Wellcare Dual Liberty (HMO D-SNP) (009): Outpatient Diagnostic Tests and Therapeutic Services and Supplies

Includes therapeutic radiology services, diagnostic radiology services, diagnostic procedures and tests, surgical and splinting supplies, and lab services.

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Cost
$0 copay for Medicare-covered services
Prior Authorization Required
Yes
Provider Referral or Order Required
Yes

How To Receive

Details on how to apply

Covered services include, but are not limited to:

  • X-rays

  • Radiation (radium and isotope) therapy including technician materials and supplies

  • Surgical supplies, such as dressings

  • Splints, casts and other devices used to reduce fractures and dislocations

  • Laboratory tests

  • Blood - including storage and administration. Coverage of whole blood and packed red cells begins with the first pint of blood that you need. All other components of blood are covered beginning with the first pint used.

  • Other outpatient diagnostic tests – Non-radiological diagnostic services (e.g., allergy test or EKG)

  • Other outpatient diagnostic tests (includes complex tests such as CT, MRI, MRA, SPECT) - Radiological diagnostic services, not including flat film X-rays

  • Diagnostic colonoscopy


Contact the Member Services at 1-800-431-9007. (TTY users should call 711) to address any additional questions

Availability
Ongoing, as ordered and authorized

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Covered services include, but are not limited to:

*Coverage of whole blood and packed red cells begins only with the fourth pint of blood needed—costs for the first 3 pints of blood in a calendar year must be paid out-of-pocket or the blood must be donated from self or by someone else. All other components of blood are covered beginning with the first pint.

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