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Wellcare Patriot Giveback (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Wellcare Patriot 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 Patriot Giveback (HMO-POS) in 2025, please refer to our full plan details page.
Wellcare Patriot Giveback (HMO-POS) is a HMO-POS plan offered by Centene Corporation available for enrollment in 2025 to people living in All counties in TN. This plan received an overall rating of 3.5 out of 5 stars in 2025.
It's important to know that Wellcare Patriot Giveback (HMO-POS) 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 (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 Patriot 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 $90.00. 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.
Drugs are not covered by this plan, so a prescription drug deductible is not applicable.
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:
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Drug Coverage
Prescription drugs are not covered by Wellcare Patriot Giveback (HMO-POS).
Additional Benefits
The Wellcare Patriot Giveback (HMO-POS) plan offers a range of benefits with varying cost-sharing. It covers inpatient hospital stays with a copay, and outpatient services like hospital visits, and substance abuse treatment, with copays ranging from $0 to $200. Emergency and urgent care services have copays, and primary care visits are covered with no copay. Preventive services, including annual exams and screenings, are covered with no copay. The plan also provides coverage for hearing and vision services, including exams and eyewear, with copays. Dental services include a variety of procedures with no copay. Other covered services include ambulance, home health, skilled nursing, and dialysis with copays or coinsurance, and durable medical equipment with 20% coinsurance.
Inpatient Hospital See details
Inpatient Hospital services are covered by the Wellcare Patriot Giveback (HMO-POS) plan. For Inpatient Hospital-Acute, you pay a $350 copay for days 1-5, and no copay for days 6-90; for Inpatient Hospital Psychiatric, you pay a $325 copay for days 1-4, and no copay for days 5-90. Additional Days for Inpatient Hospital-Acute, Non-Medicare-covered Stay for Inpatient Hospital-Acute, Upgrades for Inpatient Hospital-Acute, Additional Days for Inpatient Hospital Psychiatric, and Non-Medicare-covered Stay for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services for the Wellcare Patriot Giveback (HMO-POS) plan include coverage for Outpatient Hospital Services with a copay between $0 and $200, Observation Services with a copay between $125 and $200, Ambulatory Surgical Center (ASC) Services with a $100 copay, and Outpatient Blood Services with no copay. The plan also covers Individual and Group Sessions for Outpatient Substance Abuse with no copay.
Partial Hospitalization See details
Partial Hospitalization is covered by the Wellcare Patriot Giveback (HMO-POS) plan with a $75 copay, and prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Wellcare Patriot Giveback (HMO-POS) plan. Ground and air ambulance services have a $200 copay, and there is no coinsurance, but transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Coverage are covered by the Wellcare Patriot Giveback (HMO-POS) plan. Emergency Services have a $125 copay, and Urgently Needed Services have a $35 copay, while Worldwide Emergency Coverage has a $125 copay. Worldwide Emergency Transportation is not covered. All services have no coinsurance.
Primary Care See details
The Wellcare Patriot Giveback (HMO-POS) plan covers primary care physician services with no copay, chiropractic services with a $20 copay, occupational therapy services with a $25 copay, physician specialist services with a $25 copay, and mental health specialty services with no copay for individual and group sessions. The plan also covers other health care professional services, psychiatric services, physical therapy and speech-language pathology services with a $25 copay, and opioid treatment program services with a $25 copay.
Preventive Services See details
The Wellcare Patriot Giveback (HMO-POS) plan covers preventive services including annual physical exams with no copay, additional preventive services, kidney disease education services with 20% coinsurance, glaucoma screenings, diabetes self-management training, barium enemas, digital rectal exams, and EKG following a Welcome Visit, all with no copay. The plan does not cover health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge in-home medication reconciliation, re-admission prevention, wigs for hair loss related to chemotherapy, weight management programs, therapeutic massage, adult day health services, nutritional/dietary benefits, home-based palliative care, in-home support services, support for caregivers, additional sessions of smoking and tobacco cessation counseling, enhanced disease management, telemonitoring services, home and bathroom safety devices and modifications, or counseling services.
Hearing Services See details
Hearing exams are covered with a $25 copay, and routine hearing exams and fitting/evaluation for hearing aids have no copay. Prescription hearing aids are covered with a maximum plan benefit of $1500 per year and prescription hearing aids (all types) have no copay. OTC hearing aids, and prescription hearing aids - inner ear, outer ear, and over the ear are not covered.
Vision Services See details
The Wellcare Patriot Giveback (HMO-POS) plan covers vision services, including eye exams with a copay between $0 and $25 and eyewear with no copay, including contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades. Eyewear has a combined maximum benefit of $300 per year.
Dental Services See details
The Wellcare Patriot Giveback (HMO-POS) plan covers Medicare Dental Services with a $25 copay. Oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatment, other preventive dental services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), and oral and maxillofacial surgery are covered with no copay. Orthodontic services are covered up to a maximum of $2000 per year, but maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered under the Wellcare Patriot Giveback (HMO-POS) plan. Medicare Part B Insulin Drugs have a $35 copay, while Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the Wellcare Patriot Giveback (HMO-POS) plan. You will pay 20% coinsurance for these services.
Medical Equipment See details
The Wellcare Patriot Giveback (HMO-POS) plan covers Durable Medical Equipment (DME) with 20% coinsurance and requires prior authorization, and Prosthetics/Medical Supplies with 20% coinsurance; Durable Medical Equipment for use outside the home is not covered. Diabetic Supplies are covered with no copay, and Diabetic Therapeutic Shoes/Inserts are covered with 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered under the Wellcare Patriot Giveback (HMO-POS) plan. Diagnostic Procedures/Tests have a copay between $0 and $20, and Lab Services have no copay. Diagnostic Radiological Services have a copay of at most $200, Therapeutic Radiological Services have a coinsurance of at least 20%, and Outpatient X-Ray Services have a $25 copay.
Home Health Services See details
Home Health Services are covered by the Wellcare Patriot Giveback (HMO-POS) 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 Patriot Giveback (HMO-POS) plan. The plan does not cover Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, or Additional Cardiac Rehabilitation Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Wellcare Patriot Giveback (HMO-POS) plan, but require prior authorization. For days 1-20 and 51-100, there is no copay, while days 21-50 have a $214 copay.
Other Services See details
The Wellcare Patriot Giveback (HMO-POS) plan does not cover acupuncture, over-the-counter (OTC) items, meal benefits, Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, or Self-Directed Personal Assistance Services. No authorization or referrals are required for these services.
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