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Wellpoint Kidney Care (HMO-POS C-SNP) Medicare Special Need Plan H2593-031 • 2027

CMS Rating: ☆☆☆☆☆ (3.0 out of 5 stars*)
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, $350.00 deductible
Additional Benefits
Dental, Vision, Hearing
Service Area
See List
Total Enrollment
114 beneficiaries
Last update:

Introduction

Wellpoint Kidney Care, offered by Wellpoint, is a Medicare Advantage Chronic Condition Special Needs Plan (C-SNP) identified by CMS Plan ID H2593-031. 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 $350.00.

This plan has 114 beneficiaries enrolled across its service areas based on CMS enrollment data. To enroll, you must live within the plan's service area: See List.

Eligibility

Wellpoint Kidney Care is a Medicare C-SNP plan for individuals with specific chronic or disabling conditions.

Special Needs Plan Type
Chronic Condition Special Needs Plan (C-SNP)
Medicare Requirement
Must have Medicare Part A and Part B
Special Needs Requirement
This plan is for individuals with chronic kidney disease.
Service Area Requirement
Must live in the plan's service area
Prescription Drug Coverage
Medicare Part D prescription drug coverage is included.

Plan Benefits

Wellpoint Kidney Care 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 H2593-031.

Compare 2027 plan benefits with 2026.

Office Visits

Office visit costs by plan year.
Covered Service 2027 2026
Primary care In-network: $0 copay
Out-of-network: $0 copay		 In-network: $0 copay
Out-of-network: $0 copay
Specialist In-network: $0 copay, 20% coinsurance
Out-of-network: $0 copay, 20% coinsurance		 In-network: $0 copay, 20% coinsurance
Out-of-network: $0 copay, 20% coinsurance

Preventive and Wellness Services

Preventive and wellness service costs and benefits by plan year.
Covered Service 2027 2026
Annual wellness exam In-network: $0 copay In-network: $0 copay
Telehealth benefit In-network: $0 copay In-network: $0 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

Diagnostic, laboratory, and imaging service costs by plan year.
Covered Service 2027 2026
Diagnostic radiology services In-network: 20% coinsurance
Out-of-network: 20% coinsurance		 In-network: 20% coinsurance
Out-of-network: 20% coinsurance
Lab services In-network: 20% coinsurance
Out-of-network: 20% coinsurance		 In-network: 20% coinsurance
Out-of-network: 20% coinsurance
Outpatient x-rays In-network: 20% coinsurance
Out-of-network: 20% coinsurance		 In-network: 20% coinsurance
Out-of-network: 20% coinsurance
Diagnostic tests and procedures In-network: 20% coinsurance
Out-of-network: 20% coinsurance		 In-network: 20% coinsurance
Out-of-network: 20% coinsurance

Emergency and Urgent Care Services

Emergency, urgent care, hospital, ambulance, and skilled nursing costs by plan year.
Covered Service 2027 2026
Emergency room care $115 copay $115 copay
Worldwide emergency care Coming soon Not covered
Urgent care $40 copay $40 copay
Inpatient hospital care In-network:
Tier 1
$0 per day for days 1-60
$434 per day for days 61-90
$868 per day for days 91-150
Out-of-network:
$0 per day for days 1-60
$434 per day for days 61-90
$868 per day for days 91-150		 In-network:
Tier 1
$0 per day for days 1-60
$419 per day for days 61-90
$838 per day for days 91-150
Out-of-network:
$0 per day for days 1-60
$419 per day for days 61-90
$838 per day for days 91-150
Skilled Nursing Facility In-network:
Tier 1
$0 per day for days 1-20
$217 per day for days 21-100		 In-network:
Tier 1
$0 per day for days 1-20
$209.5 per day for days 21-100
Ground ambulance In-network: 20% coinsurance
Out-of-network: 20% coinsurance		 In-network: 20% coinsurance
Out-of-network: 20% coinsurance

Mental Health Services

Mental health therapy and inpatient psychiatric care costs by plan year.
Covered Service 2027 2026
Outpatient individual therapy In-network: 20% coinsurance
Out-of-network: 20% coinsurance		 In-network: 20% coinsurance
Out-of-network: 20% coinsurance
Outpatient group therapy In-network: 20% coinsurance
Out-of-network: 20% coinsurance		 In-network: 20% coinsurance
Out-of-network: 20% coinsurance
Inpatient psychiatric hospital care In-network:
Tier 1
$0 per day for days 1-60
$434 per day for days 61-90
$868 per day for days 91-150
Out-of-network:
$0 per day for days 1-60
$434 per day for days 61-90
$868 per day for days 91-150		 In-network:
Tier 1
$0 per day for days 1-60
$419 per day for days 61-90
$838 per day for days 91-150
Out-of-network:
$0 per day for days 1-60
$419 per day for days 61-90
$838 per day for days 91-150

Rehabilitation Services

Physical, speech, and occupational therapy costs by plan year.
Covered Service 2027 2026
Physical therapy and speech and language therapy In-network: 20% coinsurance
Out-of-network: 20% coinsurance		 In-network: 20% coinsurance
Out-of-network: 20% coinsurance
Occupational therapy In-network: 20% coinsurance
Out-of-network: 20% coinsurance		 In-network: 20% coinsurance
Out-of-network: 20% coinsurance

Medical Equipment and Supplies

Diabetes supplies, durable medical equipment, and prosthetic costs by plan year.
Covered Service 2027 2026
Diabetes supplies In-network: $0 copay
Out-of-network: 20% coinsurance		 In-network: $0 copay
Out-of-network: 20% coinsurance
Durable medical equipment In-network: 20% coinsurance In-network: 0%-20% coinsurance
Prosthetics In-network: 20% coinsurance
Out-of-network: 20% coinsurance		 In-network: 20% coinsurance
Out-of-network: 20% coinsurance

Medicare Part B Drugs

Chemotherapy and other Medicare Part B-covered drug costs by plan year.
Covered Service 2027 2026
Chemotherapy In-network: 0%-20% coinsurance
Out-of-network: $35 copay, 0%-20% coinsurance		 In-network: 0%-20% coinsurance
Out-of-network: $35 copay, 0%-20% coinsurance
Other Part B drugs (Medicare-covered) In-network: 0%-20% coinsurance
Out-of-network: $35 copay, 0%-20% coinsurance		 In-network: 0%-20% coinsurance
Out-of-network: $35 copay, 0%-20% coinsurance

Dental Services

Preventive and comprehensive dental service costs by plan year.
Covered Service 2027 2026
Oral exam In-network: $0 copay
Out-of-network: 20%-50% coinsurance		 In-network: $0 copay
Out-of-network: 20%-50% coinsurance
Dental x-rays In-network: $0 copay
Out-of-network: 20%-50% coinsurance		 In-network: $0 copay
Out-of-network: 20%-50% coinsurance
Cleaning In-network: $0 copay
Out-of-network: 20%-50% coinsurance		 In-network: $0 copay
Out-of-network: 20%-50% coinsurance
Periodontics In-network: $0 copay
Out-of-network: 20%-50% coinsurance		 In-network: $0 copay
Out-of-network: 20%-50% coinsurance
Endodontics In-network: $0 copay
Out-of-network: 20%-50% coinsurance		 In-network: $0 copay
Out-of-network: 20%-50% coinsurance
Restorative services In-network: $0 copay
Out-of-network: 20%-50% coinsurance		 In-network: $0 copay
Out-of-network: 20%-50% coinsurance
Implant services Not covered Not covered
Orthodontics Not covered Not covered
Oral/Maxillofacial surgery In-network: $0 copay
Out-of-network: 20%-50% coinsurance		 In-network: $0 copay
Out-of-network: 20%-50% coinsurance

Vision Services

Routine eye exams, contact lenses, and eyewear costs by plan year.
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 Not covered Not covered

Hearing Services

Hearing exams, fittings, and hearing aid costs by plan year.
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
You can choose for this plan to cover
either
your prescription or over-the-counter hearing aids each year, but
not
both.		 In-network: $0 copay
OTC hearing aids In-network: $0 copay
You can choose for this plan to cover
either
your prescription or over-the-counter hearing aids each year, but
not
both.		 In-network: $0 copay

Additional and Special Needs Services

Additional and special needs service costs and benefits by plan year.
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 Not covered Not covered
Massage therapy Not covered Not covered
Home/bathroom safety devices Not covered Not covered

Certain preventive services are covered 100% by Wellpoint Kidney Care as a Part B benefit.

Prescription Drug Coverage

Wellpoint Kidney Care 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.

Wellpoint Kidney Care (H2593-031-0) Prescription Drug Plan Premium Details
Part D Premium Component Amount
Basic Part D Premium:($40.70)
Supplemental Part D Premium:$40.70
Total Part D Premium:$0.00
Low-Income Premium Subsidy:$6.27
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 $350.00 annual Part D deductible. You'll pay this deductible at the pharmacy before Wellpoint starts contributing towards your prescription costs.

Prescription Drug Plan Out-of-Pocket Costs

Beyond premiums and deductibles, Wellpoint Kidney Care may have additional costs at pharmacies. The table below outlines out-of-pocket expenses by drug tier.

Wellpoint Kidney Care (H2593-031-0) Pharmacy Out-of-Pocket Costs by Drug Tier
Drug Tier Retail Mail Order
Preferred Generic$0.00 copay$0.00 copay
Generic$0.00 copay$0.00 copay
Preferred Brand15% coinsurance10% coinsurance
Non-Preferred Drug30% coinsurance30% coinsurance
Specialty Tier29% coinsurance29% coinsurance
Select Care DrugsNot available$0.00 copay
*Deductible does not apply.

CMS 5-Star Performance Ratings (Contract ID: H2593)

Medicare assigns star ratings to plans based on quality and performance across multiple measures, including customer service, member experience, and health outcomes. Ratings are updated annually by the Centers for Medicare & Medicaid Services (CMS) and are shown on a 1 to 5 star scale, with 5 stars representing the highest quality.

2027 Medicare Star Ratings for Contract H2593
CMS Measure Star Rating
2027 Overall Rating ☆☆☆☆☆
Staying Healthy: Screenings, Tests, Vaccines ☆☆☆☆☆
Managing Chronic (Long Term) Conditions ☆☆☆☆☆
Member Experience with Health Plan Not enough data available
Complaints and Changes in Plans Performance ☆☆☆☆☆
Health Plan Customer Service Not enough data available
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 CMS Version
Landscape Source Files Centers for Medicare & Medicaid Services CY2027 Landscape (202609.1)
Medicare Part C & D Performance Centers for Medicare & Medicaid Services 2027 Star Ratings Data Tables
Plan Benefits Package Centers for Medicare & Medicaid Services PBP Benefits-2027
Monthly Enrollment by Contract/Plan/State/County Centers for Medicare & Medicaid Services 2026-09

Data sources and methodology documentation.

Official plan information and secondary Medicare references.
Publisher Reference Last Accessed
Wellpoint (official source) http://shop.amerigroup.com/medicare October 4, 2026
CMS.gov Chronic Condition Special Needs Plans (C-SNPs) April 28, 2026
Medicare.gov Compare types of 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 is documented in accordance with the U.S. Core Data for Interoperability (USCDI) Provenance standard.