Wellcare Patriot Simple (HMO-POS)

WELLCARE OF GEORGIA, INC. · 2026 plan year

Plan ID H1112-034-000

HMOPOS★ 3.5 CMS Stars
MOOP (in-network)
$3,400
MOOP (combined)
—
Monthly premium
$0/mo
Prescription drugs
Not included

This plan in 2027

Plan information

Contract / Plan / Segment
H1112-034-000
Medical deductible
$0 — no deductible
Also owed
Your Medicare Part B premium, paid separately

More WELLCARE OF GEORGIA, INC. plans in GA

Benefits & cost sharing

Hospital

BenefitIn-network
Worldwide Urgent Care Coverage$150
Inpatient Hospital — Acute$350/day for days 1–5, $0 after
Inpatient Hospital — Psychiatric$325/day for days 1–4, $0 after

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 SessionsNo charge
Mental Health — Group SessionsNo charge
Supplemental Health BenefitsSee plan details

Other

BenefitIn-network
Cardiac & Pulmonary RehabilitationSee plan details
Emergency Services$150
Urgently Needed Services$35
Worldwide Emergency & Urgent CoverageSee plan details
Worldwide Emergency Coverage$150
Partial Hospitalization Program$175
Intensive Outpatient Program (IOP)$175
Home Health ServicesNo charge
Primary Care Physician ServicesNo charge
Chiropractic ServicesNo charge
Occupational Therapy ServicesNo charge
Physician Specialist ServicesNo charge
Podiatry ServicesNo charge
Other Health Care Professional ServicesNo charge
Psychiatric ServicesSee plan details
Psychiatric Services — Individual SessionsNo charge
Psychiatric Services — Group SessionsNo charge
Physical Therapy & Speech-Language PathologyNo charge
Additional Telehealth Services (Part B)$0-$35
Opioid Treatment Program ServicesNo charge
Diagnostic Tests & Lab ServicesSee plan details
Diagnostic Procedures & Tests$0-$20
Laboratory Services$0-$50
Radiological ServicesSee plan details
Diagnostic Radiology$0-$300
Therapeutic Radiology20% coinsurance
X-Ray Services$25
Outpatient Hospital Services$0-$300
Hospital Observation Services$150-$300 per stay
Ambulatory Surgical Center (ASC)$250
Outpatient Substance Abuse ServicesSee plan details
Substance Abuse — Individual SessionsNo charge
Substance Abuse — Group SessionsNo charge
Outpatient Blood ServicesNo charge
Ambulance ServicesSee plan details
Ground Ambulance$200
Air Ambulance$200
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
Dialysis Services20% coinsurance
Over-the-Counter (OTC) ItemsNo charge
Meal BenefitNo charge
Medicare-Covered Preventive ServicesSee plan details
Annual Physical ExamNo charge
Fitness BenefitNo charge
Remote Access TechnologiesNo charge
Personal Emergency Response System (PERS)No 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 ServicesNo 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 — Restorative ServicesNo charge
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 — Oral & Maxillofacial SurgeryNo charge
Dental — Adjunctive General ServicesNo charge
Vision — Eye ExamsNo charge
Vision — Eye ExamsSee plan details
Vision — Routine Eye ExamsNo charge
Vision — EyewearNo charge
Vision — Eyeglass LensesNo charge
Vision — Eyeglass FramesNo charge
Vision — Eyewear UpgradesNo charge
Hearing — ExamsNo charge
Hearing — ExamsSee plan details
Hearing — Routine ExamsNo charge
Hearing — Fitting & Evaluation for Hearing AidNo charge
Hearing — Prescription Hearing AidsSee plan details
Hearing — Hearing Aids (All Types)No charge
Diabetic SuppliesNo charge
Cardiac Rehabilitation — Additional Sessions$50
Intensive Cardiac Rehabilitation — Additional Sessions$65
Pulmonary Rehabilitation — Additional Sessions$40
Supervised Exercise Therapy (SET)$30
Diabetic Therapeutic Shoes & Inserts20% coinsurance
Skilled Nursing Facility (SNF)$0/day for days 1–20, $218/day for days 21–40, $0 after
Vision — EyewearSee plan details
Vision — Contact LensesNo charge
Vision — Eyeglasses (Lenses & Frames)No charge

Service area

  • GA: 141 counties

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