Medicare Plans

Open Medicare Plan Data.

Wellpoint Kidney Care (HMO-POS C-SNP) H2593-031 • 2027 • El Paso County, TX

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
El Paso County, TX
Local Enrollment
47 beneficiaries in El Paso County
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.

Eligible Medicare beneficiaries residing in El Paso County, Texas can enroll in this plan. According to CMS, 47 beneficiaries in El Paso County are enrolled in this plan. New members can contact the plan at (833)668-0940 (TTY 711) for help and additional plan information.

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.

Compare Similar Plans in El Paso County

Compare this plan with the two most-enrolled HMO-POS C-SNP plans available in El Paso County, Texas. Enrollment is based on CMS local enrollment data.

HMO-POS C-SNP plan comparison for El Paso County, Texas
Plan Detail Wellpoint Kidney Care UHC Complete Care TX-17 Alignment Health Heart & Diabetes 002
CMS Plan ID H2593-031-0 H4527-040-0 H5472-002-0
Local Enrollment 47 5,869 1,058
Monthly Premium $0.00 $0.00 $0.00
Medical Deductible $0.00 $0.00 $0.00
Maximum Out-of-Pocket $9,850.00 $4,200.00 $3,190.00
Part B Giveback Not offered Not offered Not offered
Primary Care $0 copay $0 copay $0 copay
Specialist $0 copay, 20% coinsurance $0-$25 copay $15 copay
Part D Deductible $350.00 $440.00 $0.00
CMS Star Rating 3.0 4.0 4.5
Dental $0 copay $0 copay $10 copay
Vision $0 copay $0 copay $0 copay
Hearing $0 copay $0 copay $0 copay

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.

You can also compare 2027 costs and coverage with last year, side-by-side: Plan H2593-031-0 Cost Compare.

Office Visits

Primary care
In-network: $0 copay
Out-of-network: $0 copay
Specialist
In-network: $0 copay, 20% coinsurance
Out-of-network: $0 copay, 20% coinsurance

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: 20% coinsurance
Out-of-network: 20% coinsurance
Lab services
In-network: 20% coinsurance
Out-of-network: 20% coinsurance
Outpatient x-rays
In-network: 20% coinsurance
Out-of-network: 20% coinsurance
Diagnostic tests and procedures
In-network: 20% coinsurance
Out-of-network: 20% coinsurance

Emergency and Urgent Care Services

Emergency room care
$115 copay
Worldwide emergency care
Coming soon
Urgent care
$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
Skilled Nursing Facility
In-network:
Tier 1
$0 per day for days 1-20
$217 per day for days 21-100
Ground ambulance
In-network: 20% coinsurance
Out-of-network: 20% coinsurance

Mental Health Services

Outpatient individual therapy
In-network: 20% coinsurance
Out-of-network: 20% coinsurance
Outpatient group therapy
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

Rehabilitation Services

Physical therapy and speech and language therapy
In-network: 20% coinsurance
Out-of-network: 20% coinsurance
Occupational therapy
In-network: 20% coinsurance
Out-of-network: 20% coinsurance

Medical Equipment and Supplies

Diabetes supplies
In-network: $0 copay
Out-of-network: 20% coinsurance
Durable medical equipment
In-network: 20% coinsurance
Prosthetics
In-network: 20% coinsurance
Out-of-network: 20% coinsurance

Medicare Part B Drugs

Chemotherapy
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

Dental Services

Oral exam
In-network: $0 copay
Out-of-network: 20%-50% coinsurance
Dental x-rays
In-network: $0 copay
Out-of-network: 20%-50% coinsurance
Cleaning
In-network: $0 copay
Out-of-network: 20%-50% coinsurance
Periodontics
In-network: $0 copay
Out-of-network: 20%-50% coinsurance
Endodontics
In-network: $0 copay
Out-of-network: 20%-50% coinsurance
Restorative services
In-network: $0 copay
Out-of-network: 20%-50% coinsurance
Implant services
Not covered
Orthodontics
Not covered
Oral/Maxillofacial surgery
In-network: $0 copay
Out-of-network: 20%-50% 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
Not covered

Hearing Services

Hearing exam
In-network: $0 copay
Fitting/evaluation
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.
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.

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
Not covered
Massage therapy
Not covered
Home/bathroom safety devices
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

MedicarePlans.com operates as an independent, non-government informational resource and is not affiliated with or endorsed by the U.S. Government or the federal Medicare program.

Data provenance is documented in accordance with the U.S. Core Data for Interoperability (USCDI) Provenance standard.