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Wellcare Meridian Health Dual Access (HMO-POS D-SNP) H5475-001 • 2027 • Gladwin County, MI

CMS Rating: Not yet rated by CMS.
Monthly Premium
$0.00Plus Part B premium.
Medical Deductible
$0.00
Maximum Out-of-Pocket
$9850.00In-network
Part B Giveback
Not offered
Prescription Coverage
Enhanced, $700.00 deductible
Additional Benefits
Dental, Vision, Hearing
Service Area
Gladwin County, MI
Local Enrollment
0 beneficiaries in Gladwin County
Last update:

Introduction

Wellcare Meridian Health Dual Access, offered by Wellcare, is a Medicare Advantage Dual-Eligible Special Needs Plan (D-SNP) identified by CMS Plan ID H5475-001. The plan's Health Maintenance Organization with a Point of Service (HMO-POS) provider network serves its covered medical benefits, and the plan includes Medicare Part D prescription drug coverage. Its 2027 costs include a $0.00 monthly premium, $0.00 medical deductible, and $9850.00 in-network maximum out-of-pocket. The 2027 Part D prescription drug deductible is $700.00.

This plan is available to eligible beneficiaries who live in Gladwin County, Michigan. According to CMS, 0 beneficiaries in Gladwin County are enrolled in this plan. New members can contact the plan at (844)480-0680 (TTY 711) for help and additional plan information.

Eligibility

Wellcare Meridian Health Dual Access is a Dual Eligible Special Needs Plan (D-SNP) designed for individuals enrolled in both Medicare and Medicaid.

Special Needs Plan Type
Dual-Eligible Special Needs Plan (D-SNP)
Medicare Requirement
Medicare Part A and Part B
Special Needs Requirement
Must qualify for Medicaid
Service Area Requirement
Must live in the plan's service area
Prescription Drug Coverage
Medicare Part D prescription drug coverage is included.

Compare Similar Plans in Gladwin County

Compare this plan with the two most-enrolled HMO-POS D-SNP plans available in Gladwin County, Michigan. Enrollment is based on CMS local enrollment data.

HMO-POS D-SNP plan comparison for Gladwin County, Michigan
Plan Detail Wellcare Meridian Health Dual Access UHC Dual Complete MI-Q1 UHC Dual Advantage MI-V1
CMS Plan ID H5475-001-0 H2247-001-0 H2247-003-0
Local Enrollment 0 79 24
Monthly Premium $0.00 $0.00 $0.00
Medical Deductible $0.00 $0.00 $0.00
Maximum Out-of-Pocket $9,850.00 $9,850.00 $7,150.00
Part B Giveback Not offered Not offered Not offered
Primary Care $0 copay $0 copay $0 copay
Specialist $0 copay $0 copay $0 or $0-$50 copay
Part D Deductible $700.00 $315.00 $700.00
CMS Star Rating Not yet rated Not yet rated Not yet rated
Dental $0 copay $0 copay $0 copay
Vision $0 copay $0 copay $0 copay
Hearing $0 copay $0 copay $0 copay

Plan Benefits

Wellcare Meridian Health Dual Access has cost-sharing, meaning there are out-of-pocket costs when receiving covered healthcare services. The tables below detail the most common in-network out-of-pocket expenses for plan H5475-001.

You can also compare 2027 costs and coverage with last year, side-by-side: Plan H5475-001-0 Cost Compare.

Office Visits

Primary care
In-network: $0 copay
Specialist
In-network: $0 copay

Preventive and Wellness Services

Annual wellness exam
In-network: $0 copay
Telehealth benefit
In-network: $0 copay
Routine chiropractic
Not covered
Fitness benefits
Coming soon
Health education
Not covered
Counseling services
Not covered
Over-the-counter drug benefits
In-network: $0 copay
Health transportation (non-emergency)
Coming soon

Diagnostic, Lab, and Imaging Services

Diagnostic radiology services
In-network: $0 copay
Lab services
In-network: $0 copay
Outpatient x-rays
In-network: $0 copay
Diagnostic tests and procedures
In-network: $0 copay

Emergency and Urgent Care Services

Emergency room care
$0 copay
Worldwide emergency care
Coming soon
Urgent care
$0 copay
Inpatient hospital care
In-network:
Tier 1
$0 per stay
Skilled Nursing Facility
In-network:
Tier 1
$0 per day for days 1-20
$0 per day for days 21-70
$0 per day for days 71-100
Ground ambulance
In-network: $0 copay

Mental Health Services

Outpatient individual therapy
In-network: $0 copay
Outpatient group therapy
In-network: $0 copay
Inpatient psychiatric hospital care
In-network:
Tier 1
$0 per stay

Rehabilitation Services

Physical therapy and speech and language therapy
In-network: $0 copay
Occupational therapy
In-network: $0 copay

Medical Equipment and Supplies

Diabetes supplies
In-network: $0 copay
Durable medical equipment
In-network: $0 copay
Prosthetics
In-network: $0 copay

Medicare Part B Drugs

Chemotherapy
In-network: $0 copay
Other Part B drugs (Medicare-covered)
In-network: $0 copay

Dental Services

Oral exam
In-network: $0 copay
Out-of-network: 25% coinsurance
Dental x-rays
In-network: $0 copay
Out-of-network: 25% coinsurance
Cleaning
In-network: $0 copay
Out-of-network: 25% coinsurance
Periodontics
In-network: $0 copay
Out-of-network: 25% coinsurance
Endodontics
In-network: $0 copay
Out-of-network: 25% coinsurance
Restorative services
In-network: $0 copay
Out-of-network: 25% coinsurance
Implant services
Not covered
Orthodontics
Not covered
Oral/Maxillofacial surgery
In-network: $0 copay
Out-of-network: 25% coinsurance

Vision Services

Routine eye exam
In-network: $0 copay
Contact lenses
In-network: $0 copay
Eyeglass frames only
In-network: $0 copay
Eyeglass lenses only
In-network: $0 copay
Eyeglasses (frames & lenses)
In-network: $0 copay
Upgrades
In-network: $0 copay

Hearing Services

Hearing exam
In-network: $0 copay
Fitting/evaluation
In-network: $0 copay
Prescription hearing aids
In-network: $0 copay
OTC hearing aids
Not covered

Additional and Special Needs Services

Adult day health services
Not covered
Home-based palliative care
Not covered
Personal emergency response system
Coming soon
Weight management programs
Not covered
Wigs for chemotherapy-related hair loss
Coming soon
Alternative therapies
In-network: $0 copay
Massage therapy
Not covered
Home/bathroom safety devices
Not covered

Certain preventive services are covered 100% by Wellcare Meridian Health Dual Access as a Part B benefit.

Prescription Drug Coverage

Wellcare Meridian Health Dual Access includes a Medicare Part D prescription drug plan (PDP). Plan type and coverage level are defined by CMS and may vary between basic and enhanced benefit designs.

Prescription Drug Plan Premium

The Part D prescription drug plan premium is included in the overall Medicare Advantage plan cost. Additional adjustments may apply through the Low-Income Subsidy (LIS) program, also known as Extra Help, administered by Social Security. LIS benefits are separate from Medicare Special Needs Plan coverage.

Wellcare Meridian Health Dual Access (H5475-001-0) Prescription Drug Plan Premium Details
Part D Premium Component Amount
Basic Part D Premium:($31.30)
Supplemental Part D Premium:$31.30
Total Part D Premium:$0.00
Low-Income Premium Subsidy:$6.28
Low-Income Premium Subsidy Paid by CMS:$0.00
Low-Income Subsidy Premium:$0.00

For more details, visit the Social Security Extra Help program .

Prescription Drug Plan Deductible

This plan has a $700.00 annual Part D deductible. You'll pay this deductible at the pharmacy before Wellcare starts contributing towards your prescription costs.

Prescription Drug Plan Out-of-Pocket Costs

Beyond premiums and deductibles, Wellcare Meridian Health Dual Access may have additional costs at pharmacies. The table below outlines out-of-pocket expenses by drug tier.

Wellcare Meridian Health Dual Access (H5475-001-0) Pharmacy Out-of-Pocket Costs by Drug Tier
Drug Tier Retail Mail Order
Generic$0.00 copay$19.00 copay
Preferred Brand20% coinsurance$47.00 copay
Non-Preferred Drug42% coinsurance42% coinsurance
Injectable Drugs0% coinsuranceNot available
Specialty Tier25% coinsurance25% coinsurance
Select Care Drugs$0.00 copay$0.00 copay
Preferred GenericNot available$18.00 copay
*Deductible does not apply.

CMS 5-Star Performance Ratings (Contract ID: H5475)

Medicare evaluates plan quality using a star rating system developed by the Centers for Medicare & Medicaid Services (CMS). Ratings are based on measures such as health outcomes, member experience, and customer service, and are reported on a 1 to 5 star scale, with higher ratings indicating stronger overall performance.

2027 Medicare Star Ratings for Contract H5475
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 Not enough data available
Drug Safety and Accuracy of Drug Pricing ☆☆☆☆☆
Medicare Plan Data Sources and Methodology
Primary CMS datasets used for this Medicare Advantage Plan resource.
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.

Official plan information and secondary Medicare references.
Publisher Reference Last Accessed
Wellcare (official source) http://go.wellcare.com/Medicare October 4, 2026
CMS.gov Dual Eligible Special Needs Plans (D-SNPs) April 28, 2026
Medicare.gov Understanding Medicare Advantage Plans April 28, 2026
NCOA.org 5 Steps to Choosing the Right Medicare Plan for You April 28, 2026

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Data provenance documentation is maintained in alignment with the U.S. Core Data for Interoperability (USCDI) Provenance standard.