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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 $116.00. 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 deductible for prescription drugs. After the deductible is met, you will pay a copay or coinsurance depending on the drug tier and the pharmacy you use. For example, you will pay no copay for preferred generic drugs and specialty tier drugs at preferred pharmacies. For preferred brand drugs, you will pay 39% coinsurance at preferred pharmacies. Once your total drug costs reach $2000, you enter the catastrophic coverage phase and pay nothing for Part D covered drugs.
Additional Benefits
The Wellcare Giveback (HMO) plan offers a variety of benefits, including coverage for inpatient hospital stays with a copay, outpatient services with copays, and emergency services with a copay. The plan also covers primary care, preventive services, hearing, vision, and dental services with varying copays and maximum benefits. This plan provides coverage for home health services with no copay, as well as skilled nursing facility services with copays depending on the length of stay. The plan also offers benefits for medical equipment, diagnostic and radiological services, and home infusion bundled services with copays and coinsurance.
Inpatient Hospital See details
The Wellcare Giveback (HMO) plan covers inpatient hospital stays, with a copay of $425 for days 1-6 and no copay for days 7-90. Inpatient hospital psychiatric services are also covered with a $2,000 copay per stay, while additional days and non-Medicare-covered stays for both acute and psychiatric services are not covered.
Outpatient Services See details
Outpatient Services includes coverage for all outpatient hospital services with a copay between $0 and $450, observation services with a copay between $125 and $450, and ambulatory surgical center services with a $125 copay. This plan also covers outpatient substance abuse services with a $40 copay per session, and outpatient blood services with no copay.
Partial Hospitalization See details
Partial Hospitalization is covered under the Wellcare Giveback (HMO) plan, requiring 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 $275 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 $30 copay; all have no coinsurance. 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 services with a $35 copay, and physician specialist services with a $35 copay. The plan also covers mental health specialty services with a $40 copay for individual and group sessions, and psychiatric services with a $40 copay for individual and group sessions. Physical therapy and speech-language pathology services have a $35 copay, and additional telehealth benefits have a copay between $0 and $40.
Preventive Services See details
Wellcare Giveback (HMO) covers preventive services, including an annual physical exam with no copay. Additional preventive services, including Fitness Benefit, Remote Access Technologies, and Alternative Therapies, are covered with no copay. Kidney Disease Education Services are covered with 20% coinsurance. Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit are covered with no copay. Health Education, In-Home Safety Assessment, Personal Emergency Response System, Medical Nutrition Therapy, Post discharge In-Home Medication Reconciliation, Re-admission Prevention, Wigs for Hair Loss Related to Chemotherapy, Weight Management Programs, Therapeutic Massage, Adult Day Health Services, Nutritional/Dietary Benefit, Home-Based Palliative Care, In-Home Support Services, Support for Caregivers of Enrollees, Additional Sessions of Smoking and Tobacco Cessation Counseling, Enhanced Disease Management, Telemonitoring Services, Home and Bathroom Safety Devices and Modifications, and Counseling Services are not covered.
Hearing Services See details
Hearing Services include hearing exams with a $35 copay, routine hearing exams with no copay for one exam per year, and fitting/evaluation for hearing aids with no copay for one exam per year. Prescription hearing aids (all types) are covered, with no copay for two visits per year, and a maximum benefit of $500 per ear per year; however, inner ear, outer ear, and over-the-ear hearing aids are not covered, and OTC hearing aids are also not covered.
Vision Services See details
The Wellcare Giveback (HMO) plan covers vision services, including eye exams and eyewear. Eye exams have a copay of $0-$35, and routine eye exams have no copay. Eyewear, including contact lenses, eyeglasses, and upgrades, are covered with a combined maximum plan benefit of $200 per year, and have no copay.
Dental Services See details
The Wellcare Giveback (HMO) plan covers Medicare Dental Services with a $35 copay, as well as oral exams, dental x-rays, other diagnostic services, prophylaxis (cleaning), fluoride treatment, and other preventive dental services with no copay. However, restorative services, endodontics, periodontics, prosthodontics, maxillofacial prosthetics, implant services, and oral surgery 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, and a doctor referral is required. You will pay a coinsurance of 20% for these services.
Medical Equipment See details
Medical equipment is covered, including durable medical equipment, prosthetics, medical supplies, and diabetic equipment. Durable medical equipment has a 20% coinsurance and requires prior authorization, while durable medical equipment for use outside the home is not covered. Prosthetic devices and medical supplies have a 20% coinsurance and require authorization, and there is no copay. Diabetic supplies have no copay, and diabetic therapeutic shoes/inserts have a 20% coinsurance, and there is a copay.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including diagnostic procedures and tests with a copay between $0 and $40, and lab services with no copay. Outpatient X-ray services have a $100 copay, while diagnostic radiological services have a copay up to $275. 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; however, Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Wellcare Giveback (HMO) does not cover Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, or SET for PAD Services. A doctor referral is required for covered services.
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, while days 21-50 have a $214 copay.
Other Services See details
The Wellcare Giveback (HMO) plan does not cover acupuncture, over-the-counter items, meal benefits, or dual eligible SNPs with highly integrated services. Additionally, 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 are not covered.
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