A non-government entity
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 2025, 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 3.5 out of 5 stars in 2025.
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 $132.00. 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 $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 $5000.00 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:
Sign up for Wellcare Giveback (HMO)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
Drug Coverage
The Wellcare Giveback (HMO) plan has a $420 deductible for prescription drugs. After the deductible is met, you will pay for your prescriptions based on the drug tier and pharmacy type. For preferred generic drugs and specialty tier drugs, there is no copay at preferred pharmacies and preferred mail order. For standard generic, preferred brand, and non-preferred drugs, you will pay coinsurance.
Additional Benefits
The Wellcare Giveback (HMO) plan offers a range of benefits with varying costs. Inpatient hospital stays have a copay, with no copay for most days, while outpatient services have copays depending on the service. Emergency and urgent care services have copays, and primary care visits have no copay. Preventive services, including annual physical exams, have no copay, and there is no copay for hearing exams, vision services, and many dental services. The plan also covers home health services with no copay, and skilled nursing facility stays with no copay for some days.
Inpatient Hospital See details
Inpatient Hospital benefits, including both Acute and Psychiatric care, are covered, but require prior authorization and a doctor's referral. For Inpatient Hospital-Acute, the copay is $350 for days 1-8, and no copay for days 9-90. Inpatient Hospital Psychiatric care has a copay of $2000 per admission or stay. Additional days, non-Medicare-covered stays, and upgrades for both Inpatient Hospital-Acute and Psychiatric care are not covered.
Outpatient Services See details
Outpatient services include coverage for all outpatient hospital services, observation services, ambulatory surgical center (ASC) services, outpatient substance abuse services, and outpatient blood services. Outpatient Hospital Services have a copay of $0-$450, Observation Services have a copay of $125-$450, Ambulatory Surgical Center (ASC) Services have a $50 copay, and Outpatient Substance Abuse Services, including individual and group sessions, have a $40 copay. Outpatient blood services have no copay.
Partial Hospitalization See details
Partial Hospitalization is covered by the Wellcare Giveback (HMO) plan, but requires prior authorization and a doctor's referral. The copay for this benefit is $105.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Wellcare Giveback (HMO) plan. Ground and Air Ambulance Services have a $300 copay, with no coinsurance, while Transportation Services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Coverage are covered by the Wellcare Giveback (HMO) plan. Emergency Services and Worldwide Emergency Coverage have a $125 copay, while Urgently Needed Services have a $25 copay; all three have no coinsurance. Worldwide Urgent Coverage has a $125 copay. Worldwide Emergency Transportation is not covered.
Primary Care See details
The Wellcare Giveback (HMO) plan covers primary care physician services with no copay, chiropractic services with a $20 copay, occupational therapy with a $35 copay, physician specialist services and physical therapy with a $35 copay, and mental health specialty services, psychiatric services, and opioid treatment program services with a copay of $40 for individual and group sessions. The plan also covers other health care professionals with a copay between $0 and $35, additional telehealth benefits with a copay between $0 and $40, and routine chiropractic care with a $20 copay for 12 visits per year. Podiatry services are not covered.
Preventive Services See details
Preventive services include coverage for annual physical exams with no copay, and additional preventive services with varying copays. Kidney disease education services are covered with 20% coinsurance. Other preventive services include no copay for glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKG following welcome visit.
Hearing Services See details
Hearing Services include hearing exams with a $35 copay and routine hearing exams and fitting/evaluation for hearing aids with no copay. Prescription hearing aids are partially covered, with a maximum plan benefit of $1000 per ear per year, and prescription hearing aids (all types) have no copay.
Vision Services See details
The Wellcare Giveback (HMO) plan covers vision services, including eye exams with a copay between $0 and $35, and eyewear with a maximum plan benefit of $100 per year with no copay. Contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades are also covered with no copay.
Dental Services See details
The Wellcare Giveback (HMO) plan covers Medicare Dental Services with a $35 copay, and other dental services including oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatment, and other preventive dental services, each with no copay. Restorative services, endodontics, periodontics, prosthodontics, maxillofacial prosthetics, implant services, and oral and maxillofacial surgery are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by the Wellcare Giveback (HMO) plan. Medicare Part B Insulin Drugs have a $35 copay, while Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the Wellcare Giveback (HMO) plan, and a doctor referral is required. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment, including Durable Medical Equipment, Prosthetics/Medical Supplies, and Diabetic Equipment, is covered. Durable Medical Equipment has a 20% coinsurance, and Medical Supplies also have a 20% coinsurance. Prosthetic Devices and Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance, and Diabetic Supplies have no copay.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including all diagnostic services, diagnostic procedures/tests with a copay between $0 and $40, lab services with no copay, and outpatient X-ray services with a $50 copay. Therapeutic Radiological Services have a coinsurance of at least 20%, and diagnostic radiological services may have a copay up to $280.
Home Health Services See details
Home Health Services are covered by the Wellcare Giveback (HMO) 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 under the Wellcare Giveback (HMO) plan, but the plan does not cover Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, or Additional Cardiac Rehabilitation Services. A doctor's referral is required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Wellcare Giveback (HMO) plan, with prior authorization and a doctor's referral required. For days 1-20 and 51-100, there is no copay, while for days 21-50, the copay is $214.
Other Services See details
The "Other Services" benefit in the Wellcare Giveback (HMO) plan does not cover acupuncture, over-the-counter items, meal benefits, 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, or Self-Directed Personal Assistance Services. No authorization or referrals are required for these services.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
*/SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
MedicareAdvantageRX.com is owned and operated by Dog Media Solutions LLC.
This is a promotional communication.
Every year, Medicare evaluates plans based on a 5-star rating system.
Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
Enrollment in Medicare/Medicare Advantage may be limited to certain times of the year unless you qualify for a Special Enrollment Period
We do not offer every plan available in your area. Currently, we represent 18 organizations, which offer 52,101 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
We represent Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan's contract renewal.
Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.
Please contact Medicare.gov ,1-800-MEDICARE , or your local State Health Insurance Program (SHIP) to get information on all of your options.
Medicare has neither approved nor endorsed any information on this site.
Speak with a licensed insurance agent: 1-877-649-2073 / TTY 711 | 8am - 11pm ET | 7 days a week
© 2023 Dog Media Solutions LLC. All rights reserved