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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 NC. This plan received an overall rating of 3.5 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 $175.00. 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 combined Maximum Out-Of-Pocket cost of $13300.00 (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 $13300.00 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) plan offers comprehensive medical coverage with predictable costs, featuring no copays or coinsurance for primary care visits, mental health services, and home health care. Specialist visits and therapy services require a $35 copay, while inpatient hospital stays are covered with a daily copay for the first few days and no copay thereafter. Outpatient hospital services and diagnostic lab tests also feature low to no copays, helping you manage your healthcare budget. This Medicare Advantage plan also provides valuable supplemental benefits, including preventive dental, routine vision exams, and hearing screenings with no copay. You will receive generous annual allowances, including up to $2,000 for dental services, $1,000 per ear for prescription hearing aids, and $200 for routine eyewear. For other medical needs, durable medical equipment and dialysis are covered with a 20% coinsurance and no copay.
Inpatient Hospital See details
Wellcare Patriot Giveback Open (PPO) covers inpatient acute and psychiatric hospital stays with no coinsurance, requiring a daily copay of $325 for the first 8 days of acute stays and the first 6 days of psychiatric stays, followed by no copay up to 90 days. This benefit is partially covered, as additional days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Wellcare Patriot Giveback Open (PPO) covers outpatient services with no coinsurance, featuring outpatient hospital copays from $0 to $400 and ambulatory surgical center copays of $250. Patients will also pay no copays or coinsurance for outpatient substance abuse and blood services, while observation services require a copay of $115 to $400 per stay.
Partial Hospitalization See details
Wellcare Patriot Giveback Open (PPO) covers partial hospitalization services with a $105.00 copay and no coinsurance. Prior authorization is required to receive coverage for this benefit.
Ambulance and Transportation Services See details
Wellcare Patriot Giveback Open (PPO) covers ground and air ambulance services with a $335 copay and no coinsurance, subject to prior authorization. Some transportation services are covered, but 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 $115 copay and no coinsurance, and urgently needed services with a $30 copay and no coinsurance, with copays waived if admitted to the hospital within 24 hours. Worldwide emergency services are partially covered up to a $50,000 maximum benefit with a $115 copay and no coinsurance for emergency and urgent care, but worldwide emergency transportation is not covered.
Primary Care See details
Wellcare Patriot Giveback Open (PPO) provides primary care physician, mental health, and psychiatric services with no copay and no coinsurance. Specialist visits, physical, occupational, and speech therapies require a $35 copay and no coinsurance, while podiatry is not covered and chiropractic services are only partially covered since routine chiropractic care is excluded.
Preventive Services See details
Wellcare Patriot Giveback Open (PPO) features partially covered preventive services with no copay and no coinsurance for annual physicals, fitness benefits, and routine screenings, while kidney disease education requires a 20% coinsurance and no copay. Sub-services not covered under this plan include health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, chemotherapy wigs, weight management, therapeutic massage, adult day health, nutritional benefits, palliative care, in-home support, caregiver support, smoking cessation, disease management, telemonitoring, bathroom safety devices, and counseling.
Hearing Services See details
Wellcare Patriot Giveback Open (PPO) offers partially covered hearing services, featuring routine exams and fitting evaluations with no copay and no coinsurance, and Medicare-covered exams for a $35 copay and no coinsurance. Prescription hearing aids are covered up to $1,000 per ear annually with no copay or coinsurance, though OTC, inner ear, outer ear, and over-the-ear models are not covered.
Vision Services See details
Wellcare Patriot Giveback Open (PPO) offers partially covered vision services with no deductible, no coinsurance, and copays ranging from no copay to $35 for eye exams. While other eye exam services are not covered, routine exams (limited to one per year) and eyewear are covered with no copay up to a combined annual maximum of $200.
Dental Services See details
Wellcare Patriot Giveback Open (PPO) offers partially covered dental services, featuring a $35 copay and no coinsurance for Medicare-covered dental, and no copay or coinsurance for preventive and comprehensive services up to a $2,000 annual maximum. However, prosthodontics (fixed and removable), maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Wellcare Patriot Giveback Open (PPO) covers home infusion bundled services with no copay, though prior authorization is required. Under this benefit, Medicare Part B insulin drugs require a $35 copay and no coinsurance, while chemotherapy, radiation, and other Part B drugs have no copay and a coinsurance ranging from 0% to 20%.
Dialysis Services See details
Dialysis services are covered under the Wellcare Patriot Giveback Open (PPO) with no copay and a 20% coinsurance.
Medical Equipment See details
Wellcare Patriot Giveback Open (PPO) covers medical equipment, including 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 services.
Diagnostic and Radiological Services See details
Wellcare Patriot Giveback Open (PPO) covers diagnostic services with no coinsurance, featuring no copay for lab services and a copay of $0 to $100 for other procedures. Covered radiological services require a $50 copay for outpatient X-rays, a 20% coinsurance for therapeutic radiology, and no copay for diagnostic radiology, with prior authorization required for all services.
Home Health Services See details
Wellcare Patriot Giveback Open (PPO) covers home health services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered with no coinsurance under the Wellcare Patriot Giveback Open (PPO), meaning some services are covered, but cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and SET for PAD services are not covered.
Skilled Nursing Facility (SNF) See details
Wellcare Patriot Giveback Open (PPO) covers skilled nursing facility (SNF) services with no coinsurance and no required three-day prior hospital stay, though prior authorization is required. There is no copay for days 1 to 20 and days 71 to 100, a $218 daily copay for days 21 to 70, and additional days beyond the 100-day limit are not covered.
Other Services See details
Wellcare Patriot Giveback Open (PPO) does not provide coverage for other services, meaning acupuncture, over-the-counter (OTC) items, and meal benefits are not covered.
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