A non-government entity
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 $157.00. 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:
Sign up for Wellcare Giveback (HMO)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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 pharmacy used. For preferred generic drugs, you will have no copay at preferred pharmacies and mail order, and a $10 copay at standard pharmacies. For specialty tier drugs, this plan has no copay.
Additional Benefits
The Wellcare Giveback (HMO) plan offers a range of benefits with varying costs. You can expect no copay for many services, including primary care visits, routine eye exams, dental exams, and home health services. The plan also covers inpatient hospital stays with a $350 copay for the first week, and $214 copay for skilled nursing facility stays between days 21-50. This plan includes coverage for outpatient services, emergency services, and various therapies, with copays ranging from $0 to $450. Additionally, the plan provides hearing and vision benefits, including coverage for hearing aids (up to $500 per ear annually) and eyewear with no copay. However, some services like cardiac rehabilitation, and certain dental and vision services, are not covered.
Inpatient Hospital See details
Inpatient Hospital services, including acute and psychiatric care, are covered with prior authorization and a doctor's referral. For Inpatient Hospital-Acute, there is a $350 copay for days 1-7, and no copay for days 8-90. For Inpatient Hospital Psychiatric, there is a $2,179 copay per admission or stay. Additional days, non-Medicare covered stays, and upgrades for both acute and psychiatric services are not covered.
Outpatient Services See details
Outpatient Services include coverage for outpatient hospital services with a copay of $0 to $450, observation services with a copay of $125 to $450, ambulatory surgical center (ASC) services with a $250 copay, outpatient substance abuse services with a $40 copay for individual and group sessions, and outpatient blood services with no copay. Prior authorization and a doctor referral are required for some of these services.
Partial Hospitalization See details
Wellcare Giveback (HMO) covers partial hospitalization with a $105 copay. Prior authorization and a doctor referral are required for coverage.
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 copay of $225, with no coinsurance, while other transportation services are not covered.
Emergency Services See details
Emergency Services under the Wellcare Giveback (HMO) plan includes a $125 copay, with no coinsurance, and the copay is waived if admitted to the hospital within 24 hours. Urgently Needed Services have a $25 copay with no coinsurance, and the copay is waived if admitted to the hospital within 24 hours. Worldwide Emergency Coverage and Worldwide Urgent Coverage have a $125 copay, with 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 $15 copay, and occupational therapy services with a $15 copay. It also covers physician specialist services, mental health specialty services, and psychiatric services, all with a $15 copay for some services and a $40 copay for others. Additionally, physical therapy and speech-language pathology services have a $15 copay, and additional telehealth benefits have a copay between $0 and $40. Podiatry services are not covered.
Preventive Services See details
Preventive services include an annual physical exam with no copay, and additional preventive services may have a copay. Other services like Health Education, In-Home Safety Assessment, and Personal Emergency Response System are not covered, while Kidney Disease Education Services have a 20% coinsurance. Other services such as Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit have no copay.
Hearing Services See details
The Wellcare Giveback (HMO) plan covers hearing exams with a $15 copay, routine hearing exams with no copay, and fitting/evaluation for hearing aids with no copay. Prescription hearing aids are covered, with a maximum benefit of $500 per ear every year. Prescription hearing aids for the inner ear, outer ear, and over the ear are not covered, nor are OTC hearing aids.
Vision Services See details
Vision Services include coverage for eye exams, routine eye exams, and eyewear. Eye exams have a copay between $0 and $15, while routine eye exams have no copay. Eyewear, including contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades, have no copay, but a combined maximum benefit of $200 per year.
Dental Services See details
Dental Services include oral exams with no copay, dental x-rays with no copay, other diagnostic dental services with no copay, prophylaxis (cleaning) with no copay, fluoride treatment with no copay, other preventive dental services with no copay, and adjunctive general services with no copay. Restorative Services, Endodontics, Periodontics, Prosthodontics, removable, Maxillofacial Prosthetics, Implant Services, Prosthodontics, fixed, Oral and Maxillofacial Surgery, and Orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by the Wellcare Giveback (HMO) plan and require prior authorization. Medicare Part B Insulin Drugs have a $35 copay. Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have between 0% and 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered under the Wellcare Giveback (HMO) plan, and a doctor referral is required. You will pay 20% coinsurance for this service.
Medical Equipment See details
Medical equipment, including durable medical equipment, prosthetics, medical supplies, and diabetic equipment, is covered. Durable Medical Equipment (DME) has a 20% coinsurance and requires authorization. Prosthetic devices have a 20% coinsurance, and medical supplies have a 20% coinsurance. Diabetic supplies have no copay, and diabetic therapeutic shoes/inserts have a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, with a doctor referral and prior authorization required. Diagnostic Procedures/Tests have a copay between $0 and $30, Lab Services have no copay, Diagnostic Radiological Services have a copay of at most $250, Therapeutic Radiological Services have a coinsurance of at least 20%, and Outpatient X-Ray Services have a $100 copay.
Home Health Services See details
Home Health Services are covered by the Wellcare Giveback (HMO) plan with no copay and no coinsurance. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the Wellcare Giveback (HMO) plan. A doctor referral is required for Cardiac Rehabilitation 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 referral. There is no copay for days 1-20 and days 51-100, but there is a $214 copay for days 21-50.
Other Services See details
Other Services, including acupuncture, over-the-counter items, meal benefits, and more, are not covered under the Wellcare Giveback (HMO) plan. No authorization or referrals are required for these additional services.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
*/SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
MedicareAdvantageRX.com is owned and operated by Dog Media Solutions LLC.
This is a promotional communication.
Every year, Medicare evaluates plans based on a 5-star rating system.
Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
Enrollment in Medicare/Medicare Advantage may be limited to certain times of the year unless you qualify for a Special Enrollment Period
We do not offer every plan available in your area. Currently, we represent 18 organizations, which offer 52,101 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
We represent Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan's contract renewal.
Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.
Please contact Medicare.gov ,1-800-MEDICARE , or your local State Health Insurance Program (SHIP) to get information on all of your options.
Medicare has neither approved nor endorsed any information on this site.
Speak with a licensed insurance agent: 1-877-649-2073 / TTY 711 | 8am - 11pm ET | 7 days a week
© 2023 Dog Media Solutions LLC. All rights reserved