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Wellcare Giveback (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Wellcare Giveback (HMO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Wellcare Giveback (HMO) in 2026, please refer to our full plan details page.
Wellcare Giveback (HMO) is a HMO plan offered by Centene Corporation available for enrollment in 2025 to people living in Select counties in FL. This plan received an overall rating of 4 out of 5 stars in 2026.
It's important to know that Wellcare Giveback (HMO) 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).
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), 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 $91.00. 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 $7200.00 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) prescription drug plan has an annual drug deductible of $615. You can save money on generic medications, as there is no copay for Tier 1 preferred generics, Tier 2 generics, and Tier 6 select care drugs when filled at a preferred pharmacy or through preferred mail order. Standard pharmacies charge a copay ranging from $5 to $30 for Tier 1 and Tier 2 drugs, while Tier 6 drugs feature no copay at all pharmacies. For brand-name and specialty medications, you will pay a percentage of the drug cost through coinsurance. Tier 3 preferred brands and Tier 5 specialty drugs require a 25% coinsurance, while Tier 4 non-preferred drugs carry a 45% coinsurance. These coinsurance percentages remain the same whether you use a preferred or standard pharmacy.
Additional Benefits
The Wellcare Giveback (HMO) plan offers affordable essential healthcare with no copay and no coinsurance for primary care visits, annual physicals, fitness benefits, and home health services. For more intensive medical needs, members pay a $35 copay for specialists, a $375 daily copay for the first seven days of inpatient hospital stays, and a $115 copay for emergency room visits. Urgent care is also accessible for a $25 copay, with all emergency copays waived if you are admitted to the hospital. Additional benefits include routine dental, vision, and hearing exams with no copay, plus coverage for eyewear up to $100 annually and prescription hearing aids up to $1,000 per ear. Essential medical equipment, diabetic therapeutic shoes, and dialysis services generally require a 20% coinsurance with no copay, whereas diabetic supplies are available with no copay. Note that certain services, including routine transportation, over-the-counter items, meal benefits, and comprehensive dental care, are not covered under this plan.
Inpatient Hospital See details
Wellcare Giveback (HMO) covers inpatient acute hospital stays with no coinsurance, requiring a $375 daily copay for days 1 to 7 and no copay for days 8 to 95, though upgrades and non-Medicare-covered stays are not covered. Inpatient psychiatric hospital care is also covered with no coinsurance and a $2,000 copay per stay, but additional psychiatric days are excluded.
Outpatient Services See details
Wellcare Giveback (HMO) covers outpatient hospital services with no coinsurance and copays ranging from no copay up to $450.00, and ambulatory surgical center services with a $50.00 copay and no coinsurance. Outpatient substance abuse services feature a $40.00 copay with no coinsurance, while outpatient blood services are covered with no copay, no coinsurance, and no deductible.
Partial Hospitalization See details
Wellcare Giveback (HMO) covers partial hospitalization services with a $105.00 copay and no coinsurance. Prior authorization and a referral are required to receive this covered benefit.
Ambulance and Transportation Services See details
Ambulance and transportation services are partially covered by Wellcare Giveback (HMO), with ground and air ambulance services requiring a $300 copay and no coinsurance. Transportation services to plan-approved or any health-related locations are not covered.
Emergency Services See details
Wellcare Giveback (HMO) covers emergency services for a $115 copay and urgent care for a $25 copay, with no coinsurance for either service and copays waived if admitted to the hospital within 24 hours. Worldwide emergency and urgent services are partially covered up to a $50,000 maximum benefit with a $115 copay and no coinsurance, though worldwide emergency transportation is not covered.
Primary Care See details
Wellcare Giveback (HMO) provides primary care physician services with no copay and no coinsurance, while specialist visits, physical therapy, and occupational therapy require a $35 copay and no coinsurance. Chiropractic care is partially covered, offering routine visits for a $15 copay and no coinsurance, whereas podiatry services are not covered under this plan.
Preventive Services See details
Wellcare Giveback (HMO) covers preventive services with no copay and no coinsurance for annual physicals, fitness, alternative therapies, remote access, and other screenings, though kidney disease education requires no copay and a 20% coinsurance. This benefit is partially covered as health education, in-home safety assessments, PERS, medical nutrition therapy, medication reconciliation, re-admission prevention, wigs, weight management, therapeutic massage, adult day health, nutritional benefits, palliative care, in-home support, caregiver support, smoking cessation, disease management, telemonitoring, home safety modifications, and counseling are not covered.
Hearing Services See details
Hearing services are partially covered by Wellcare Giveback (HMO) with no coinsurance, requiring a $35 copay for Medicare-covered exams and no copay for annual routine exams or fitting evaluations. Prescription hearing aids are covered up to $1,000 per ear annually with no copay, though OTC, inner ear, outer ear, and over-the-ear models are not covered.
Vision Services See details
Wellcare Giveback (HMO) offers partially covered vision services with no coinsurance and eye exam copays ranging from $0 to $35, which includes one annual routine exam with no copay. Eyewear is covered with no copay up to a $100 annual limit, though other eye exam services are not covered.
Dental Services See details
Wellcare Giveback (HMO) dental services are partially covered, offering Medicare-covered dental care for a $35 copay and no coinsurance, and preventive, diagnostic, and adjunctive services with no copay and no coinsurance. Restorative services, endodontics, periodontics, fixed and removable prosthodontics, maxillofacial prosthetics, implant services, oral and maxillofacial surgery, and orthodontics are not covered.
Home Infusion bundled Services See details
Wellcare Giveback (HMO) covers home infusion bundled services with no copay, though prior authorization is required. Under this plan, Medicare Part B insulin drugs have a $35 copay and no coinsurance, while chemotherapy and other Part B drugs feature no copay and 0% to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered by Wellcare Giveback (HMO) with no copay and a 20% coinsurance, although a referral is required.
Medical Equipment See details
Wellcare Giveback (HMO) covers medical equipment, including durable medical equipment, prosthetics, and medical supplies, with no copay and a 20% coinsurance. Diabetic supplies are covered with no copay, while diabetic therapeutic shoes and inserts incur a 20% coinsurance, with prior authorization required for these benefits.
Diagnostic and Radiological Services See details
Wellcare Giveback (HMO) covers diagnostic and radiological services, requiring prior authorization and referrals for all care. Diagnostic services feature no coinsurance, with no copay for lab tests and a $0 to $40 copay for procedures, while radiological services range from no copay for diagnostic imaging to a $50 copay for X-rays and a minimum 20% coinsurance for therapeutic radiological services.
Home Health Services See details
Home Health Services are covered by Wellcare Giveback (HMO) with no copay and no coinsurance, though prior authorization and a referral are required.
Cardiac Rehabilitation Services See details
Wellcare Giveback (HMO) covers Cardiac Rehabilitation Services with no copay and no coinsurance, though in practice only some services are covered as cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is covered by Wellcare Giveback (HMO) with no coinsurance, featuring no copay for days 1 to 20 and 61 to 100, and a $218 daily copay for days 21 to 60. Prior authorization and referrals are required, and additional days beyond the Medicare-covered 100 days are not covered.
Other Services See details
Other Services, including acupuncture, over-the-counter (OTC) items, and meal benefits, are not covered under the Wellcare Giveback (HMO) plan.
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