A non-government entity
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 NE. This plan received an overall rating of 3 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 $82.00. 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 $8850.00 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-POS)
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-POS) plan features an annual prescription drug deductible of $615. For Tier 1 preferred generics, Tier 2 generics, and Tier 6 select care drugs, you will pay no copay when using a preferred pharmacy or preferred mail-order service. Standard pharmacies and standard mail-order options are also available but carry small copays ranging from $5 to $30 depending on the tier and supply. Brand-name and higher-tier medications on this plan require coinsurance rather than flat copays. Tier 3 preferred brands and Tier 5 specialty drugs both carry a 25% coinsurance, while Tier 4 non-preferred drugs require 37% coinsurance at preferred pharmacies and 38% at standard pharmacies.
Additional Benefits
The Wellcare Giveback (HMO-POS) plan offers affordable coverage with no copay for primary care doctor visits, annual physicals, and fitness benefits. For specialized care, members pay a $50 copay for specialists, while emergency services carry a $115 copay and urgent care costs $35. If you require hospital care, inpatient acute stays require a $1,450 copay per stay, while outpatient services range from no copay to a $350 copay with no coinsurance. Routine dental, vision, and hearing exams are highly accessible with no copay, alongside allowances of up to $100 for eyewear and $500 per ear for prescription hearing aids. Home health care also features no copay, while dialysis and durable medical equipment require a 20% coinsurance. Skilled nursing facility stays are covered with no copay for the first 20 days, followed by a $218 daily copay for days 21 through 70.
Inpatient Hospital See details
Wellcare Giveback (HMO-POS) inpatient hospital services are partially covered, requiring a $1,450 copayment per stay for acute care and a $1,937 copayment per stay for psychiatric care, with no coinsurance for either. Prior authorization is required, and additional days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Wellcare Giveback (HMO-POS) covers outpatient hospital services with a $0 to $350 copay and observation services with a $115 to $350 copay per stay, both with no coinsurance. Ambulatory surgical center services require a $200 copay, outpatient substance abuse sessions have a $40 copay, and outpatient blood services have no copay, all featuring no coinsurance.
Partial Hospitalization See details
Wellcare Giveback (HMO-POS) covers partial hospitalization services with a $105.00 copay and no coinsurance, although prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and transportation services are partially covered by Wellcare Giveback (HMO-POS), with ground and air ambulance services requiring a $315 copay and no coinsurance. Transportation services to plan-approved or other health-related locations are not covered.
Emergency Services See details
Wellcare Giveback (HMO-POS) covers emergency services with a $115 copay and no coinsurance, and urgently needed services with a $35 copay and no coinsurance, with copays waived if admitted to the hospital within 24 hours. Worldwide emergency and urgent services are partially covered up to a $50,000 limit with a $115 copay and no coinsurance, but worldwide emergency transportation is not covered.
Primary Care See details
Wellcare Giveback (HMO-POS) features primary care physician visits with no copay and no coinsurance, while specialist visits require a $50 copay and no coinsurance. Covered mental health, psychiatric, and therapy services have copays ranging from $35 to $40 with no coinsurance, though chiropractic and podiatry services are not covered.
Preventive Services See details
Preventive Services under Wellcare Giveback (HMO-POS) are partially covered, featuring annual physicals, fitness benefits, and remote access technologies with no copay and no coinsurance. Kidney disease education is available with no copay and a 20% coinsurance, but other supplemental services like health education, weight management, and nutritional benefits are not covered.
Hearing Services See details
Hearing services are partially covered by Wellcare Giveback (HMO-POS), featuring a $50 copay and no coinsurance for Medicare-covered exams, alongside annual routine exams and fitting evaluations with no copay and no coinsurance. Prescription hearing aids are covered up to $500 per ear annually with no copay and no coinsurance, while OTC, inner ear, outer ear, and over-the-ear devices are not covered.
Vision Services See details
Vision services are partially covered by Wellcare Giveback (HMO-POS), offering routine eye exams with no copay and no coinsurance, though other eye exam services are not covered. Eyewear is covered with no copay and no coinsurance, up to a $100 annual maximum benefit limit for contacts, eyeglasses, lenses, frames, and upgrades.
Dental Services See details
Dental services are covered by Wellcare Giveback (HMO-POS), which provides Medicare-covered dental services for a $50 copay and no coinsurance, and preventive services with no copay and no coinsurance. Comprehensive dental is only partially covered, with adjunctive general services available at no copay and no coinsurance, while restorative, endodontic, periodontic, prosthodontic, implant, oral surgery, and orthodontic services are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by Wellcare Giveback (HMO-POS) with no copay and no coinsurance. Under this benefit, Medicare Part B insulin requires a $35 copay and no coinsurance, while other Part B chemotherapy and radiation drugs have a 0% to 20% coinsurance and no copay.
Dialysis Services See details
Wellcare Giveback (HMO-POS) covers Dialysis Services with no copay and a 20% coinsurance.
Medical Equipment See details
Wellcare Giveback (HMO-POS) covers durable medical equipment, prosthetics, and medical supplies with no copay and a 20% coinsurance. Diabetic supplies are covered with no copay, while diabetic therapeutic shoes and inserts require a 20% coinsurance, with prior authorization required for these benefits.
Diagnostic and Radiological Services See details
Wellcare Giveback (HMO-POS) covers diagnostic services with no coinsurance, featuring no copay for lab services and a $0 to $50 copay for diagnostic tests. Radiological services require prior authorization, with outpatient X-rays carrying a $50 copay plus coinsurance, diagnostic radiology starting at no copay, and therapeutic radiology requiring a copay and a minimum 20% coinsurance.
Home Health Services See details
Home health services are covered under the Wellcare Giveback (HMO-POS) plan with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by Wellcare Giveback (HMO-POS) with no coinsurance, and although some services are covered, cardiac rehabilitation (with a $30 copay), intensive cardiac rehabilitation (with a $40 copay), pulmonary rehabilitation (with a $25 copay), and SET for PAD services (with a $20 copay) are not covered.
Skilled Nursing Facility (SNF) See details
Wellcare Giveback (HMO-POS) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring prior authorization but no prior three-day hospital stay. You will pay no copay for days 1 through 20 and days 71 through 100, a $218 daily copay for days 21 through 70, and any additional days beyond the standard 100-day benefit period are not covered.
Other Services See details
Wellcare Giveback (HMO-POS) provides coverage for other services, meaning some services are covered, but acupuncture, over-the-counter (OTC) items, and meal benefits are not covered.
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