Wellcare Patriot Simple (HMO-POS) Medicare Advantage Plan H1112-034 • 2027
- Monthly Premium
- $0.00Plus Part B premium.
- Medical Deductible
- $0.00
- Maximum Out-of-Pocket
- $3400.00In-network
- Part B Giveback
- Not offered
- Prescription Coverage
- Not Included
- Additional Benefits
- Dental, Vision, Hearing
- Service Area
- See List
- Total Enrollment
- 761 beneficiaries
Wellcare Patriot Simple (HMO-POS) Introduction
This Medicare Advantage HMO-POS plan, Wellcare Patriot Simple, is offered by Wellcare and uses a Health Maintenance Organization with a Point of Service (HMO-POS) provider network. It comes without prescription drug coverage. For the 2027 plan year, the monthly premium is $0.00, the medical deductible is $0.00, and the in-network maximum out-of-pocket is $3400.00. The plan is identified by CMS Plan ID H1112-034.
Plan Benefits
Wellcare Patriot Simple includes cost-sharing, which refers to out-of-pocket expenses for covered healthcare services. The tables below outline the most common in-network out-of-pocket costs associated with plan H1112-034.
Compare 2027 plan benefits with 2026.
Office Visits
| Covered Service | 2027 | 2026 |
|---|---|---|
| Primary care | In-network: $0 copay | In-network: $0 copay |
| Specialist | In-network: $0 copay | In-network: $0 copay |
Preventive and Wellness Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Annual wellness exam | In-network: $0 copay | In-network: $0 copay |
| Telehealth benefit | In-network: $0-$35 copay | In-network: $0-$35 copay |
| Routine chiropractic | Not covered | Not covered |
| Fitness benefits | Coming soon | In-network: $0 copay |
| Health education | Not covered | Not covered |
| Counseling services | Not covered | Not covered |
| Over-the-counter drug benefits | In-network: $0 copay | In-network: $0 copay |
| Health transportation (non-emergency) | Coming soon | In-network: $0 copay |
Diagnostic, Lab, and Imaging Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Diagnostic radiology services | In-network: $0-$300 copay | In-network: $0-$300 copay |
| Lab services | In-network: $0-$50 copay | In-network: $0-$50 copay |
| Outpatient x-rays | In-network: $20 copay | In-network: $25 copay |
| Diagnostic tests and procedures | In-network: $0-$20 copay | In-network: $0-$20 copay |
Emergency and Urgent Care Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Emergency room care | $150 copay | $150 copay |
| Worldwide emergency care | Coming soon | $150 copay |
| Urgent care | $35 copay | $35 copay |
| Inpatient hospital care | In-network: Tier 1 $350 per day for days 1-5 $0 per day for days 6-90 $0 per stay |
In-network: Tier 1 $350 per day for days 1-5 $0 per day for days 6-90 $0 per stay |
| Skilled Nursing Facility | In-network: Tier 1 $0 per day for days 1-20 $221 per day for days 21-40 $0 per day for days 41-100 |
In-network: Tier 1 $0 per day for days 1-20 $218 per day for days 21-40 $0 per day for days 41-100 |
| Ground ambulance | In-network: $200 copay | In-network: $200 copay |
Mental Health Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Outpatient individual therapy | In-network: $0 copay | In-network: $0 copay |
| Outpatient group therapy | In-network: $0 copay | In-network: $0 copay |
| Inpatient psychiatric hospital care | In-network: Tier 1 $350 per day for days 1-5 $0 per day for days 6-90 $0 per stay |
In-network: Tier 1 $350 per day for days 1-5 $0 per day for days 6-90 $0 per stay |
Rehabilitation Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Physical therapy and speech and language therapy | In-network: $0 copay | In-network: $0 copay |
| Occupational therapy | In-network: $0 copay | In-network: $0 copay |
Medical Equipment and Supplies
| Covered Service | 2027 | 2026 |
|---|---|---|
| Diabetes supplies | In-network: $0 copay | In-network: $0 copay |
| Durable medical equipment | In-network: 20% coinsurance | In-network: 20% coinsurance |
| Prosthetics | In-network: 20% coinsurance | In-network: 20% coinsurance |
Medicare Part B Drugs
| Covered Service | 2027 | 2026 |
|---|---|---|
| Chemotherapy | In-network: 0%-20% coinsurance | In-network: 0%-20% coinsurance |
| Other Part B drugs (Medicare-covered) | In-network: 0%-20% coinsurance | In-network: 0%-20% coinsurance |
Dental Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Oral exam | In-network: $0 copay Out-of-network: 25% coinsurance |
In-network: $0 copay Out-of-network: 25% coinsurance |
| Dental x-rays | In-network: $0 copay Out-of-network: 25% coinsurance |
In-network: $0 copay Out-of-network: 25% coinsurance |
| Cleaning | In-network: $0 copay Out-of-network: 25% coinsurance |
In-network: $0 copay Out-of-network: 25% coinsurance |
| Periodontics | In-network: $0 copay Out-of-network: 25% coinsurance |
In-network: $0 copay Out-of-network: 25% coinsurance |
| Endodontics | In-network: $0 copay Out-of-network: 25% coinsurance |
In-network: $0 copay Out-of-network: 25% coinsurance |
| Restorative services | In-network: $0 copay Out-of-network: 25% coinsurance |
In-network: $0 copay Out-of-network: 25% coinsurance |
| Implant services | Not covered | Not covered |
| Orthodontics | Not covered | Not covered |
| Oral/Maxillofacial surgery | In-network: $0 copay Out-of-network: 25% coinsurance |
In-network: $0 copay Out-of-network: 25% coinsurance |
Vision Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Routine eye exam | In-network: $0 copay | In-network: $0 copay |
| Contact lenses | In-network: $0 copay | In-network: $0 copay |
| Eyeglass frames only | In-network: $0 copay | In-network: $0 copay |
| Eyeglass lenses only | In-network: $0 copay | In-network: $0 copay |
| Eyeglasses (frames & lenses) | In-network: $0 copay | In-network: $0 copay |
| Upgrades | In-network: $0 copay | In-network: $0 copay |
Hearing Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Hearing exam | In-network: $0 copay | In-network: $0 copay |
| Fitting/evaluation | In-network: $0 copay | In-network: $0 copay |
| Prescription hearing aids | In-network: $0 copay | In-network: $0 copay |
| OTC hearing aids | Not covered | Not covered |
Additional and Special Needs Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Adult day health services | Not covered | Not covered |
| Home-based palliative care | Not covered | Not covered |
| Personal emergency response system | Coming soon | In-network: $0 copay |
| Weight management programs | Not covered | Not covered |
| Wigs for chemotherapy-related hair loss | Coming soon | Not covered |
| Alternative therapies | In-network: $0 copay | In-network: $0 copay |
| Massage therapy | Not covered | Not covered |
| Home/bathroom safety devices | Not covered | Not covered |
Certain preventive services are covered 100% by Wellcare Patriot Simple as a Part B benefit.
Prescription Drug Coverage
This plan does not include a Medicare Part D plan for prescriptions.
CMS 5-Star Performance Ratings (Contract ID: H1112)
CMS evaluates Medicare Advantage (Part C) and Part D plans annually using a 5-star rating system. Ratings reflect performance in preventive care, chronic condition management, and member experience.
| CMS Measure | Star Rating |
|---|---|
| 2027 Overall Rating | |
| Staying Healthy: Screenings, Tests, Vaccines | |
| Managing Chronic (Long Term) Conditions | |
| Member Experience with Health Plan | |
| Complaints and Changes in Plans Performance | |
| Health Plan Customer Service | |
| Drug Plan Customer Service | |
| Complaints and Changes in the Drug Plan | |
| Member Experience with the Drug Plan | |
| Drug Safety and Accuracy of Drug Pricing |
Contact Information for Wellcare
- Website
- Wellcare Plan Page
- Providers
- Wellcare Providers Page
- Formulary
- Wellcare Formulary Page
- Pharmacy
- Wellcare Pharmacy Page
- New Member Health Plan Help
- (844)480-0680
- New Member Health Plan TTY
- 711
Enrollment status and eligibility information are available through the Social Security Administration. Additional information about Medicare Advantage is available at Medicare.gov.
Plan Availability
Wellcare Patriot Simple (H1112-034-0) is available in the following locations:
Georgia Counties Served
- Appling
- Atkinson
- Bacon
- Baker
- Baldwin
- Banks
- Barrow
- Bartow
- Ben Hill
- Berrien
- Bibb
- Bleckley
- Brantley
- Brooks
- Bryan
- Burke
- Butts
- Camden
- Candler
- Catoosa
- Charlton
- Chatham
- Chattahoochee
- Chattooga
- Cherokee
- Clarke
- Clayton
- Clinch
- Coffee
- Colquitt
- Columbia
- Cook
- Coweta
- Crawford
- Crisp
- Dade
- Dawson
- Decatur
- Dekalb
- Dodge
- Dooly
- Douglas
- Echols
- Elbert
- Emanuel
- Evans
- Fannin
- Fayette
- Forsyth
- Franklin
- Fulton
- Gilmer
- Glascock
- Grady
- Greene
- Gwinnett
- Habersham
- Hall
- Hancock
- Haralson
- Harris
- Hart
- Heard
- Henry
- Houston
- Irwin
- Jackson
- Jasper
- Jeff Davis
- Jefferson
- Jenkins
- Johnson
- Jones
- Lamar
- Lanier
- Laurens
- Liberty
- Lincoln
- Long
- Lowndes
- Lumpkin
- Macon
- Madison
- Marion
- Mcduffie
- Mcintosh
- Meriwether
- Miller
- Mitchell
- Monroe
- Montgomery
- Morgan
- Murray
- Muscogee
- Newton
- Oconee
- Oglethorpe
- Paulding
- Peach
- Pickens
- Pike
- Pulaski
- Putnam
- Quitman
- Rabun
- Randolph
- Richmond
- Rockdale
- Schley
- Screven
- Seminole
- Spalding
- Stephens
- Stewart
- Talbot
- Taliaferro
- Tattnall
- Taylor
- Telfair
- Thomas
- Tift
- Towns
- Treutlen
- Troup
- Turner
- Twiggs
- Union
- Upson
- Walker
- Walton
- Ware
- Warren
- Washington
- Wayne
- Webster
- Wheeler
- White
- Wilcox
- Wilkes
- Wilkinson
- Worth
Frequently Asked Questions
Here are some of the most frequently asked questions about this plan (click to open).
Frequently Asked Questions About Wellcare Patriot Simple (HMO-POS)
What is the monthly premium for Wellcare Patriot Simple (HMO-POS)?
The 2027 monthly premium is $0.00. The Medicare Part B premium is paid separately.
What is the in-network MOOP for plan H1112-034?
For 2027, the in-network maximum out-of-pocket is $3400.00. The plan pays 100% of covered in-network services beyond this amount.
What is the total enrollment for plan H1112-034?
Total enrollment is 761 beneficiaries based on the latest CMS data.
Is there a Part D deductible for this plan?
The Part D deductible is $0.00.
Medicare Plan Data Sources and Methodology
| Data Source | Publisher | Last Accessed |
|---|---|---|
| Landscape Source Files | Centers for Medicare & Medicaid Services | October 5, 2026 |
| Medicare Part C & D Performance | Centers for Medicare & Medicaid Services | October 5, 2026 |
| Plan Benefits Package | Centers for Medicare & Medicaid Services | October 5, 2026 |
| Monthly Enrollment by Contract/Plan/State/County | Centers for Medicare & Medicaid Services | October 5, 2026 |
Data sources and methodology documentation.
| Publisher | Reference | Last Accessed |
|---|---|---|
| Wellcare (official source) | http://www.wellcare.com/medicare | October 4, 2026 |
| CMS.gov | Medicare Advantage Plan Fact Sheet | 25 May, 2025 |
| Medicare.gov | Joining a plan | 25 May, 2025 |
| Medicare.gov | Your coverage options | 25 May, 2025 |
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Data provenance documentation is maintained in alignment with the U.S. Core Data for Interoperability (USCDI) Provenance standard.
Page content independently curated and maintained by David W. Bynon, Editorial Steward, using a standardized, data-driven methodology for accurate, non-commercial Medicare plan interpretation and resolution.