Wellcare Low Premium Focus (HMO)
Wellcare · HMO · 2027 coverage
The big numbers
The plan premium is on top of your Part B premium.
- Monthly premium
- $27
- Higher than most plans here
- Most you pay in a year for covered care in network
- $4,150
- Higher than most plans here
- Drug deductible
- $700
- Tied for highest here
- Medicare star rating
- No rating yet
In plain English
Compared with the 4 other plans in Imperial County that the same person could join.
Watch out for
- $27 monthly premium, higher than most plans here
- Up to $4,150 a year for covered care, higher than most plans here
- $1,875 for a 5-day hospital stay, highest of 5 plans here
- $5 for specialist visits, tied for highest here
What a year could cost
Premiums plus the plan’s copays for three example years. Medicines are not included.
- A light year$424$324 in premiums + $100 for careHigher than most plans here2 checkups and 2 lab tests.Uses the highest listed cost for: Lab tests.
- A busier year$569$324 in premiums + $245 for careHigher than most plans here4 checkups, 4 specialist visits, 4 lab tests, 1 X-ray and 1 urgent care visit.Uses the highest listed cost for: Lab tests.
- A hard year$3,459$324 in premiums + $3,135 for careHigher than most plans here6 checkups, 12 specialist visits, 6 lab tests, 2 scans, an ambulance ride, an ER visit and a 5-day hospital stay.Uses the highest listed cost for: Lab tests, MRI, CT and other scans.
The visit counts are examples we chose to show how costs add up, not a prediction. Your costs depend on the care you get.
What you pay for care
Your cost each time, at doctors and hospitals in the plan’s network.
- Primary care visit$0
- Specialist visit$5Tied for highest hereReferral neededPlan approval may be needed
- Urgent care$25Tied for highest here
- Emergency room$150Tied for highest hereNot charged if you stay in the hospital within 24 hours
- Hospital stay$375 a day for days 1 to 6, then $0 for days 7 to 90Highest of 5 plans hereReferral neededPlan approval may be needed
- Lab tests$0 to $50Depends on the serviceReferral neededPlan approval may be needed
More care: surgery, X-rays, scans, ambulance, nursing home
- Outpatient surgery center$275Highest of 5 plans hereReferral neededPlan approval may be needed
- Outpatient hospital care$0 to $375Depends on the service
- X-rays$0Referral neededPlan approval may be needed
- MRI, CT and other scans$0 to $250Depends on the serviceReferral neededPlan approval may be needed
- Ground ambulance$250Highest of 4 plans herePlan approval may be needed
- Skilled nursing facility$0 for days 1 to 20, then $221 a day for days 21 to 40, then $0 for days 41 to 100Referral neededPlan approval may be needed
From the costs the plan filed with Medicare for 2027. A range like “$0 to $100” means the cost depends on the service or the place. “Lower than most” compares this plan with the 4 other plans in Imperial County that the same person could join. Read the plan’s 2027 booklet (PDF)
What medicines cost
| Drug tier | Preferred pharmacy | Other network pharmacy |
|---|---|---|
| 1Generic | $0 | $10 |
| 2Preferred BrandAfter the deductible | 25% of the price | 25% of the price |
| 3Non-Preferred DrugAfter the deductible | 41% of the price | 42% of the price |
| 4Injectable DrugsAfter the deductible | 1% of the price | 1% of the price |
| 5Specialty TierAfter the deductible | 25% of the price | 25% of the price |
| 6Select Care Drugs | $0 | $0 |
For a 1-month supply. The $700 drug deductible applies only to the tiers marked. Covered insulin costs at most $35 for a month’s supply. Your medicine’s tier is on the plan’s drug list; check it below.
Check my medicines
See if this plan covers each medicine you take in 2027, and what a month costs.
Type the name on the bottle. Add the strength to narrow it down.
Add each medicine once. We’ll show if this plan covers it, what a month costs, and any rules.
Extras
Help Original Medicare doesn’t give you.
- Dental IncludedCleanings and exams covered. Fillings, crowns and dentures covered.
- Vision IncludedYearly eye exam: $0.
- Hearing Not included
- Over-the-counter items Not included
- Fitness Not included
- Rides to care Not included
What changed from 2026
In 2026 this plan was called Wellcare Low Premium (HMO).
- Monthly premium2026$30 a month2027$27 a month
- Drug deductible2026$6152027$700
- Hospital stay2026$375 a day for days 1 to 7, then $0 for days 8 to 902027$375 a day for days 1 to 6, then $0 for days 7 to 90
- Outpatient hospital care2026$0 to $4002027$0 to $375
- X-rays2026$252027$0
- MRI, CT and other scans2026$0 to $3002027$0 to $250
- Ground ambulance2026$2702027$250
- Skilled nursing facility2026$0 for days 1 to 20, then $218 a day for days 21 to 40, then $0 for days 41 to 1002027$0 for days 1 to 20, then $221 a day for days 21 to 40, then $0 for days 41 to 100
- Dental2026Cleanings and exams: $0. Fillings, crowns and dentures covered2027Cleanings and exams covered. Fillings, crowns and dentures covered
- Vision2026Yearly eye exam: $0. Glasses or contacts covered. Eyewear: plan pays up to $200 a year2027Yearly eye exam: $0
- Hearing2026Hearing test: $0. Hearing aids covered. Plan pays up to $25 a month for hearing tests and aids combined, both ears2027Not covered
- Over-the-counter items2026Covered for things like vitamins, pain relief and bandages2027Not covered
- Fitness2026Includes gym or fitness classes2027Not covered
Is my doctor in this plan?
Look up your doctors, then confirm with their office.
Call each doctor’s office and ask:
“Do you take Wellcare Low Premium Focus (HMO), plan number H0562-012, for 2027?”