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Wellcare Patriot Giveback Open (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Wellcare Patriot Giveback Open (PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Wellcare Patriot Giveback Open (PPO) in 2026, please refer to our full plan details page.
Wellcare Patriot Giveback Open (PPO) is a PPO plan offered by Centene Corporation available for enrollment in 2025 to people living in Select counties in GA. This plan received an overall rating of 3.5 out of 5 stars in 2026.
It's important to know that Wellcare Patriot Giveback Open (PPO) is a Medicare Advantage (MA) Plan without drug coverage. That means that this plan covers medical services but doesn't cover prescription drugs. If you are looking for a plan with prescription drug coverage, please search for other MA and PDP plans offered in your area.
Key Plan Facts
Below are a few key facts and commonly-asked questions about Wellcare Patriot Giveback Open (PPO).
Plan Costs:
The cost of a Medicare Advantage Plan is made up of four main parts.
- First, the monthly premium — the amount you pay every month.
- Second, the deductible — the amount you pay out of pocket for covered services before the plan starts paying.
- Third, the copayments and coinsurance — the amounts you pay out of pocket for covered services, usually after meeting the deductible (if applicable). Copays are fixed dollar amounts; coinsurance is a percentage of the cost.
- Fourth, the Out-of-Pocket Maximum — the maximum amount you could have to pay out of pocket in a year. This may be different for in-network and out-of-network services.
For Wellcare Patriot Giveback Open (PPO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $0.00. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $140.00. You must continue to pay paying your reduced Part B Premium.
Deductibles
This plan does not have a health deductible. Your insurance coverage on covered health services will start immediately.
Drugs are not covered by this plan, so a prescription drug deductible is not applicable.
Out-of-Pocket Maximums
This plan has a combined Maximum Out-Of-Pocket cost of $13900.00 (in-network or out-of-network combined). You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $13900.00 for covered services, the plan will pay 100% of covered costs for the rest of the year.
The plan may have separate out-pocket-maximums for in-network and out-of-network services. See our full plan details page for more information.
You can see below for the coinsurance and specific copayments for in the Additional Benefits section below, or refer to our Plan Details page for more details.
Common Services:
Doctor Visits:
Specialist Visits:
Emergency Room:
Urgent Care:
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Drug Coverage
Prescription drugs are not covered by Wellcare Patriot Giveback Open (PPO).
Additional Benefits
The Wellcare Patriot Giveback Open (PPO) plan offers affordable coverage for core medical needs, featuring no copay for primary care, routine preventive services, and home health care. Specialist visits require a $50 copay, and emergency room visits carry a $115 copay, which is waived if you are admitted. Inpatient hospital stays require a $400 daily copay for the first five to six days, with no copay for subsequent days. This plan also includes valuable supplemental benefits, such as dental and vision coverage with no copay for preventive dental up to $1,000 annually and routine eye exams, plus up to $300 for eyewear. Hearing services feature no copay for routine exams and up to $500 annually for prescription hearing aids. Additionally, durable medical equipment is covered with no copay and a 20% coinsurance, while over-the-counter items and chronic illness meals are available with no copay.
Inpatient Hospital See details
Wellcare Patriot Giveback Open (PPO) partially covers inpatient hospital services with no coinsurance, requiring a $400 daily copay for days 1 through 6 of acute stays and days 1 through 5 of psychiatric stays, with no copay for subsequent days up to day 90. Prior authorization is required, and additional days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Outpatient Services under the Wellcare Patriot Giveback Open (PPO) are covered with no coinsurance, featuring a copay of $0 to $400 for outpatient hospital services and $300 for ambulatory surgical center services. Observation services require a $115 to $400 copay per stay, while outpatient substance abuse sessions and blood services are covered with no copay.
Partial Hospitalization See details
Wellcare Patriot Giveback Open (PPO) covers partial hospitalization benefits with a $105.00 copay and no coinsurance, though prior authorization is required.
Ambulance and Transportation Services See details
Wellcare Patriot Giveback Open (PPO) covers ground and air ambulance services with a $350 copay and no coinsurance, though prior authorization is required. Transportation services to plan-approved or other health-related locations are not covered.
Emergency Services See details
Wellcare Patriot Giveback Open (PPO) covers emergency services with a $115 copay and no coinsurance, and urgent care with a $30 copay and no coinsurance, with copays waived if admitted to the hospital within 24 hours. Worldwide emergency and urgent services are partially covered up to a $50,000 maximum limit with a $115 copay and no coinsurance, but worldwide emergency transportation is not covered.
Primary Care See details
Wellcare Patriot Giveback Open (PPO) covers primary care physician visits, mental health, and psychiatric sessions with no copay and no coinsurance. Specialist visits require a $50 copay, therapy services cost a $35 copay, and telehealth ranges from a $0 to $50 copay with no coinsurance, while podiatry and chiropractic services are not covered.
Preventive Services See details
Preventive Services are partially covered by the Wellcare Patriot Giveback Open (PPO), featuring no copay and no coinsurance for annual physicals, fitness benefits, remote access, alternative therapies, and select screenings, while kidney disease education has no copay and a 20% coinsurance. However, several services are not covered, including health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, wigs, weight management, therapeutic massage, adult day health, nutritional/dietary benefits, home-based palliative care, in-home support, caregiver support, smoking cessation counseling, enhanced disease management, telemonitoring, home safety modifications, and counseling.
Hearing Services See details
Wellcare Patriot Giveback Open (PPO) provides partially covered hearing services with no deductibles, featuring a $50 copay and no coinsurance for Medicare-covered exams, and no copay and no coinsurance for annual routine exams and fitting evaluations. Prescription hearing aids are covered up to $500 annually with no copay and no coinsurance, but OTC hearing aids along with inner ear, outer ear, and over the ear prescription hearing aids are not covered.
Vision Services See details
Vision services are partially covered by the Wellcare Patriot Giveback Open (PPO), which features no deductibles and no coinsurance. Eye exams carry a copay of $0 to $50, which includes one annual routine exam with no copay, though other eye exam services are not covered. Eyewear is covered with no copay up to a combined maximum benefit of $300 per year.
Dental Services See details
Wellcare Patriot Giveback Open (PPO) offers partially covered dental services, featuring a $50 copay and no coinsurance for Medicare-covered dental services, and no copay and no coinsurance for covered preventive and comprehensive services up to a $1,000 annual maximum. Removable and fixed prosthodontics, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Wellcare Patriot Giveback Open (PPO) covers Home Infusion bundled Services with no copay, subject to prior authorization. Under this benefit, Medicare Part B chemotherapy and other drugs require no copay and a 0% to 20% coinsurance, while Medicare Part B insulin is covered with a $35 copay and no coinsurance.
Dialysis Services See details
Dialysis services are covered under the Wellcare Patriot Giveback Open (PPO) with no copay and a 20% coinsurance.
Medical Equipment See details
Wellcare Patriot Giveback Open (PPO) covers medical equipment, including durable medical equipment (DME), prosthetics, and diabetic services, with prior authorization required for these benefits. Durable medical equipment, prosthetics, and medical supplies are offered with no copay and a 20% coinsurance, while diabetic supplies feature no copay and diabetic therapeutic shoes or inserts require a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered by Wellcare Patriot Giveback Open (PPO), with prior authorization required for all services. Diagnostic procedures and tests have no coinsurance and a copay between $0 and $100, lab services and diagnostic radiological services have no copay, outpatient X-rays have a $50 copay, and therapeutic radiological services require 20% coinsurance.
Home Health Services See details
Home Health Services are fully covered under the Wellcare Patriot Giveback Open (PPO) plan with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Wellcare Patriot Giveback Open (PPO) offers Cardiac Rehabilitation Services with no coinsurance, but in practice, some services are covered. Specific programs, including cardiac ($30 copay), intensive cardiac ($40 copay), pulmonary ($25 copay), and SET for PAD ($20 copay) rehabilitation services, are not covered.
Skilled Nursing Facility (SNF) See details
Wellcare Patriot Giveback Open (PPO) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring prior authorization but allowing admission without a prior three-day hospital stay. There is no copay for days 1 to 20 and days 71 to 100, while days 21 to 70 require a $218 daily copay, with no coverage for additional days beyond the standard Medicare limit.
Other Services See details
Wellcare Patriot Giveback Open (PPO) partially covers other services, offering over-the-counter (OTC) items and chronic illness meal benefits with no copay and no coinsurance. Acupuncture is not covered under this benefit, and a referral is required to receive the meal benefits.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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