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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 $172.00. 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) Medicare Advantage plan features an annual prescription drug deductible of $615. You will pay no copay for Tier 1 (Preferred Generic), Tier 2 (Generic), and Tier 6 (Select Care) medications when utilizing preferred pharmacies or preferred mail-order services. Standard pharmacies charge copays starting at $5 for Tier 1 and $10 for Tier 2 drugs, while Tier 6 drugs have no copay across all network pharmacies. For higher-tier medications, costs transition to a coinsurance percentage rather than a flat copayment. Tier 3 (Preferred Brand) and Tier 5 (Specialty Tier) drugs require a 25% coinsurance, while Tier 4 (Non-Preferred) drugs carry a 46% coinsurance at preferred pharmacies and 47% at standard pharmacies. Choosing preferred network pharmacies and mail-order delivery offers the most significant savings on your prescription drug costs under this plan.
Additional Benefits
The Wellcare Giveback (HMO) plan offers comprehensive coverage for essential medical services with predictable out-of-pocket costs. Members benefit from no copay and no coinsurance for primary care visits, routine preventive services, and home health care. For hospital stays, the plan features a $375 daily copay for the first seven days of inpatient care with no copay for days 8 through 100, alongside a $115 copay for emergency room visits. Additional benefits include routine vision, dental, and hearing services, which feature no copay or coinsurance for routine exams and preventive care. The plan also covers prescription hearing aids up to $500 per ear and eyewear up to a $200 annual limit. While durable medical equipment requires a 20% coinsurance, diabetic supplies are covered with no copay, making everyday health management highly affordable.
Inpatient Hospital See details
Wellcare Giveback (HMO) inpatient hospital benefits are partially covered with no coinsurance, requiring a $375 daily copay for days 1 to 7 of acute care (with no copay for days 8 to 100) and a $1,500 copay per psychiatric stay. Prior authorization and referrals are required, and upgrades, additional psychiatric days, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Wellcare Giveback (HMO) covers outpatient services with no coinsurance, featuring copays ranging from $0 to $450 for outpatient hospital care and $75 for ambulatory surgical center services. Outpatient substance abuse sessions carry a $40 copay with no coinsurance, while outpatient blood services are available with no copay and no coinsurance.
Partial Hospitalization See details
Partial hospitalization is covered under the Wellcare Giveback (HMO) plan with a $105.00 copay and no coinsurance. Both prior authorization and a referral are required to access this benefit.
Ambulance and Transportation Services See details
Wellcare Giveback (HMO) covers ground and air ambulance services with a $225 copay and no coinsurance, subject to prior authorization. Transportation services to health-related locations are not covered under this plan.
Emergency Services See details
Wellcare Giveback (HMO) covers emergency services with a $115 copay and urgently needed services with a $10 copay, both featuring no coinsurance and waived fees if admitted to the hospital within 24 hours. Worldwide emergency and urgent care are partially covered up to a $50,000 maximum benefit 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, physical therapy, occupational therapy, and speech therapy require a $20 copay and no coinsurance. Mental health and psychiatric services have a $40 copay and no coinsurance, whereas podiatry services are not covered. Chiropractic services are partially covered with a $15 copay and no coinsurance for up to 12 routine visits per year, but other chiropractic services are not covered.
Preventive Services See details
Wellcare Giveback (HMO) covers preventive services with no copay and no coinsurance for annual physical exams, fitness benefits, and alternative therapies, though additional preventive benefits are partially covered as services like health education, in-home safety assessments, and weight management are excluded. Other covered screenings and training require a referral with no copay and no coinsurance, while kidney disease education requires a referral and has no copay but a 20% coinsurance.
Hearing Services See details
Hearing services are partially covered by Wellcare Giveback (HMO), featuring Medicare-covered exams for a $20 copay and no coinsurance, as well as annual routine exams and fittings with no copay or coinsurance. Prescription hearing aids are covered up to $500 per ear annually with no copay or coinsurance, but OTC, inner ear, outer ear, and over-the-ear models are not covered.
Vision Services See details
Vision services are partially covered by Wellcare Giveback (HMO) with no deductibles or coinsurance, offering annual routine eye exams with no copay and other exams with a $0 to $20 copay, though other eye exam services are not covered. Covered eyewear, including contacts, lenses, and frames, has no copay and no coinsurance up to a $200 annual maximum benefit.
Dental Services See details
Wellcare Giveback (HMO) dental benefits are partially covered, offering Medicare-covered dental services for a $20 copay and no coinsurance. Preventive and adjunctive general dental services are available with no copay and no coinsurance, while restorative, endodontic, periodontic, prosthodontic, implant, oral surgery, and orthodontic services 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 benefit, Medicare Part B insulin drugs carry a $35 copay and no coinsurance, while chemotherapy and other Part B drugs require no copay and a 0% to 20% coinsurance.
Dialysis Services See details
Wellcare Giveback (HMO) covers Dialysis Services with no copay and a 20% coinsurance, although a referral is required to receive these services.
Medical Equipment See details
Wellcare Giveback (HMO) covers durable medical equipment, prosthetics, and medical supplies with no copay and 20% coinsurance. Diabetic supplies are covered with no copay, while diabetic therapeutic shoes and inserts require 20% coinsurance. Prior authorization is required for these benefits, and diabetic supplies are limited to specified manufacturers.
Diagnostic and Radiological Services See details
Wellcare Giveback (HMO) covers diagnostic and radiological services, with diagnostic services featuring no coinsurance, no copay for lab work, and a $0 to $40 copay for diagnostic tests. Radiological services require a 20% coinsurance for therapeutic radiology, a $50 copay for outpatient X-rays, and no copay for diagnostic radiology.
Home Health Services See details
Home health services are covered by Wellcare Giveback (HMO) with no copay and no coinsurance. To access this benefit, both a referral and prior authorization are required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by Wellcare Giveback (HMO) with no coinsurance and require a referral. While the overall benefit is covered, specific sub-services—including cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation—are not covered in practice and carry copays ranging from $20 to $40.
Skilled Nursing Facility (SNF) See details
Wellcare Giveback (HMO) covers Skilled Nursing Facility (SNF) stays with no coinsurance, though prior authorization and referrals are required. There is no copay for days 1 to 20 and days 61 to 100, a $218 daily copay for days 21 to 60, and additional days beyond the standard Medicare limit are not covered.
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.
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