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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 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 $142.00. 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:
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Drug Coverage
The Wellcare Giveback (HMO) plan has a $420.00 deductible for prescription drugs. After the deductible, you will pay a copay or coinsurance depending on the drug tier and where you get your prescription filled. For preferred generic drugs, there is no copay when filled at a preferred pharmacy or through preferred mail order, but a $10 copay at standard pharmacies or through standard mail order. For specialty drugs, there is no copay, regardless of the pharmacy.
Additional Benefits
The Wellcare Giveback (HMO) plan offers coverage for a wide range of services, including inpatient and outpatient care, with varying copays. Inpatient hospital stays have a copay, and outpatient services have copays from $0 to $250. Emergency services and primary care have copays, and preventive services are covered with no copay for annual physical exams. This plan also covers hearing, vision, and dental services. Hearing exams and prescription hearing aids have no copay, and vision services include eye exams and eyewear. Dental services include coverage for Medicare Dental Services, with a 20% coinsurance for restorative services.
Inpatient Hospital See details
Inpatient Hospital benefits, including Acute and Psychiatric, are covered, but require prior authorization and a doctor referral. For Inpatient Hospital-Acute, you will pay a $325 copay for days 1-8, and no copay for days 9-90; Inpatient Hospital Psychiatric has a $2000 copay.
Outpatient Services See details
Outpatient Services with the Wellcare Giveback (HMO) plan includes coverage for all outpatient hospital services, with a copay between $0 and $250, and observation services with a copay between $125 and $250. Ambulatory Surgical Center (ASC) services have a $50 copay, and outpatient substance abuse services have a $40 copay for both individual and group sessions. Outpatient blood services are covered with no copay.
Partial Hospitalization See details
Partial Hospitalization is covered under the Wellcare Giveback (HMO) plan, but requires prior authorization and a doctor 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 each have a $200 copay, and there is no coinsurance; however, 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 under the Wellcare Giveback (HMO) plan, with copays of $125, $20, and $125, respectively, and no coinsurance. Worldwide Urgent Coverage also has a $125 copay and no coinsurance, while 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, and occupational therapy services with a $20 copay. This plan also covers physician specialist services, physical therapy, and speech-language pathology services with a $20 copay, and mental health and psychiatric services with a $40 copay for individual and group sessions. Additional telehealth benefits range from no copay to a $40 copay, and opioid treatment program services have a $20 copay.
Preventive Services See details
Preventive services, including annual physical exams, are covered by the Wellcare Giveback (HMO) plan. Annual physical exams have no copay, and other preventive services have a copay as described in the plan details. Kidney disease education services have a 20% coinsurance. Other services like health education, in-home safety assessments, and more are not covered.
Hearing Services See details
Hearing exams are covered by the Wellcare Giveback (HMO) plan with a $20 copay. Routine hearing exams and fitting/evaluation for hearing aids have no copay, and prescription hearing aids (all types) have no copay, but the plan covers a maximum of $750 per year for prescription hearing aids.
Vision Services See details
The Wellcare Giveback (HMO) plan covers vision services, including eye exams and eyewear. Eye exams have a copay of $0 to $20, while routine eye exams have no copay. Eyewear, including contact lenses, eyeglasses, eyeglass lenses, eyeglass frames, and upgrades, have no copay, with a combined maximum plan benefit of $200 per year.
Dental Services See details
Dental Services include coverage for Medicare Dental Services with a $20 copay, and other services like Oral Exams and Dental X-Rays with no copay. Restorative Services, Adjunctive General Services, Endodontics, Periodontics, Prosthodontics (removable and fixed), and Oral and Maxillofacial Surgery have a 20% coinsurance. Maxillofacial Prosthetics, Implant Services, and Orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered under 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, with a doctor referral 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, are covered. Durable Medical Equipment has a 20% coinsurance, while Prosthetic Devices, Medical Supplies, and Diabetic Therapeutic Shoes/Inserts also have a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered. Diagnostic Procedures/Tests have a copay between $0 and $40, while Lab Services have no copay. Diagnostic Radiological Services have a copay of at most $250, and Therapeutic Radiological Services have a coinsurance of at least 20%. Outpatient X-Ray Services have a $40 copay.
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 not covered by the Wellcare Giveback (HMO) plan. Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, and Additional Cardiac Rehabilitation Services are also not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Wellcare Giveback (HMO) plan, but require prior authorization and a doctor's referral. For days 1-20 and 51-100, there is no copay, but there is a $214 copay for days 21-50.
Other Services See details
Other Services, including acupuncture, over-the-counter items, and meal benefits, are not covered. Also not covered are 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.
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