Prophylaxis (Cleaning)No charge
Dental — Fluoride TreatmentNo charge
Dental — Other Preventive ServicesNo charge
Dental — ComprehensiveSee plan details
Dental — Adjunctive General ServicesNo charge
Vision — Eye Exams$0-$25
Vision — Eye ExamsSee plan details
Vision — Routine Eye ExamsNo charge
Vision — Other Eye ServicesNo charge

Service area

  • MO: 49 counties

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