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 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 $77.00. 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:
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) Medicare prescription drug plan features an annual drug deductible of $615. Beneficiaries enjoy no copay for Tier 1 preferred generic and Tier 2 generic medications when using preferred pharmacies or preferred mail-order services. Additionally, Tier 6 select care drugs feature no copay regardless of whether you use preferred or standard pharmacies and mail-order options. For brand-name and specialty medications, costs are structured as coinsurance rather than flat copays. Tier 3 preferred brand drugs and Tier 5 specialty drugs require a 25% coinsurance, while Tier 4 non-preferred drugs have a 50% coinsurance. Standard pharmacies and standard mail-order options are also available, with copays for generic tiers ranging from $5 to $30 depending on the supply.
Additional Benefits
The Wellcare Giveback (HMO) plan offers affordable healthcare coverage with no copay for primary care doctor visits and a $35 copay for specialist appointments. Inpatient hospital stays require a $400 daily copay for the first six days, followed by no copay for days seven through 95, while outpatient services range from no copay up to a $250 copay. Emergency room visits carry a $115 copay, which is waived if you are admitted, and urgent care services require a $25 copay. For routine wellness, this plan features no copay for preventive services, annual fitness benefits, routine dental cleanings, and annual eye and hearing exams. Additionally, members receive allowance coverage for prescription hearing aids and eyewear with no copay, though advanced dental services are not covered. It is important to note that this plan does not cover transportation, over-the-counter items, or meal benefits.
Inpatient Hospital See details
Wellcare Giveback (HMO) covers inpatient hospital services with no coinsurance, though prior authorization and referrals are required. Acute care requires a $400 daily copay for days 1 through 6 and no copay for days 7 through 95, while psychiatric stays carry a $2,000 copay per stay; non-Medicare-covered stays and upgrades are not covered.
Outpatient Services See details
Wellcare Giveback (HMO) covers outpatient services with no coinsurance, featuring no copay to a $250 copay for outpatient hospital services and a $115 to $250 copay per stay for observation services. Ambulatory surgical center services require a $100 copay, outpatient substance abuse sessions carry a $40 copay, and outpatient blood services are covered with no copay or deductible.
Partial Hospitalization See details
Partial hospitalization is covered by Wellcare Giveback (HMO) with a $105.00 copay and no coinsurance. This benefit requires both a referral and prior authorization.
Ambulance and Transportation Services See details
Wellcare Giveback (HMO) covers ground and air ambulance services with a $250 copay and no coinsurance, though prior authorization is required. Transportation services to health-related locations are not covered under this plan.
Emergency Services See details
Emergency services are covered by Wellcare Giveback (HMO) with a $115 copay and no coinsurance, which is waived if admitted to the hospital within 24 hours, and urgent care is covered with a $25 copay and no coinsurance. Worldwide emergency and urgent services are partially covered up to a $50,000 lifetime maximum with a $115 copay and no coinsurance, but worldwide emergency transportation is not covered.
Primary Care See details
Wellcare Giveback (HMO) covers primary care physician services with no copay and no coinsurance, while specialist visits require a $35 copay and no coinsurance. Additional benefits like physical therapy and mental health sessions have copays up to $40 and no coinsurance, though chiropractic services are only partially covered—excluding non-routine care—and podiatry services are not covered.
Preventive Services See details
Preventive services are partially covered by Wellcare Giveback (HMO), featuring annual exams, fitness benefits, and alternative therapies with no copay and no coinsurance, though kidney disease education requires a 20% coinsurance and no copay. Non-covered sub-services include health education, weight management, nutritional benefits, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, wigs, therapeutic massage, adult day health, home-based palliative care, in-home support, caregiver support, smoking cessation, enhanced disease management, telemonitoring, home/bathroom safety, and counseling.
Hearing Services See details
Hearing services are covered by Wellcare Giveback (HMO), featuring a $35 copay and no coinsurance for Medicare-covered exams, and no copay or coinsurance for annual routine exams and fittings. Prescription hearing aids are partially covered with no copay or coinsurance up to $1,000 per ear annually, but OTC, inner ear, outer ear, and over-the-ear hearing aids are not covered.
Vision Services See details
Wellcare Giveback (HMO) vision services are partially covered with no deductible and no coinsurance, offering no copay for one annual routine eye exam and eyewear up to a $100 yearly limit. Medicare-covered eye exams require a copay ranging from no copay to $35, though other eye exam services are not covered.
Dental Services See details
Wellcare Giveback (HMO) covers Medicare-covered dental services for a $35 copay and no coinsurance, and preventive services like exams and cleanings with no copay and no coinsurance. Other dental services are partially covered, offering adjunctive general services with no copay and no coinsurance, but 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 by Wellcare Giveback (HMO) with no copay, though prior authorization is required. Medicare Part B insulin is covered with 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
Wellcare Giveback (HMO) covers Dialysis Services with no copay and a 20% coinsurance, although a prior referral is required.
Medical Equipment See details
Wellcare Giveback (HMO) covers durable medical equipment, prosthetics, and medical supplies with no copay and a 20% coinsurance. Diabetic supplies are offered with no copay, while diabetic therapeutic shoes or inserts carry a 20% coinsurance, with prior authorization required for most equipment.
Diagnostic and Radiological Services See details
Wellcare Giveback (HMO) covers diagnostic and radiological services, offering diagnostic tests with no coinsurance, no copay for lab services, and copays ranging from $0 to $40 for diagnostic procedures. Radiological services require referrals and prior authorization, featuring a $50 copay for outpatient X-rays, a 20% coinsurance for therapeutic radiology, and diagnostic radiology copays starting at $0.
Home Health Services See details
Home Health Services are covered by Wellcare Giveback (HMO) with no copay and no coinsurance. Both a referral and prior authorization are required to access these services.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by Wellcare Giveback (HMO) with no coinsurance and a required referral, though only some services are covered. Specifically, standard cardiac ($30 copay), intensive cardiac ($40 copay), pulmonary ($25 copay), and SET for PAD ($20 copay) rehabilitation services are not covered.
Skilled Nursing Facility (SNF) See details
Wellcare Giveback (HMO) covers Skilled Nursing Facility (SNF) care with no coinsurance, offering no copay for days 1 to 20 and 61 to 100, and a $218 daily copay for days 21 to 60. The benefit is partially covered since additional days beyond the Medicare-covered limit are not covered, and both prior authorization and referrals are required.
Other Services See details
Other Services are not covered under the Wellcare Giveback (HMO) plan, as acupuncture, over-the-counter (OTC) items, and meal benefits are all excluded from coverage.
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