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Wellcare Patriot Giveback Open (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Wellcare Patriot Giveback Open (PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Wellcare Patriot Giveback Open (PPO) in 2026, please refer to our full plan details page.
Wellcare Patriot Giveback Open (PPO) is a PPO 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 Patriot Giveback Open (PPO) is a Medicare Advantage (MA) Plan without drug coverage. That means that this plan covers medical services but doesn't cover prescription drugs. If you are looking for a plan with prescription drug coverage, please search for other MA and PDP plans offered in your area.
Key Plan Facts
Below are a few key facts and commonly-asked questions about Wellcare Patriot Giveback Open (PPO).
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 Patriot Giveback Open (PPO), 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 $135.00. You must continue to pay paying your reduced Part B Premium.
Deductibles
This plan has a $225.00 health deductible. This means, every calendar year, you pay this amount towards covered services before your insurance coverage kicks in.
Drugs are not covered by this plan, so a prescription drug deductible is not applicable.
Out-of-Pocket Maximums
This plan has a combined Maximum Out-Of-Pocket cost of $9500.00 (in-network or out-of-network combined). You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $9500.00 for covered services, the plan will pay 100% of covered costs for the rest of the year.
The plan may have separate out-pocket-maximums for in-network and out-of-network services. See our full plan details page for more information.
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
Prescription drugs are not covered by Wellcare Patriot Giveback Open (PPO).
Additional Benefits
The Wellcare Patriot Giveback Open (PPO) offers robust coverage for essential medical needs with predictable out-of-pocket costs. You will pay no copay and no coinsurance for primary care visits, home health services, and preventive annual exams, while specialist visits require a $35 copay. For hospital stays, inpatient acute care requires a $425 copay for days 1 through 6 followed by no copay, and emergency room visits feature a $130 copay with no coinsurance. This plan also provides valuable supplemental benefits, including routine dental, vision, and hearing exams with no copay and no coinsurance. Prescription hearing aids are covered up to a $1,000 annual limit and eyewear is covered up to a $200 limit, both with no copay. Additionally, diagnostic lab services and diabetic supplies are available with no copay, while durable medical equipment requires a 20% coinsurance.
Inpatient Hospital See details
Wellcare Patriot Giveback Open (PPO) inpatient hospital care is partially covered with no coinsurance, excluding upgrades, additional days, and non-Medicare-covered stays. Acute stays require a $425 copay for days 1 to 6 and no copay for days 7 to 90, while psychiatric stays require a $350 copay for days 1 to 5 and no copay for days 6 to 90.
Outpatient Services See details
Wellcare Patriot Giveback Open (PPO) outpatient services are covered with no coinsurance, featuring copays ranging from $0 to $350 for hospital outpatient visits and $130 to $350 per stay for observation services. Ambulatory surgical center services require a $300 copay with no coinsurance, while outpatient substance abuse and blood services are available with no copays and no coinsurance.
Partial Hospitalization See details
Wellcare Patriot Giveback Open (PPO) covers partial hospitalization services with a $140.00 copay and no coinsurance. Prior authorization is required to receive this benefit.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered under the Wellcare Patriot Giveback Open (PPO) with a $325 copay and no coinsurance for both ground and air ambulance services, which require prior authorization. While some transportation services are covered, transportation to plan-approved health-related locations and any health-related locations is not covered.
Emergency Services See details
Wellcare Patriot Giveback Open (PPO) covers emergency services with a $130 copay and no coinsurance (waived if admitted within 24 hours), and urgently needed services with a $40 copay and no coinsurance. Worldwide emergency and urgent care are partially covered up to a $50,000 maximum with a $130 copay and no coinsurance, though worldwide emergency transportation is not covered.
Primary Care See details
Wellcare Patriot Giveback Open (PPO) covers primary care physician, mental health, and psychiatric services with no copay and no coinsurance, while specialist visits and physical, occupational, and speech therapies require a $35 copay and no coinsurance. Chiropractic and podiatry services are not covered, and prior authorization is required for most specialty services.
Preventive Services See details
Wellcare Patriot Giveback Open (PPO) preventive services are partially covered with no copay and no coinsurance for annual exams, fitness benefits, and alternative therapies, though kidney education requires a 20% coinsurance. Supplemental services not covered under this benefit include health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, 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 Patriot Giveback Open (PPO) covers Medicare-covered hearing exams for a $35 copay and no coinsurance, while routine exams and fittings have no copay and no coinsurance, all with no deductible. Prescription hearing aids are covered with no copay or coinsurance up to a $1,000 annual maximum, though inner ear, outer ear, over-the-ear, and over-the-counter (OTC) hearing aids are not covered.
Vision Services See details
Wellcare Patriot Giveback Open (PPO) vision services are partially covered with no coinsurance, as other eye exam services are not covered. Covered routine eye exams have no copay (with other exams ranging up to a $35 copay), while eyewear like contacts and eyeglasses has no copay up to a combined $200 annual maximum.
Dental Services See details
Wellcare Patriot Giveback Open (PPO) partially covers dental services, offering Medicare-covered dental care for a $35 copay and no coinsurance, alongside preventive and comprehensive services with no copay and no coinsurance up to a $2,000 annual limit. Maxillofacial prosthetics, implant services, and orthodontics are not covered under this plan, and prior authorization is required for most services.
Home Infusion bundled Services See details
Wellcare Patriot Giveback Open (PPO) covers Home Infusion bundled Services with no copay, though prior authorization is required. Covered Medicare Part B insulin drugs require a $35 copay and no coinsurance, while chemotherapy and other Part B drugs require no copay and a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis services are covered by the Wellcare Patriot Giveback Open (PPO) with no copay and a 20% coinsurance.
Medical Equipment See details
Wellcare Patriot Giveback Open (PPO) 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
Diagnostic and radiological services are covered under the Wellcare Patriot Giveback Open (PPO) with prior authorization, featuring no coinsurance and no copay for lab services, and a $0 to $100 copay for diagnostic procedures. Radiological services require no copay for diagnostic radiology, a $25 copay for outpatient X-rays, and a 20% coinsurance for therapeutic radiology.
Home Health Services See details
Wellcare Patriot Giveback Open (PPO) covers Home Health Services with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Wellcare Patriot Giveback Open (PPO) covers some cardiac rehabilitation services with no coinsurance, but several sub-services are not covered. Specifically, cardiac rehabilitation (with a $40 copay), intensive cardiac rehabilitation (with a $50 copay), pulmonary rehabilitation (with a $35 copay), and supervised exercise therapy for symptomatic peripheral artery disease (with a $25 copay) are not covered.
Skilled Nursing Facility (SNF) See details
Wellcare Patriot Giveback Open (PPO) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring prior authorization but no prior three-day hospital stay. There is no copay for days 1 through 20 and days 61 through 100, while days 21 through 60 require a $218 daily copay, up to the 100-day limit per stay.
Other Services See details
Wellcare Patriot Giveback Open (PPO) partially covers other services, offering over-the-counter (OTC) items with no copay and no coinsurance through a reimbursement program. However, acupuncture, meal benefits, and other additional services are not covered under this benefit.
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1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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