Wellcare Patriot Simple (HMO) in Jim Wells County, Texas — 2026 plan details

Last updated Jul 18, 2026

Reviewed by Jason Burns, Editorial Steward

Published by Senior Direct Answers · Licensed under Citation License 1.0

Wellcare Patriot Simple (HMO) (H5294-014) is a $0-premium Medicare Advantage HMO from Centene Corporation available in Jim Wells County, Texas in 2026, with a 3.5-star overall rating, a $3,400 in-network out-of-pocket maximum, and a $0 annual Part D drug deductible.

Plan facts (CMS CY2026 Landscape file)

OrganizationCentene Corporation
Plan nameWellcare Patriot Simple (HMO)
Contract IDH5294
Plan ID014
Segment ID0
Contract year2026
Contract categoryMA
Plan typeHMO
SNPNo
Monthly consolidated premium
Part C premium$0.00
Part D basic premium
Part D total premium
Annual Part D deductible
Maximum out-of-pocket (in-network)$3400.00
Overall star rating3.5

How this plan is structured

  • $0 consolidated premium. A $0 or near-$0 consolidated premium does not remove the Part B premium — the standard 2026 Part B premium is $202.90 per month and still applies. See the 2026 Medicare Part B premium.
  • HMO plan type. In an HMO-style Medicare Advantage plan, in-network care and primary-care referral rules generally apply. See how Medicare Advantage HMO and PPO plans differ.
  • $3,400 in-network out-of-pocket maximum. The MOOP is the annual cap on what a member pays in-network for covered Part A and Part B services. See how the Medicare Advantage MOOP works.
  • Service area = Jim Wells County. Medicare Advantage plans are sold by service area; moving out of the plan's service area triggers a Special Enrollment Period to switch plans. See how moving changes your Medicare options.

How it compares in Jim Wells County

The CMS CY2026 Landscape file lists 64 Medicare Advantage plans in Jim Wells County, Texas, of which 2 carry a 5.0-star overall rating and 42 have a $0 consolidated monthly premium. Consolidated premiums range from $0.00 to $102.00 per month, and in-network out-of-pocket maximums range from $3400.00 to $9250.00.

Other 5.0-star Medicare Advantage plans in Jim Wells County (first three alphabetically):

PlanOrganizationPremiumMOOP
Texas Independence Community Plan (HMO I-SNP)Regency ISNP Holdings LLC$4.80$9250.00
Texas Independence Health Plan, Inc. (HMO I-SNP)Regency ISNP Holdings LLC$4.80$9250.00

For the full county plan directory, see all Medicare plans in Jim Wells County, Texas.

How to verify your doctors take this plan

Network participation changes throughout the year; we hold no provider-network data, so verify directly with these three sources before you decide:

  1. Open the plan's official Medicare.gov page and use its provider-directory link: Medicare.gov Plan Finder — H5294-014.
  2. Call the plan (Centene Corporation) using the member-services number listed on that plan page and ask whether each doctor, hospital, and pharmacy is in-network for 2026.
  3. Get free, unbiased help from your State Health Insurance Assistance Program (SHIP) — see free unbiased Medicare help from SHIP.

What H5294-014 means

CMS assigns every Medicare Advantage and Part D offering a plan identifier made of three parts. In H5294-014, the leading H marks the contract type (H = Medicare Advantage / Part C contract), the four digits 5294 are the contract number issued to the organization, and the three-digit 014 is the plan benefit package under that contract. The segment ID 0 identifies the service-area segment within the plan (0 = the default single segment).

Frequently asked questions

Is Wellcare Patriot Simple (HMO) an HMO or PPO?

Wellcare Patriot Simple (HMO) is an HMO — a Health Maintenance Organization-style Medicare Advantage plan, meaning in-network care and referral rules generally apply.

Does Wellcare Patriot Simple (HMO) include prescription drug coverage?

Wellcare Patriot Simple (HMO) does not include Part D prescription drug coverage in its consolidated benefits.

What is the maximum out-of-pocket cost for Wellcare Patriot Simple (HMO)?

The 2026 in-network maximum out-of-pocket limit for Wellcare Patriot Simple (HMO) is $3400.00, per the CMS CY2026 Landscape file.

What counties offer Wellcare Patriot Simple (HMO) (H5294-014)?

Wellcare Patriot Simple (HMO) (H5294-014) is offered in 84 Texas counties: Armstrong County, Atascosa County, Bailey County, Bandera County, Bastrop County, Bee County, Bexar County, Blanco County, Borden County, Briscoe County, Brooks County, Burnet County, Caldwell County, Cameron County, Castro County, Collin County, Colorado County, Comal County, Crosby County, Dallas County, Denton County, DeWitt County, Duval County, Ector County, El Paso County, Ellis County, Fisher County, Floyd County, Garza County, Glasscock County, Goliad County, Gonzales County, Grimes County, Guadalupe County, Hays County, Hidalgo County, Hockley County, Hood County, Jack County, Jim Hogg County, Jim Wells County, Karnes County, Kendall County, Kenedy County, Kent County, Kimble County, Kleberg County, La Salle County, Lamb County, Lee County, Lubbock County, Lynn County, Martin County, Mason County, Maverick County, McCulloch County, McMullen County, Medina County, Milam County, Nolan County, Nueces County, Palo Pinto County, Parker County, Potter County, Randall County, Real County, Refugio County, Rockwall County, San Patricio County, Shackelford County, Starr County, Sterling County, Swisher County, Tarrant County, Terry County, Throckmorton County, Uvalde County, Webb County, Willacy County, Williamson County, Wilson County, Wise County, Zapata County, and Zavala County.

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