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Wellcare Giveback (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Wellcare Giveback (HMO-POS). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Wellcare Giveback (HMO-POS) in 2026, please refer to our full plan details page.
Wellcare Giveback (HMO-POS) is a HMO-POS plan offered by Centene Corporation available for enrollment in 2025 to people living in All counties in CT. This plan received an overall rating of 3.5 out of 5 stars in 2026.
It's important to know that Wellcare Giveback (HMO-POS) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Key Plan Facts
Below are a few key facts and commonly-asked questions about Wellcare Giveback (HMO-POS).
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 Giveback (HMO-POS), 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 $60.00. 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.
This plan has a $615.00 drug deductible. You will need to pay this amount towards covered prescriptions before your insurance coverage for prescription medications kicks in.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $9250.00 for out-of-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $0.00 for in-network covered services, the plan will pay 100% of in-network covered costs for the rest of the year.
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
The Wellcare Giveback (HMO-POS) plan features an annual prescription drug deductible of $615. Beneficiaries can enjoy no copay for Tier 1 (Preferred Generic) and Tier 2 (Generic) drugs when using preferred pharmacies or preferred mail-order services. Furthermore, Tier 6 (Select Care Drugs) are fully covered with no copay at both preferred and standard pharmacies. For brand-name and specialty medications, costs are based on coinsurance, with Tier 3 (Preferred Brand) and Tier 5 (Specialty) drugs requiring a 25% coinsurance. Tier 4 (Non-Preferred) drugs carry a 34% coinsurance across all pharmacy options. If you choose standard pharmacies or mail-order services for generic tiers, copays range from $5 to $30 depending on the drug tier and supply fill.
Additional Benefits
The Wellcare Giveback (HMO-POS) plan offers affordable essential medical coverage, featuring no copay and no coinsurance for primary care doctor visits, routine annual physicals, and home health services. Specialist visits and physical therapy require a $35 copay with no coinsurance, while emergency room visits carry a $115 copay. If you require hospital care, acute inpatient stays require a $2,225 copay per stay and psychiatric stays require a $2,075 copay, both with no coinsurance. For routine wellness, the plan provides routine eye exams, routine hearing exams, and preventive dental cleanings with no copay and no coinsurance. Diagnostic lab work and diabetic supplies are also covered with no copay, while durable medical equipment features a 20% coinsurance and no copay. Please note that some services, such as hearing aids, comprehensive dental treatments, and over-the-counter items, are not covered under this plan.
Inpatient Hospital See details
Wellcare Giveback (HMO-POS) partially covers inpatient hospital services, as additional days, upgrades, and non-Medicare-covered stays are not covered. Covered acute inpatient stays require a $2,225 copay per stay and no coinsurance, while psychiatric inpatient stays require a $2,075 copay per stay and no coinsurance.
Outpatient Services See details
Outpatient services covered by Wellcare Giveback (HMO-POS) include outpatient hospital visits with a copay of no copay to $500 and 30% coinsurance, and observation services with a $115 copay per stay and 30% coinsurance. Ambulatory surgical center services require a $475 copay and no coinsurance, outpatient substance abuse sessions have a $35 copay and no coinsurance, and outpatient blood services are available with no copay and no coinsurance.
Partial Hospitalization See details
Wellcare Giveback (HMO-POS) covers partial hospitalization services with a $105.00 copayment and no coinsurance. Prior authorization is required to receive this covered benefit.
Ambulance and Transportation Services See details
Wellcare Giveback (HMO-POS) covers ground and air ambulance services with a $350 copay and no coinsurance, though prior authorization is required. While some transportation services are covered, trips to plan-approved or any other health-related locations are not covered.
Emergency Services See details
Emergency Services are covered by Wellcare Giveback (HMO-POS) with a $115 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services require a $40 copay and no coinsurance, while worldwide emergency and urgent services are partially covered up to $50,000 with a $115 copay and no coinsurance, excluding worldwide emergency transportation.
Primary Care See details
Wellcare Giveback (HMO-POS) covers primary care physician services with no copay and no coinsurance, while specialist visits, physical, occupational, and speech therapies, and outpatient mental health services require a $35 copay and no coinsurance. Telehealth benefits are available with a copay of $0 to $40 and no coinsurance, but chiropractic and podiatry services are not covered.
Preventive Services See details
Wellcare Giveback (HMO-POS) covers preventive services, including annual physical exams and select screenings with no copay and no coinsurance, while kidney disease education requires no copay and a 20% coinsurance. Additional preventive benefits are partially covered, offering alternative therapies, memory fitness, and remote access with no copay and no coinsurance, whereas services such as health education, in-home safety assessments, and personal emergency response systems are not covered.
Hearing Services See details
Hearing services are partially covered by Wellcare Giveback (HMO-POS), which features a $35 copay and no coinsurance for Medicare-covered exams, and no copay or coinsurance for one routine hearing exam and fitting evaluation annually. However, prescription hearing aids and over-the-counter (OTC) hearing aids are not covered under this plan.
Vision Services See details
Vision Services are partially covered by Wellcare Giveback (HMO-POS) with no deductibles, featuring no coinsurance for all services, no copay for yearly routine eye exams, and no copay for eyewear up to a $100 annual limit. Other eye exam services are not covered, Medicare-covered exams carry a copay of up to $35.00, and prior authorization is required.
Dental Services See details
Wellcare Giveback (HMO-POS) dental services are partially covered, featuring Medicare-covered dental care for a $35 copay and no coinsurance, and preventive services like cleanings and exams with no copay and no coinsurance. Restorative services, endodontics, periodontics, prosthodontics, implants, oral surgery, and orthodontics are not covered.
Home Infusion bundled Services See details
Wellcare Giveback (HMO-POS) covers home infusion bundled services with no copay, though prior authorization is required. Under this benefit, Medicare Part B insulin has a $35 copay and no coinsurance, while chemotherapy and other Part B drugs feature no copay and a coinsurance of 0% to 20%.
Dialysis Services See details
Dialysis Services are covered under the Wellcare Giveback (HMO-POS) plan with no copay and a 20% coinsurance.
Medical Equipment See details
Medical equipment is covered by Wellcare Giveback (HMO-POS) with no copay and a 20% coinsurance for durable medical equipment, prosthetics, medical supplies, and diabetic therapeutic shoes. Diabetic supplies are covered with no copay, and prior authorization is required for these benefits.
Diagnostic and Radiological Services See details
Wellcare Giveback (HMO-POS) covers diagnostic services with no coinsurance, featuring no copay for lab services and copays from $0 to $75 for diagnostic tests. Diagnostic radiological services start at no copay, outpatient X-rays require a $50 copay, and therapeutic radiological services carry a minimum 20% coinsurance.
Home Health Services See details
Home Health Services are covered by Wellcare Giveback (HMO-POS) with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are offered by Wellcare Giveback (HMO-POS) with no coinsurance, but some services are covered while others are not. Specifically, standard cardiac rehabilitation (with a $30 copay), intensive cardiac rehabilitation (with a $40 copay), pulmonary rehabilitation (with a $25 copay), and supervised exercise therapy for peripheral artery disease (with a $20 copay) are not covered under this plan.
Skilled Nursing Facility (SNF) See details
Wellcare Giveback (HMO-POS) covers skilled nursing facility (SNF) services with no coinsurance, requiring prior authorization but allowing admission without a prior three-day inpatient hospital stay. There is no copay for days 1 to 20 and days 71 to 100, but a $218 copay applies for days 21 to 70, and additional days beyond Medicare coverage are not covered.
Other Services See details
Other Services are not covered by the Wellcare Giveback (HMO-POS) plan, which excludes coverage for acupuncture, over-the-counter (OTC) items, and meal benefits. Because these services are not covered, there are no copayments or coinsurance options available, and members must pay the full cost out of pocket.
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