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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 $156.00. 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. You can save on prescriptions with no copay for Tier 1 preferred generic and Tier 2 generic medications filled at preferred pharmacies or through preferred mail order. Tier 6 select care drugs also feature no copay at any pharmacy or mail-order option. For other prescriptions, standard pharmacy copays for Tier 1 and Tier 2 drugs range from $5 to $30. Higher-tier medications require coinsurance, with Tier 3 preferred brands and Tier 5 specialty drugs costing 25% coinsurance, and Tier 4 non-preferred drugs costing 44% coinsurance.
Additional Benefits
The Wellcare Giveback (HMO) plan offers affordable healthcare coverage with no copay and no coinsurance for primary care visits, home health services, and most preventive care. Inpatient hospital stays require a $375 daily copay for the first seven days, while emergency room visits carry a $115 copay, which is waived if you are admitted. Outpatient services and specialist visits are also highly accessible, featuring no coinsurance and low copays, such as a $15 copay for specialists. For routine wellness, this plan provides essential dental, vision, and hearing benefits with no copay for preventive dental care, routine eye exams, and prescription hearing aids up to $500 per ear. Durable medical equipment and dialysis services generally require a 20% coinsurance, while diabetic supplies are covered with no copay. Please keep in mind that this plan does not cover transportation, over-the-counter items, acupuncture, or meal benefits.
Inpatient Hospital See details
Wellcare Giveback (HMO) partially covers inpatient hospital services with no coinsurance, requiring a $375 daily copay for days 1 through 7 (no copay for days 8 through 90) for acute stays, and a $2,075 copay per stay for psychiatric stays. Prior authorization and referrals are required, and additional days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Wellcare Giveback (HMO) covers outpatient services with no coinsurance across all categories, including outpatient hospital services with copays ranging from no copay up to $450, and observation services with a $115 to $450 copay per stay. Ambulatory surgical center services require a $250 copay, outpatient substance abuse sessions have a $40 copay, and outpatient blood services feature no copay and no deductible.
Partial Hospitalization See details
Wellcare Giveback (HMO) covers partial hospitalization services 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) partially covers ambulance and transportation services, with ground and air ambulance services requiring a $225 copay and no coinsurance, subject to prior authorization. Transportation services to plan-approved or any health-related locations are not covered.
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 both copays waived if admitted to the hospital within 24 hours. Worldwide emergency and urgent services are partially covered up to a $50,000 maximum benefit with a $115 copay and no coinsurance, though worldwide emergency transportation is not covered.
Primary Care See details
Wellcare Giveback (HMO) features primary care physician services with no copay and no coinsurance, while specialist visits, physical therapy, occupational therapy, and routine chiropractic care (up to 12 visits per year) require a $15 copay and no coinsurance. Mental health, psychiatric, and telehealth services are covered with copays ranging up to $40 and no coinsurance, though podiatry and other chiropractic services are not covered.
Preventive Services See details
Wellcare Giveback (HMO) covers preventive services like annual physical exams, fitness benefits, alternative therapies, and select screenings with no copay and no coinsurance, though kidney disease education requires a 20% coinsurance and no copay. Additional preventive benefits are partially covered, excluding 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, enhanced disease management, telemonitoring, home/bathroom safety, and counseling.
Hearing Services See details
Wellcare Giveback (HMO) partially covers hearing services, offering Medicare-covered exams for a $15 copay and no coinsurance, as well as routine exams, evaluations, and prescription hearing aids with no copay and no coinsurance. Up to $500 per ear is covered annually for prescription hearing aids, though OTC hearing aids and inner ear, outer ear, and over the ear prescription hearing aids are not covered.
Vision Services See details
Wellcare Giveback (HMO) partially covers vision services, offering eye exams with a $0 to $15 copay and no coinsurance, though other eye exam services are not covered. Covered eyewear, including lenses, frames, and contacts, has no copay and no coinsurance up to a combined maximum plan benefit of $200 per year.
Dental Services See details
Wellcare Giveback (HMO) partially covers dental services, offering Medicare-covered dental care for a $15 copay and no coinsurance, alongside select preventive and adjunctive services with no copay and no coinsurance. However, restorative, endodontics, periodontics, prosthodontics, implants, maxillofacial prosthetics, 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, Medicare Part B insulin drugs have a $35 copay and no coinsurance, while chemotherapy, radiation, and other Part B drugs have no copay and a coinsurance of 0% to 20%.
Dialysis Services See details
Dialysis Services are covered by Wellcare Giveback (HMO) with no copay and a 20% coinsurance, though a referral is required to receive these services.
Medical Equipment See details
Wellcare Giveback (HMO) covers medical equipment, including durable medical equipment (DME), prosthetics, and diabetic therapeutic shoes, with no copays and a 20% coinsurance. Diabetic supplies are covered with no copay, though prior authorization is required for most services and diabetic supplies are limited to specified manufacturers.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered under Wellcare Giveback (HMO), featuring no coinsurance for diagnostic services, which include lab services at no copay and diagnostic tests with a $0 to $30 copay. Radiological services require prior authorization and referrals, carrying a $50 copay plus coinsurance for X-rays, a copay plus a minimum 20% coinsurance for therapeutic radiology, and a minimum $0 copay for diagnostic radiology.
Home Health Services See details
Home health services are covered by Wellcare Giveback (HMO) with no copay and no coinsurance, though prior authorization and a referral are required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are partially covered by Wellcare Giveback (HMO) with no coinsurance and require a referral, but specific services including cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation are not covered and require copays ranging from $20 to $40.
Skilled Nursing Facility (SNF) See details
Wellcare Giveback (HMO) partially covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring 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 additional days beyond the Medicare-covered 100 days are not covered.
Other Services See details
Wellcare Giveback (HMO) does not offer coverage for Other Services, meaning acupuncture, over-the-counter (OTC) items, and meal benefits are not covered under this plan.
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