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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 2025, 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 out of 5 stars in 2025.
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 $115.00. 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 $10100.00 (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 $10100.00 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 a variety of benefits with varying cost-sharing. Inpatient hospital stays have a $400 copay for days 1-5, and then no copay for days 6-90, while outpatient services often have copays between $0 and $400. The plan also includes coverage for primary care, preventive services, hearing, vision, and dental, with some services having no copay, and others with copays ranging from $15 to $35. This plan provides coverage for ambulance, emergency, and skilled nursing facility services, with specific copays or coinsurance amounts. Other covered services include home health, medical equipment, diagnostic and radiological services, and home infusion, with a mix of copays and coinsurance. Additional benefits such as OTC items and a meal benefit are offered.
Inpatient Hospital See details
Inpatient Hospital benefits, including acute and psychiatric, are covered under this plan. For days 1-5, there is a $400 copay, and for days 6-90, there is no copay.
Outpatient Services See details
Outpatient Services, including all outpatient hospital services, are covered by the Wellcare Patriot Giveback Open (PPO) plan. Outpatient Hospital Services have a copay between $0 and $400, Observation Services have a copay between $110 and $400, and Ambulatory Surgical Center (ASC) Services have a copay of $150. Individual and Group Sessions for Outpatient Substance Abuse have no copay, and Outpatient Blood Services have no copay.
Partial Hospitalization See details
Partial Hospitalization is covered by the Wellcare Patriot Giveback Open (PPO) plan, with a copay of $75.00. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Wellcare Patriot Giveback Open (PPO) plan. Ground and Air Ambulance Services have a $250 copay, and there is no coinsurance, while Transportation Services to any health-related location are not covered.
Emergency Services See details
Emergency Services are covered by the Wellcare Patriot Giveback Open (PPO) plan with a $110 copay and no coinsurance, while Urgently Needed Services have a $30 copay and no coinsurance. Worldwide Emergency Coverage and Worldwide Urgent Coverage have a $110 copay and no coinsurance, while Worldwide Emergency Transportation is not covered.
Primary Care See details
The Wellcare Patriot Giveback Open (PPO) plan covers primary care services with no copay. Chiropractic services have a $15 copay, and occupational therapy services have a $35 copay. Physician specialist services, physical therapy, and speech-language pathology services all have a $35 copay. Mental health and psychiatric services, as well as additional telehealth benefits, have varied copays ranging from $0 to $35. Opioid Treatment Program Services have a $35 copay. Routine chiropractic care and podiatry services are not covered.
Preventive Services See details
The Wellcare Patriot Giveback Open (PPO) plan covers preventive services with no copay for annual physical exams, glaucoma screenings, diabetes self-management training, barium enemas, digital rectal exams, and EKG following a Welcome Visit. Kidney disease education services have a 20% coinsurance. The plan does not cover health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge in-home medication reconciliation, re-admission prevention, wigs for hair loss related to chemotherapy, weight management programs, therapeutic massage, adult day health services, nutritional/dietary benefits, home-based palliative care, in-home support services, support for caregivers of enrollees, additional sessions of smoking and tobacco cessation counseling, enhanced disease management, telemonitoring services, home and bathroom safety devices and modifications, or counseling services.
Hearing Services See details
Hearing exams are covered, with a $35 copay. Routine hearing exams and fitting/evaluation for hearing aids have no copay. Prescription hearing aids are covered up to $500 per ear, and have no copay. Prescription hearing aids for the inner ear, outer ear, and over the ear are not covered. OTC hearing aids are not covered.
Vision Services See details
The Wellcare Patriot Giveback Open (PPO) plan covers vision services, including eye exams with a copay between $0 and $35, and eyewear with no copay, up to a combined maximum of $300 per year. Routine eye exams, contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades are all covered with no copay.
Dental Services See details
The Wellcare Patriot Giveback Open (PPO) plan covers Medicare Dental Services with a $35 copay, and other dental services including oral exams, dental x-rays, and other diagnostic dental services with no copay. The plan also covers prophylaxis (cleaning), fluoride treatment, oral and maxillofacial surgery, and adjunctive general services with no copay. Orthodontic services are covered up to a $1,000 maximum. Prosthodontics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered under the Wellcare Patriot Giveback Open (PPO) plan, with a $35 copay for Medicare Part B Insulin Drugs; other Medicare Part B drugs have a coinsurance between 0% and 20%. Prior authorization is required for this benefit.
Dialysis Services See details
Dialysis Services are covered under the Wellcare Patriot Giveback Open (PPO) plan. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment is covered, including Durable Medical Equipment (DME) with 20% coinsurance and Prosthetic Devices with 20% coinsurance; however, Durable Medical Equipment for use outside the home is not covered. Diabetic Supplies have no copay, and Diabetic Therapeutic Shoes/Inserts have 20% coinsurance.
Diagnostic and Radiological Services See details
The Wellcare Patriot Giveback Open (PPO) plan covers diagnostic and radiological services. Diagnostic Procedures/Tests have a copay between $0 and $50, and Lab Services have no copay. Diagnostic Radiological Services have a copay up to $280, Therapeutic Radiological Services have up to 20% coinsurance, and Outpatient X-Ray Services have a $100 copay.
Home Health Services See details
Home Health Services are covered by the Wellcare Patriot Giveback Open (PPO) plan with no copay and no coinsurance. However, additional hours of care and personal care services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by the Wellcare Patriot Giveback Open (PPO) plan, but the sub-services are not covered. There is a copay for these services, but the specific amount is not provided.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Wellcare Patriot Giveback Open (PPO) plan, but require prior authorization. There is no copay for days 1-20 and days 51-100, but there is a $214 copay for days 21-50. Additional days beyond Medicare-covered for SNF and Non-Medicare-covered stays for SNF are not covered.
Other Services See details
The "Other Services" benefit for the Wellcare Patriot Giveback Open (PPO) plan includes coverage for Over-the-Counter (OTC) Items with no copay, and a meal benefit with no copay and a required doctor referral. Acupuncture, Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, and Self-Directed Personal Assistance Services are not covered.
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