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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 MO. 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 $80.00. 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 $7000.00 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. For Tier 1 preferred generics, Tier 2 generics, and Tier 6 select care drugs, there is no copay when using a preferred pharmacy or preferred mail-order service. Standard pharmacies charge copays starting at $5 for Tier 1 and $10 for Tier 2 drugs, while Tier 6 select care drugs have no copay at any network pharmacy. Higher-tier prescription medications require coinsurance rather than flat copays. Tier 3 preferred brands and Tier 5 specialty drugs both carry a 25% coinsurance, with Tier 5 coverage limited to a one-month supply. Non-preferred drugs in Tier 4 require a 43% coinsurance at preferred pharmacies or 44% coinsurance at standard pharmacies.
Additional Benefits
The Wellcare Giveback (HMO-POS) plan offers comprehensive medical coverage featuring no copay and no coinsurance for primary care visits, annual physicals, and home health services. Specialist visits, physical therapy, and urgent care require a $40 copay with no coinsurance, while emergency room services are available with a $115 copay. For hospital stays, inpatient acute care requires a $375 daily copay for the first seven days, after which there is no copay. Routine vision, hearing, and dental preventive services are covered with no copay, including a $100 annual eyewear allowance and up to $350 per ear for prescription hearing aids. Durable medical equipment, dialysis services, and therapeutic radiological treatments require a 20% coinsurance. It is important to note that this plan does not cover routine transportation, over-the-counter items, or meal benefits.
Inpatient Hospital See details
Inpatient hospital services are partially covered by Wellcare Giveback (HMO-POS) 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 care requires a $350 daily copay for days 1 through 5 and no copay for days 6 through 90, with additional days, upgrades, and non-Medicare stays not covered.
Outpatient Services See details
Wellcare Giveback (HMO-POS) covers outpatient services with no coinsurance, featuring copays of $0 to $425 for outpatient hospital services, $115 to $425 per stay for observation services, and $250 for ambulatory surgical center services. Outpatient substance abuse sessions require a $40 copay with no coinsurance, while outpatient blood services are covered with no copay and no coinsurance.
Partial Hospitalization See details
Partial hospitalization is covered under the Wellcare Giveback (HMO-POS) plan with a $105.00 copay and no coinsurance. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Wellcare Giveback (HMO-POS) covers Medicare-approved ground and air ambulance services with a $275 copay and no coinsurance, though prior authorization is required. However, plan-approved and health-related transportation services are not covered under this plan.
Emergency Services See details
Emergency services are covered by Wellcare Giveback (HMO-POS) with a $115 copay and no coinsurance, and urgent care is covered with a $40 copay and no coinsurance, with both copays waived if admitted to the hospital within 24 hours. Worldwide emergency and urgent care are partially 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) offers primary care physician services with no copay and no coinsurance, while specialist visits, physical therapy, and mental health services require a $40 copay and no coinsurance. Chiropractic care is partially covered with a $15 copay and no coinsurance for up to 12 routine visits per year (other chiropractic services are not covered), but podiatry services are not covered by this plan.
Preventive Services See details
Wellcare Giveback (HMO-POS) covers annual physical exams, Medicare-covered preventive services, and select screenings with no copay and no coinsurance, while kidney disease education features no copay and a 20% coinsurance. Additional supplemental benefits like fitness programs, PERS, alternative therapies, and remote access are covered with no copay and no coinsurance, though other services like health education, nutritional benefits, and in-home safety assessments are not covered.
Hearing Services See details
Wellcare Giveback (HMO-POS) partially covers hearing services, featuring a $40 copay and no coinsurance for Medicare-covered exams, and no copay or coinsurance for annual routine exams and fitting evaluations. Prescription hearing aids are covered with no copay or coinsurance up to a $350 annual maximum per ear, but OTC hearing aids and inner ear, outer ear, and over-the-ear prescription hearing aids are not covered.
Vision Services See details
Vision services are partially covered by Wellcare Giveback (HMO-POS) with no coinsurance, featuring no copay for annual routine eye exams and eyewear, although other eye exam services are not covered. Covered eyewear benefits, including contacts and eyeglasses, have no copay and are subject to a combined maximum benefit of $100 per year.
Dental Services See details
Wellcare Giveback (HMO-POS) partially covers dental services, offering Medicare-covered dental care for a $40 copay and no coinsurance, alongside preventive and adjunctive services with no copay and no coinsurance. Restorative services, endodontics, periodontics, prosthodontics, implants, 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, though prior authorization and step therapy may apply. Medicare Part B insulin is covered with a $35 copay and no coinsurance, while chemotherapy, radiation, and other Part B drugs require no copay and a coinsurance of 0% to 20%.
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 is covered by Wellcare Giveback (HMO-POS) with no copays, though a 20% coinsurance applies to durable medical equipment, prosthetic devices, medical supplies, and diabetic therapeutic shoes or inserts. Prior authorization is required for these benefits, and diabetic supplies are limited to specified manufacturers.
Diagnostic and Radiological Services See details
Wellcare Giveback (HMO-POS) covers diagnostic and radiological services, with prior authorization required. Diagnostic services feature no coinsurance, offering no copay for lab services and a $0 to $45 copay for tests, while radiological services require a $50 copay and coinsurance for X-rays, and a minimum 20% coinsurance plus copay for therapeutic services.
Home Health Services See details
Home Health Services are covered under the Wellcare Giveback (HMO-POS) plan with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by Wellcare Giveback (HMO-POS) with no coinsurance; however, while some services are covered, standard cardiac rehabilitation (requiring a $30 copay), intensive cardiac rehabilitation ($40 copay), pulmonary rehabilitation ($25 copay), and SET for PAD services ($20 copay) are not covered.
Skilled Nursing Facility (SNF) See details
Wellcare Giveback (HMO-POS) covers skilled nursing facility (SNF) care with no coinsurance and requires prior authorization, without requiring a prior three-day hospital stay. There is no copay for days 1 through 20 and days 61 through 100, a $218 copay for days 21 through 60, and additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Wellcare Giveback (HMO-POS) does not cover Other Services, meaning supplemental benefits like acupuncture, over-the-counter (OTC) items, and meal benefits are not available under this plan.
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