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 $102.50. 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 either a copay or coinsurance depending on the drug tier and the pharmacy you use. Preferred Generic and Specialty drugs have no copay, while Standard Generic drugs have a 25% coinsurance. Preferred Brand drugs have a 42% coinsurance, and Non-Preferred drugs have a 28% coinsurance. Once your total drug costs reach $2000, you enter the catastrophic coverage phase where you will pay nothing for your Part D covered drugs.
Additional Benefits
The Wellcare Giveback (HMO) plan offers a wide range of benefits with varying cost-sharing. Many services have no copay, including primary care visits, preventive services like annual physical exams and routine eye exams, and home health services. Other services have copays, such as inpatient hospital stays, specialist visits, hearing exams, and dental services, with costs ranging from $20 to $350. This plan also covers outpatient services, emergency services, and ambulance services with copays, along with vision and hearing benefits. Additionally, it provides coverage for medical equipment, diagnostic and radiological services, and dialysis services, often with coinsurance. However, some services like cardiac rehabilitation and certain "other services" are not covered.
Inpatient Hospital See details
Inpatient Hospital coverage includes Inpatient Hospital-Acute and Inpatient Hospital Psychiatric services, both requiring prior authorization and a doctor referral. For Inpatient Hospital-Acute, the copay is $350 for days 1-6, and no copay for days 7-90; Inpatient Hospital Psychiatric has a $2,000 copay. Additional days, non-Medicare covered stays, and upgrades for both Inpatient Hospital-Acute and Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services include coverage for Outpatient Hospital Services with a copay between $0 and $250, Observation Services with a copay between $125 and $250, Ambulatory Surgical Center (ASC) Services with a $100 copay, Outpatient Substance Abuse Services with a $40 copay for both Individual and Group Sessions, and Outpatient Blood Services with no copay. Prior authorization and doctor referrals are required for some services.
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 $250 copay, with no coinsurance, while transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, Worldwide Emergency Coverage, and Worldwide Urgent Coverage are covered. For Emergency Services and Worldwide Emergency Coverage, the copay is $125.00, and there is no coinsurance. For Urgently Needed Services, the copay is $25.00, and there is no coinsurance. Worldwide Emergency Transportation is not covered.
Primary Care See details
Wellcare Giveback (HMO) offers primary care services with no copay, and chiropractic services with a $20 copay. Occupational Therapy Services have a $25 copay, while Physician Specialist Services and Physical Therapy and Speech-Language Pathology Services have a $25 copay. Mental Health and Psychiatric individual and group sessions have a $40 copay. Other Health Care Professional services have a copay between $0 and $25, and Opioid Treatment Program Services have a $25 copay. Additional Telehealth Benefits have a copay between $0 and $40.
Preventive Services See details
The Wellcare Giveback (HMO) plan covers preventive services, including an annual physical exam with no copay. This plan also covers additional preventive services, with no copay for Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit. Kidney Disease Education Services are covered with 20% coinsurance. Some services, such as Health Education, In-Home Safety Assessment, and Personal Emergency Response System, are not covered.
Hearing Services See details
Hearing exams are covered with a $25 copay, and routine hearing exams and fitting/evaluation for hearing aids are covered with no copay. Prescription hearing aids are covered up to $1,000 per year, with no copay for all types of prescription hearing aids, except for inner ear, outer ear, and over the ear hearing aids, which are not covered.
Vision Services See details
Vision services with the Wellcare Giveback (HMO) plan includes eye exams with a copay of $0-$25, and eyewear including contact lenses, eyeglasses, eyeglass lenses, eyeglass frames, and upgrades with no copay. Routine eye exams are covered with no copay. Eyewear has a combined maximum plan benefit coverage amount of $100 per year.
Dental Services See details
The Wellcare Giveback (HMO) plan covers Medicare dental services with a $25 copay. Oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatment, and other preventive dental services are covered with no copay. Orthodontic services are covered, but restorative services, endodontics, periodontics, prosthodontics, maxillofacial prosthetics, implant services, prosthodontics, oral and maxillofacial surgery, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, with prior authorization required. Medicare Part B Insulin Drugs have a $35 copay. 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, requiring a doctor referral. 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, while medical supplies have a 20% coinsurance 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, including all diagnostic services, are covered with a doctor referral and prior authorization. Diagnostic Procedures/Tests have a copay between $0 and $40, Lab Services have no copay, Diagnostic Radiological Services have a copay up to $250, and Outpatient X-Ray Services have a $40 copay. Therapeutic Radiological Services have a 20% coinsurance.
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. A doctor's referral is required for these services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered under the Wellcare Giveback (HMO) plan. For days 1-20 and 51-100, there is no copay, while days 21-50 have a $214 copay; additional days beyond Medicare-covered and non-Medicare-covered stays for SNF are not covered.
Other Services See details
Other Services are not covered under the Wellcare Giveback (HMO) plan, including acupuncture, over-the-counter items, meal benefits, and more. No authorization or referrals are needed for any of the additional 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