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Wellcare Giveback (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Wellcare Giveback (HMO-POS). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Wellcare Giveback (HMO-POS) in 2026, please refer to our full plan details page.
Wellcare Giveback (HMO-POS) is a HMO-POS plan offered by Centene Corporation available for enrollment in 2025 to people living in Select counties in GA. This plan received an overall rating of 3.5 out of 5 stars in 2026.
It's important to know that Wellcare Giveback (HMO-POS) 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-POS).
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-POS), 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 $9250.00 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-POS) prescription drug plan features an annual drug deductible of $615. Under this plan, you will pay no copay for Tier 1 preferred generics and Tier 2 generics when filled at a preferred pharmacy or through preferred mail order. Additionally, Tier 6 select care drugs offer no copay across all standard and preferred pharmacy and mail order options. For higher-tier medications, cost sharing is based on coinsurance rather than flat copays. Tier 3 preferred brands and Tier 5 specialty drugs require a 25% coinsurance, while Tier 4 non-preferred drugs require a 50% coinsurance. Standard pharmacies and standard mail order services are also available for Tier 1 and Tier 2 drugs, with copays ranging from $5 to $30 depending on the tier and supply duration.
Additional Benefits
The Wellcare Giveback (HMO-POS) plan offers robust coverage for essential medical services, with many benefits featuring no coinsurance. Members pay no copay for primary care visits, while specialist consultations require a 50 dollar copay. For hospital care, inpatient stays incur a 375 dollar daily copay for the first seven days, and emergency room visits carry a 115 dollar copay that is waived if admitted. Routine preventive services, including dental, vision, and hearing exams, are available with no copay, though allowances for eyewear and hearing aids are subject to annual limits. Home health services also feature no copay, whereas dialysis and durable medical equipment require a 20 percent coinsurance. Please note that several services, including inpatient care and medical equipment, require prior authorization before coverage applies.
Inpatient Hospital See details
Wellcare Giveback (HMO-POS) covers inpatient hospital services with no coinsurance, though prior authorization is required. Acute care requires a $375 daily copay for days 1 through 7 and no copay for days 8 through 90, while psychiatric stays require a $1,750 copay per stay; additional days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Outpatient services are covered by Wellcare Giveback (HMO-POS) with no coinsurance, featuring copays of $0 to $475 for hospital outpatient services and $115 to $475 per stay for observation services. Ambulatory surgical center services require a $350 copay and no coinsurance, outpatient substance abuse sessions have a $40 copay and no coinsurance, and outpatient blood services are fully covered with no copay or coinsurance.
Partial Hospitalization See details
Wellcare Giveback (HMO-POS) covers partial hospitalization services with a $105.00 copay and no coinsurance. Prior authorization is required before receiving these covered services.
Ambulance and Transportation Services See details
Wellcare Giveback (HMO-POS) covers Medicare-covered ground and air ambulance services with a $320 copay per service and no coinsurance, though prior authorization is required. Transportation services to plan-approved or other health-related locations are not covered under this plan.
Emergency Services See details
Wellcare Giveback (HMO-POS) covers emergency services with a $115 copay and no coinsurance, and urgently needed services with a $40 copay and no coinsurance, with copays waived if admitted to the hospital within 24 hours. Worldwide emergency and urgent care are also covered up to a $50,000 maximum with a $115 copay and no coinsurance, though worldwide emergency transportation is not covered.
Primary Care See details
Wellcare Giveback (HMO-POS) covers primary care physician services with no copay and no coinsurance, and specialist visits with a $50 copay and no coinsurance. Physical, occupational, speech, and mental health therapies are covered with copays ranging from $35 to $40 and no coinsurance, while chiropractic and podiatry services are not covered.
Preventive Services See details
Wellcare Giveback (HMO-POS) offers partially covered preventive services with no copay and no coinsurance for annual physical exams, fitness benefits, alternative therapies, remote access technologies, and various screenings, though kidney disease education requires a 20% coinsurance and no copay. Several sub-services are not covered under this plan, including health education, nutritional/dietary benefits, personal emergency response systems, and in-home safety assessments.
Hearing Services See details
Wellcare Giveback (HMO-POS) hearing services feature routine exams and fitting evaluations with no copay and no coinsurance, while Medicare-covered exams require a $50 copay and no coinsurance. Prescription hearing aids are partially covered with no copay and no coinsurance up to $350 per ear annually, but OTC, inner ear, outer ear, and over the ear hearing aids are not covered.
Vision Services See details
Wellcare Giveback (HMO-POS) provides partially covered vision services, featuring eye exams with a $0 to $50 copay and no coinsurance, though other eye exam services are not covered. Eyewear, including contact lenses and eyeglasses, is covered with no copay and no coinsurance up to a combined maximum benefit of $100 per year.
Dental Services See details
Wellcare Giveback (HMO-POS) covers Medicare-covered dental services with a $50 copay and no coinsurance, while preventive dental services are available with no copay and no coinsurance. Comprehensive dental benefits are only partially covered, with no copay and no coinsurance for adjunctive general services, but restorative, endodontic, periodontic, prosthodontic, implant, oral surgery, and orthodontic services are not covered.
Home Infusion bundled Services See details
Wellcare Giveback (HMO-POS) covers home infusion bundled services with no copay and no coinsurance, subject to prior authorization. Associated Medicare Part B chemotherapy and other drugs have no copay and 0% to 20% coinsurance, while Medicare Part B insulin is covered with a $35 copay and no coinsurance.
Dialysis Services See details
Dialysis Services are covered under the Wellcare Giveback (HMO-POS) plan with no copay and a 20% coinsurance.
Medical Equipment See details
Medical equipment covered by Wellcare Giveback (HMO-POS) features no copay and a 20% coinsurance for durable medical equipment, prosthetic devices, medical supplies, and diabetic therapeutic shoes or inserts. Diabetic supplies are covered with no copay from specified manufacturers, and prior authorization is required for these medical equipment services.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Wellcare Giveback (HMO-POS) with prior authorization, featuring no coinsurance and a $0 to $100 copay for diagnostic tests, and no copay for lab services. Outpatient X-rays require a $50 copay plus coinsurance, while diagnostic radiology has copays starting at $0 with no coinsurance, and therapeutic radiology requires a copay and at least 20% coinsurance.
Home Health Services See details
Wellcare Giveback (HMO-POS) covers Home Health Services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Wellcare Giveback (HMO-POS) covers some cardiac rehabilitation services with no copay and no coinsurance. However, cardiac rehabilitation (with a $30 copay), intensive cardiac rehabilitation (with a $40 copay), pulmonary rehabilitation (with a $25 copay), and supervised exercise therapy for peripheral artery disease (with a $20 copay) are not covered.
Skilled Nursing Facility (SNF) See details
Wellcare Giveback (HMO-POS) covers skilled nursing facility services with no coinsurance, offering no copay for days 1 to 20 and days 71 to 100, and a $218 daily copay for days 21 to 70. Prior authorization is required, and additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Wellcare Giveback (HMO-POS) indicates some services are covered under its other services benefit, but acupuncture, over-the-counter (OTC) items, and meal benefits are not covered. Since these specific supplemental services are not covered by the plan, members will be responsible for the full cost of these care options.
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