Wellcare Sunshine Health Dual Access (HMO-POS D-SNP)

Sunshine State Health Plan, Inc. · 2027 plan year

Plan ID H1032-249-000

HMOPOS★ 4 CMS StarsDual-Eligible SNP
MOOP (in-network)
$9,850
MOOP (combined)
—
Monthly premium
$0/mo
Part C $0 + Part D $0
Prescription drugs
Included

This plan in 2026

  • Wellcare Dual Access Sync (HMO D-SNP)

    Plan H1032-244 in 2026, combined into this plan for 2027.

    There were several regional versions of this plan in 2026. Open it to find the one for your area.

Plan information

Contract / Plan / Segment
H1032-249-000
Medical deductible
$0 — no deductible
Part D premium
$0/mo (part of the monthly premium above)
Part D deductible
$700/yr
Also owed
Your Medicare Part B premium, paid separately

More Sunshine State Health Plan, Inc. plans in FL

Benefits & cost sharing

Primary Care

BenefitIn-network
Chiropractic — Routine CareNo charge

Hospital

BenefitIn-network
Inpatient Hospital — Acute$2,180 per stay
Inpatient Hospital — Psychiatric$2,091 per stay
Worldwide Urgent Care Coverage$115

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 Sessions20% coinsurance
Mental Health — Group Sessions20% coinsurance
Supplemental Health BenefitsSee plan details

Other

BenefitIn-network
Dental — Endodontics (Root Canal)No charge
Dental — Periodontics (Gum Care)No charge
Dental — Removable Prosthodontics (Dentures)No charge
Dental — Fixed Prosthodontics (Bridges)No charge
Dental — Adjunctive General ServicesNo charge
Vision — Eye ExamsSee plan details
Vision — EyewearSee plan details
Vision — Eyewear UpgradesNo charge
Hearing — Exams20% coinsurance
Hearing — ExamsSee plan details
Hearing — Routine ExamsNo charge
Chiropractic ServicesSee plan details
Laboratory Services20% coinsurance
Medicare-Covered Preventive ServicesSee plan details
Substance Abuse — Individual Sessions20% coinsurance
Hearing — Hearing Aids (All Types)No charge
Substance Abuse — Group Sessions20% coinsurance
Psychiatric Services — Individual Sessions20% coinsurance
Psychiatric Services — Group Sessions20% coinsurance
Vision — Eyeglass LensesNo charge
Vision — Eyeglass FramesNo charge
Hearing — Fitting & Evaluation for Hearing AidNo charge
Hearing — Prescription Hearing AidsSee plan details
Outpatient Substance Abuse ServicesSee plan details
Dental — Other Preventive ServicesNo charge
Dental — ComprehensiveSee plan details
Dental — Restorative ServicesNo charge
Dental — Oral & Maxillofacial SurgeryNo charge
Vision — Eye Exams20% coinsurance
Vision — Routine Eye ExamsNo charge
Vision — Other Eye ServicesNo charge
Vision — Eyewear20% coinsurance
Vision — Contact LensesNo charge
Vision — Eyeglasses (Lenses & Frames)No charge
Skilled Nursing Facility (SNF)$0/day for days 1–20, $221/day for days 21–70, $0 after
Cardiac & Pulmonary RehabilitationSee plan details
Cardiac Rehabilitation — Additional Sessions20% coinsurance
Intensive Cardiac Rehabilitation — Additional Sessions20% coinsurance
Pulmonary Rehabilitation — Additional Sessions20% coinsurance
Supervised Exercise Therapy (SET)20% coinsurance
Emergency Services$115
Urgently Needed Services$40
Worldwide Emergency & Urgent CoverageSee plan details
Worldwide Emergency Coverage$115
Partial Hospitalization Program20% coinsurance
Intensive Outpatient Program (IOP)20% coinsurance
Home Health ServicesNo charge
Primary Care Physician ServicesNo charge
Chiropractic ServicesNo charge
Occupational Therapy Services20% coinsurance
Physician Specialist Services20% coinsurance
Podiatry Services20% coinsurance
Other Health Care Professional Services20% coinsurance
Psychiatric ServicesSee plan details
Physical Therapy & Speech-Language Pathology20% coinsurance
Additional Telehealth Services (Part B)$0-$40 copay + 20% coinsurance
Opioid Treatment Program Services20% coinsurance
Diagnostic Tests & Lab ServicesSee plan details
Diagnostic Procedures & Tests20% coinsurance
Radiological ServicesSee plan details
Diagnostic Radiology20% coinsurance
Therapeutic Radiology20% coinsurance
X-Ray Services20% coinsurance
Outpatient Hospital Services20% coinsurance
Hospital Observation Services20% coinsurance
Ambulatory Surgical Center (ASC)20% coinsurance
Outpatient Blood Services20% coinsurance
Ambulance ServicesSee plan details
Ground Ambulance20% coinsurance
Air Ambulance20% coinsurance
Non-Emergency Transportation — Health FacilityNo charge
Durable Medical Equipment (DME)20% coinsurance
Prosthetics & OrthoticsSee plan details
Prosthetic Devices20% coinsurance
Medical Supplies20% coinsurance
Diabetic Supplies & ServicesSee plan details
Diabetic Supplies20% coinsurance
Diabetic Therapeutic Shoes & Inserts20% coinsurance
Diabetic Monitors20% coinsurance
Dialysis Services20% coinsurance
Over-the-Counter (OTC) ItemsNo charge
Meal BenefitNo charge
Annual Physical ExamNo charge
Fitness BenefitNo charge
Remote Access TechnologiesNo charge
Alternative TherapiesNo charge
Kidney Disease Education Services20% coinsurance
Glaucoma Screening20% coinsurance
Diabetes Self-Management Training20% coinsurance
Digital Rectal Exams20% coinsurance
Welcome to Medicare EKG20% coinsurance
Insulin (Part B)$35
Dental — Medicare-Covered Services20% coinsurance
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

Service area

  • FL: 5 counties

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