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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 2025, 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 2025.
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 $72.60. 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 $420.00 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 $9350.00 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 has a $420 deductible for prescription drugs. After meeting your deductible, you'll pay a copay or coinsurance depending on the drug tier and pharmacy you use. For example, preferred generic drugs have no copay at preferred pharmacies and mail order, and a $10 copay at standard pharmacies. The plan offers an "Enhanced Alternative" drug benefit. In the initial coverage phase, coinsurance rates range from 25% to 31% depending on the drug tier and pharmacy. Once your total drug costs reach $2,000, you enter the catastrophic coverage phase, where you pay nothing for Part D covered drugs.
Additional Benefits
The Wellcare Giveback (HMO-POS) plan offers a range of benefits, including coverage for inpatient and outpatient hospital services, with varying copays and coinsurance amounts. It also provides coverage for primary care, specialist visits, mental health, and therapy services with copays, along with preventive services at no cost. Vision and dental services are covered with no or low copays, and home health services are available with no cost.
Inpatient Hospital See details
Inpatient hospital benefits are covered, including inpatient hospital-acute and inpatient hospital psychiatric, each with a copay of $2020.00 and $2036.00 respectively per admission or stay, while additional days, non-Medicare covered stays, and upgrades for both sub-services are not covered.
Outpatient Services See details
The Wellcare Giveback (HMO-POS) plan covers outpatient services, including outpatient hospital services with a 30% coinsurance and a copay between $0 and $500, and observation services with a 30% coinsurance and a $110 copay. Ambulatory Surgical Center (ASC) services have a $475 copay, and outpatient substance abuse services have a copay of $35 for both individual and group sessions. Outpatient blood services are covered with no copay.
Partial Hospitalization See details
Partial Hospitalization is covered by the Wellcare Giveback (HMO-POS) plan, but requires prior authorization. You will pay an $80 copay for this service.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Wellcare Giveback (HMO-POS) plan, but require prior authorization. Ground and Air Ambulance Services have a $300 copay, and there is no coinsurance. Transportation Services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Coverage all have a $110 copay with no coinsurance. Worldwide Urgent Coverage has a $110 copay with no coinsurance. Worldwide Emergency Transportation is not covered.
Primary Care See details
The Wellcare Giveback (HMO-POS) plan offers primary care services with no copay, chiropractic services with a $15 copay, and occupational therapy services with a $35 copay. It also covers physician specialist services with a $35 copay, mental health and psychiatric services with a $35 copay, and physical therapy and speech-language pathology services with a $35 copay. Additional telehealth benefits have a copay between $0 and $45, while opioid treatment program services have a $35 copay. Routine chiropractic care and podiatry services are not covered.
Preventive Services See details
Preventive Services include annual physical exams with no copay, and additional services like glaucoma screenings, diabetes self-management training, and more, all with no copay. 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, and counseling services.
Hearing Services See details
Hearing exams have a $35 copay, while routine hearing exams and fitting/evaluation for hearing aids have no copay. Prescription and OTC hearing aids are not covered.
Vision Services See details
The Wellcare Giveback (HMO-POS) plan covers vision services, including eye exams with a copay of $0-$35, and eyewear with no copay, including contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades. Routine eye exams have no copay.
Dental Services See details
The Wellcare Giveback (HMO-POS) plan covers dental services including oral exams, dental x-rays, and other diagnostic and preventive services with no copay, and also covers Medicare dental services with a $35 copay. Restorative services, endodontics, periodontics, prosthodontics, maxillofacial prosthetics, implant services, oral and maxillofacial surgery, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs with a $35 copay, and Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs with coinsurance between 0% and 20%. Prior authorization is required.
Dialysis Services See details
Dialysis Services are covered by the Wellcare Giveback (HMO-POS) plan. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment is covered under the Wellcare Giveback (HMO-POS) plan. Durable Medical Equipment (DME) has a 20% coinsurance with no copay, while Durable Medical Equipment for use outside the home is not covered. Prosthetic Devices have a 20% coinsurance with no copay, and Medical Supplies have a 20% coinsurance with no copay. Diabetic Supplies have no copay, and Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services, including all diagnostic services, diagnostic procedures/tests, lab services, all radiological services, diagnostic radiological services, therapeutic radiological services, and outpatient X-ray services, are covered. Diagnostic Procedures/Tests have a copay between $0 and $50. Lab Services have no copay. Diagnostic Radiological Services have a copay up to $500. Outpatient X-Ray Services have a $50 copay. Therapeutic Radiological Services have a coinsurance of at least 20%.
Home Health Services See details
Home Health Services are covered by the Wellcare Giveback (HMO-POS) plan with no copay and no coinsurance. Additional hours of care and personal care services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by the Wellcare Giveback (HMO-POS) plan, but no copay or coinsurance information is provided. However, the specific services of Cardiac Rehabilitation, Intensive Cardiac Rehabilitation, Pulmonary Rehabilitation, and SET for PAD are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered under the Wellcare Giveback (HMO-POS) plan, but prior authorization is required. For days 1-20 and 71-100, there is no copay, and for days 21-70, the copay is $214. Additional days beyond Medicare-covered and non-Medicare-covered stays for SNF are not covered.
Other Services See details
Under "Other Services," acupuncture, over-the-counter items, 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. The plan covers a meal benefit with a $0 copay, and requires a doctor's referral.
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