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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 $141.00. 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) plan features an annual drug deductible of $615. Under this Medicare prescription drug coverage, you will enjoy no copay for Tier 1 preferred generics and Tier 2 generics when using preferred pharmacies or preferred mail order services. Additionally, Tier 6 select care drugs are highly affordable with no copay across all standard and preferred pharmacy networks. For higher-tier medications, costs transition to a percentage-based coinsurance. Tier 3 preferred brand drugs and Tier 5 specialty drugs require a 25% coinsurance, while Tier 4 non-preferred drugs carry a 50% coinsurance. Standard pharmacies are also available for generic medications, with copays ranging from $5 to $30 depending on the tier and supply duration.
Additional Benefits
The Wellcare Giveback (HMO) plan offers affordable access to essential medical care, featuring no copay and no coinsurance for primary care visits, while specialist visits require a $45 copay. For hospital stays, members pay a $375 daily copay for the first seven days of inpatient care with no copay thereafter, alongside a $115 copay for emergency room visits. Diagnostic lab services, home health care, and routine clinical services are also covered with no copay and no coinsurance. This plan also provides valuable coverage for routine wellness, offering no copay and no coinsurance for preventive dental services, routine eye exams, and annual hearing exams. Prescription hearing aids and routine eyewear are covered with no copay up to specified annual limits, although restorative dental work and transportation services are not covered. Additionally, durable medical equipment and dialysis services are available with no copay and a 20% coinsurance.
Inpatient Hospital See details
Wellcare Giveback (HMO) partially covers inpatient hospital services with no coinsurance, requiring a $375 daily copay for days 1 to 7 and no copay for days 8 to 100 of acute stays, while upgrades and non-Medicare-covered stays are not covered. Inpatient psychiatric care is covered with no coinsurance and a $2,000 copay per stay, but additional days and non-Medicare-covered psychiatric stays are excluded.
Outpatient Services See details
Wellcare Giveback (HMO) covers outpatient services with no coinsurance, featuring a $100 copay for ambulatory surgical center services and no copay for blood services. Outpatient hospital services require a copay of $0 to $450, observation services cost $115 to $450, and outpatient substance abuse sessions carry a $40 copay.
Partial Hospitalization See details
Partial hospitalization is covered by Wellcare Giveback (HMO) with a $105.00 copay and no coinsurance. Both prior authorization and a referral are required for these services.
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 no coinsurance, and urgently needed services with a $25 copay and no coinsurance, with copays waived if admitted to the hospital within 24 hours. Worldwide emergency and urgent care are partially covered up to a $50,000 lifetime maximum 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 require a $45 copay and no coinsurance. Other benefits such as physical therapy and mental health services carry copays between $35 and $45 with no coinsurance, whereas chiropractic care is partially covered with a $15 copay for routine care only and podiatry services are not covered.
Preventive Services See details
Wellcare Giveback (HMO) offers partially covered preventive services, including annual physicals, fitness benefits, alternative therapies, and select screenings with no copay and no coinsurance, while kidney disease education requires no copay and a 20% coinsurance. However, several services are not covered, including health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, wigs, weight management, therapeutic massage, adult day health, nutritional/dietary benefits, home-based palliative care, in-home support, caregiver support, smoking cessation, disease management, telemonitoring, home safety devices, and counseling.
Hearing Services See details
Wellcare Giveback (HMO) covers hearing services, featuring Medicare-covered exams for a $45 copay and no coinsurance, and annual routine exams and fittings with no copay and no coinsurance. Prescription hearing aids are partially covered with no copay and no coinsurance up to a $1,000 maximum per ear annually, though OTC devices and inner, outer, or over-the-ear prescription models are not covered.
Vision Services See details
Wellcare Giveback (HMO) partially covers vision services with no deductibles and no coinsurance, though prior authorization is required and other eye exam services are not covered. Routine eye exams and eyewear, including lenses and frames, feature no copay, with eyewear coverage limited to a combined maximum of $100 annually.
Dental Services See details
Wellcare Giveback (HMO) covers Medicare-covered dental services for a $45.00 copay and no coinsurance, and preventive dental services with no copay and no coinsurance. Other dental services are only partially covered, as restorative services, endodontics, periodontics, prosthodontics, maxillofacial prosthetics, implants, oral and maxillofacial surgery, and orthodontics are not covered.
Home Infusion bundled Services See details
Wellcare Giveback (HMO) covers home infusion bundled services with no copay, although prior authorization and step therapy are required. Covered Medicare Part B insulin drugs carry a $35 copay and no coinsurance, while chemotherapy, radiation, and other Part B drugs have a coinsurance ranging from 0% to 20%.
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 to receive care.
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 also covered with no copay, while diabetic therapeutic shoes and inserts are subject to a 20% coinsurance.
Diagnostic and Radiological Services See details
Wellcare Giveback (HMO) covers diagnostic and radiological services, requiring referrals and prior authorization. Diagnostic services feature no coinsurance, offering lab services with no copay and diagnostic tests with a $0 to $40 copay, while radiological services include a $50 copay for X-rays, a minimum 20% coinsurance for therapeutic services, and diagnostic radiology starting at no copay.
Home Health Services See details
Home health services are covered under the Wellcare Giveback (HMO) with no copay and no coinsurance. To access these services, both a referral and prior authorization are required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered under the Wellcare Giveback (HMO) with no copay and no coinsurance, though a referral is required. In practice, only some services are covered, while standard cardiac, intensive cardiac, pulmonary, and Supervised Exercise Therapy (SET) for symptomatic peripheral artery disease (PAD) services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by Wellcare Giveback (HMO) with no coinsurance, featuring 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 for these services, and the plan does not cover additional SNF days beyond the standard 100-day Medicare benefit period.
Other Services See details
Other Services are not covered under the Wellcare Giveback (HMO) plan, meaning acupuncture, over-the-counter (OTC) items, and meal benefits are excluded from coverage.
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