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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 $75.00. 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) prescription drug plan features an annual drug deductible of $615. For Tier 1 (Preferred Generic) and Tier 2 (Generic) medications, you pay no copay when using a preferred pharmacy or preferred mail-order service. Additionally, Tier 6 (Select Care Drugs) are highly affordable, requiring no copay at any standard or preferred network pharmacy. Brand-name and specialized medications are subject to coinsurance rather than flat copayments. Tier 3 (Preferred Brand) and Tier 5 (Specialty Tier) drugs both carry a 25% coinsurance, while Tier 4 (Non-Preferred) drugs require a 50% coinsurance. These percentage-based costs apply uniformly across preferred and standard pharmacies as well as mail-order options.
Additional Benefits
The Wellcare Giveback (HMO) plan focuses on affordable essential care, offering no copay and no coinsurance for primary care doctor visits, routine physicals, and home health services. Specialist visits require a copay of $35 to $45, while inpatient hospital stays incur a $400 daily copay for the first six days, followed by no copay for days seven through 95. Emergency services are covered with a $115 copay, which is waived if you are admitted to the hospital within 24 hours. For supplemental care, the plan features no copay and no coinsurance for routine vision, hearing, and preventive dental exams, though comprehensive dental services and transportation are not covered. Prescription hearing aids are covered up to $500 per ear annually and eyewear up to a $100 annual limit, both with no copay or deductible. Additionally, medical equipment and dialysis services are covered with no copay and a 20% coinsurance.
Inpatient Hospital See details
Wellcare Giveback (HMO) partially covers inpatient hospital services with no coinsurance, requiring a $400 daily copay for days 1 to 6 of an acute stay (no copay for days 7 to 95) and a $2,000 copay per psychiatric stay. Prior authorization and referrals are required, and upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Outpatient services are covered by Wellcare Giveback (HMO) with no coinsurance, featuring copays ranging from $0 to $450 for outpatient hospital visits, $115 to $450 per stay for observation services, and $125 for ambulatory surgical center services. Outpatient substance abuse sessions have a $40 copay with no coinsurance, while outpatient blood services are covered with no copay and no coinsurance.
Partial Hospitalization See details
Partial hospitalization is covered by the Wellcare Giveback (HMO) plan with a $105.00 copay and no coinsurance. Prior authorization and a referral are required to receive these services.
Ambulance and Transportation Services See details
Ambulance and transportation services are partially covered by Wellcare Giveback (HMO), which features a $275 copay and no coinsurance for ground and air ambulance services, subject to prior authorization. Transportation services to plan-approved or any other health-related locations are not covered.
Emergency Services See details
Wellcare Giveback (HMO) covers emergency services with a $115 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services require a $30 copay and no coinsurance, while worldwide emergency and urgent care are partially covered up to a $50,000 limit with a $115 copay and no coinsurance, though 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, therapy, and mental health services require copays ranging from $35 to $45 and no coinsurance. Chiropractic services are partially covered, featuring a $15 copay and no coinsurance for routine care but excluding other chiropractic services, while podiatry services are not covered.
Preventive Services See details
Wellcare Giveback (HMO) covers preventive services with no copay and no coinsurance for annual physicals, fitness benefits, alternative therapies, remote access, and routine screenings, while kidney disease education has no copay and a 20% coinsurance. This benefit is partially covered, as health education, in-home safety, PERS, medical nutrition therapy, medication reconciliation, re-admission prevention, wigs, weight management, therapeutic massage, adult day health, nutritional benefits, palliative care, in-home support, caregiver support, smoking cessation, disease management, telemonitoring, home modifications, and counseling are not covered.
Hearing Services See details
Hearing services covered by Wellcare Giveback (HMO) require prior authorization and feature no deductible, offering Medicare-covered exams for a $45 copay and no coinsurance, while routine exams and fittings have no copay and no coinsurance. Prescription hearing aids are covered up to $500 per ear annually with no copay or coinsurance, though OTC hearing aids and inner, outer, or over-the-ear models are not covered.
Vision Services See details
Wellcare Giveback (HMO) vision services are partially covered, offering routine eye exams with no copay and no coinsurance, while other eye exam services are not covered. Eyewear is also covered with no copay, no coinsurance, and no deductible up to a $100 annual maximum.
Dental Services See details
Wellcare Giveback (HMO) partially covers dental services, offering Medicare-covered dental care for a $45 copay and no coinsurance, alongside preventive services with no copay and no coinsurance. Comprehensive care such as restorative services, endodontics, periodontics, prosthodontics, implants, oral 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. Under this plan, covered Medicare Part B insulin requires a $35 copay and no coinsurance, while chemotherapy and other Part B drugs have no coinsurance to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered under the Wellcare Giveback (HMO) plan with no copay and a 20% coinsurance, although a referral is required.
Medical Equipment See details
Wellcare Giveback (HMO) covers medical equipment, including durable medical equipment (DME), prosthetics, medical supplies, and diabetic equipment, with prior authorization required. There is no copay for these benefits, though a 20% coinsurance applies to DME, prosthetics, medical supplies, and diabetic therapeutic shoes or inserts.
Diagnostic and Radiological Services See details
Wellcare Giveback (HMO) covers diagnostic and radiological services, requiring prior authorization and referrals for all services. Diagnostic procedures and tests range from no copay to a $40 copay with no coinsurance, lab services feature no copay and no coinsurance, and radiological services range from no copay for diagnostic imaging to a $50 copay for X-rays and a minimum 20% coinsurance for therapeutic radiation.
Home Health Services See details
Wellcare Giveback (HMO) covers Home Health Services with no copay and no coinsurance. Prior authorization and a referral are required to receive these covered services.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the Wellcare Giveback (HMO) plan, as standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) services are all excluded from coverage.
Skilled Nursing Facility (SNF) See details
Wellcare Giveback (HMO) covers Skilled Nursing Facility (SNF) services with no coinsurance, offering no copay for days 1 to 20 and days 61 to 100, and a $218 daily copay for days 21 to 60. Prior authorization and referrals are required, and additional days beyond the standard 100-day Medicare benefit are not covered.
Other Services See details
Other services are covered by Wellcare Giveback (HMO), meaning some services are covered, but acupuncture, over-the-counter (OTC) items, and meal benefits are not covered.
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