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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 MS. 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 $81.00. 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 $7700.00 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 has an annual drug deductible of $615. You can save on medication costs with no copay for Tier 1 preferred generics and Tier 2 generics when using a preferred pharmacy or preferred mail order service. Tier 6 select care drugs also feature no copay at both preferred and standard pharmacies. For higher-tier medications, cost-sharing shifts to coinsurance. Tier 3 preferred brand drugs and Tier 5 specialty drugs require a 25% coinsurance, while Tier 4 non-preferred drugs carry a 50% coinsurance. Standard pharmacies and standard mail order options are also available for Tier 1 and Tier 2 drugs, with copays ranging from $5 to $30 depending on the supply.
Additional Benefits
The Wellcare Giveback (HMO-POS) plan offers affordable medical coverage with no copay for primary care visits and a $45 copay for specialist visits. For inpatient hospital stays, members pay a $450 daily copay for days 1 to 5 and no copay for days 6 to 90. Emergency room visits require a $115 copay, while many diagnostic lab services, home health visits, and preventive care services are covered with no copay or coinsurance. Supplemental benefits include routine dental, vision, and hearing exams with no copay, alongside annual allowances for prescription hearing aids and eyewear. Preventive dental services are fully covered with no copay, while Medicare-covered dental exams and hearing tests require a $45 copay. However, some common supplemental perks like transportation, over-the-counter items, and meal benefits are not covered by this plan.
Inpatient Hospital See details
Wellcare Giveback (HMO-POS) covers inpatient hospital services with no coinsurance, requiring prior authorization for acute and psychiatric stays. For acute stays, there is a $450 copay per day for days 1 to 5 and no copay for days 6 to 90, while psychiatric stays charge a $387 copay per day for days 1 to 5 and no copay for days 6 to 90. Additional days, upgrades, and non-Medicare-covered stays are not covered under this benefit.
Outpatient Services See details
Wellcare Giveback (HMO-POS) covers outpatient services with no coinsurance, featuring a copay of $0 to $500 for outpatient hospital services and $115 to $500 per stay for observation services. Ambulatory surgical center services require a $185 copay, outpatient substance abuse sessions have a $25 copay, and outpatient blood services are covered with no copay and no deductible.
Partial Hospitalization See details
Wellcare Giveback (HMO-POS) covers partial hospitalization services with a $105.00 copay and no coinsurance. Prior authorization is required to receive this benefit.
Ambulance and Transportation Services See details
Wellcare Giveback (HMO-POS) covers ground and air ambulance services with a $250 copay and no coinsurance, though prior authorization is required. Transportation services are not covered.
Emergency Services See details
Wellcare Giveback (HMO-POS) covers emergency services with a $115 copay and urgently needed services with a $40 copay, both with no coinsurance and copays waived if admitted within 24 hours. Worldwide emergency and urgent care are partially covered up to a $50,000 maximum with a $115 copay and no coinsurance, but worldwide emergency transportation is not covered.
Primary Care See details
Wellcare Giveback (HMO-POS) offers primary care services with no copay and no coinsurance, while specialist visits require a $45 copay and no coinsurance. Outpatient therapies and mental health services have copays ranging from $25 to $45 and no coinsurance, but podiatry is not covered, and for chiropractic care, some services are covered but routine and other chiropractic services are not.
Preventive Services See details
Wellcare Giveback (HMO-POS) covers preventive services, including annual physical exams, fitness benefits, alternative therapies, and select screenings with no copay and no coinsurance. Kidney disease education is covered with no copay and 20% coinsurance, though several supplemental services like health education, nutritional counseling, and in-home safety assessments are not covered.
Hearing Services See details
Wellcare Giveback (HMO-POS) covers hearing services with no deductible, featuring a $45 copay for Medicare-covered exams and no copay or coinsurance for annual routine exams, fittings, and prescription hearing aids. While prescription aids are covered up to $350 per ear annually, OTC hearing aids and inner, outer, or over-the-ear prescription models are not covered, and prior authorization is required for most services.
Vision Services See details
Vision Services are partially covered by Wellcare Giveback (HMO-POS), featuring one routine eye exam per year with no copay and no coinsurance, while other eye exam services are not covered. Covered eyewear—including contacts, eyeglasses, and upgrades—carries no copay, no coinsurance, and no deductible, up to a combined maximum plan benefit of $100 annually.
Dental Services See details
Dental services are covered by Wellcare Giveback (HMO-POS), featuring Medicare-covered dental with a $45 copay and no coinsurance, alongside preventive services with no copay and no coinsurance. Other dental benefits are only partially covered, offering adjunctive general services with no copay and no coinsurance, while restorative services, endodontics, periodontics, prosthodontics, implant services, oral and maxillofacial surgery, and orthodontics 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, radiation, and other drugs have a 0% to 20% coinsurance and no copay, while Part B insulin is covered with a $35 copay and no coinsurance, which does not count toward the plan deductible.
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
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.
Diagnostic and Radiological Services See details
Wellcare Giveback (HMO-POS) covers diagnostic and radiological services, though prior authorization is required. Diagnostic tests have a copay of $0 to $20 with no coinsurance, lab and diagnostic radiological services have no copay, outpatient X-rays require a $25 copay, and therapeutic radiological services carry a 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, though some services are covered while cardiac rehabilitation (with a $30 copay), intensive cardiac rehabilitation (with a $40 copay), pulmonary rehabilitation (with a $25 copay), and supervised exercise therapy for symptomatic peripheral artery disease (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, featuring no copay for days 1 to 20 and 61 to 100, and a $218 daily copay for days 21 to 60. Prior authorization is required, a prior three-day hospital stay is not, and additional days beyond the standard 100 days are not covered.
Other Services See details
Wellcare Giveback (HMO-POS) does not cover Other Services in practice, as acupuncture, over-the-counter (OTC) items, and meal benefits are not covered.
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