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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 MI. 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 $125.00. You must continue to pay paying your reduced Part B Premium.
Deductibles
This plan has a $100.00 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 $8950.00 (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 $8950.00 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 provides comprehensive medical coverage with predictable out-of-pocket costs, featuring no copays and no coinsurance for primary care visits, preventive services, and home health care. For specialized medical care, members pay fixed copayments with no coinsurance, such as a $30 copay for specialist visits and a $130 copay for emergency services. Inpatient hospital stays require a daily copay for the first seven days, after which there is no copay for up to 90 days. This plan also features robust supplemental benefits, including dental, vision, and hearing care with no deductibles and mostly no copays or coinsurance. Routine eye exams, preventive dental services, and hearing fittings are covered with no copay, alongside generous annual allowances like $3,000 for dental care and $1,000 for prescription hearing aids. Additionally, members can access over-the-counter items and chronic illness meals with no copay and no coinsurance.
Inpatient Hospital See details
Inpatient hospital care is partially covered by Wellcare Patriot Giveback Open (PPO) with no coinsurance, though prior authorization is required. Acute stays require a $350 copay for days 1 through 7 and no copay for days 8 through 90, while psychiatric stays require a $300 copay for days 1 through 7 and no copay for days 8 through 90. Additional days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Outpatient services are covered by Wellcare Patriot Giveback Open (PPO) with no coinsurance, featuring a $0 to $280 copay for outpatient hospital services and a $130 to $280 copay per stay for observation services. Ambulatory surgical center services require a $175 copay with no coinsurance, while outpatient substance abuse and blood services are covered 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 access this benefit.
Ambulance and Transportation Services See details
Wellcare Patriot Giveback Open (PPO) provides partial coverage for ambulance and transportation services, featuring a $225 copay and no coinsurance for ground and air ambulance services, which require prior authorization. Transportation services to plan-approved and any health-related locations are not covered.
Emergency Services See details
Wellcare Patriot Giveback Open (PPO) covers emergency services with a $130 copay and no coinsurance, and urgently needed services with a $50 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 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 visits, mental health, and psychiatric services with no copay and no coinsurance, while specialist, physical therapy, and occupational therapy services require a $30 copay and no coinsurance. Podiatry and chiropractic services are not covered under this plan, and prior authorization is required for most specialty services.
Preventive Services See details
Wellcare Patriot Giveback Open (PPO) covers preventive services, including annual physical exams, alternative therapies, memory fitness, and select screenings, with no copay and no coinsurance. Kidney disease education is covered with no copay and a 20% coinsurance, though some supplemental services like health education, nutritional training, and weight management are not covered.
Hearing Services See details
Wellcare Patriot Giveback Open (PPO) partially covers hearing services with no deductible, offering Medicare-covered exams for a $30 copay and no coinsurance, and routine exams and fittings at no copay and no coinsurance. Prescription hearing aids are covered up to $1,000 annually with no copay and no coinsurance, but OTC, inner ear, outer ear, and over-the-ear hearing aids are not covered.
Vision Services See details
Wellcare Patriot Giveback Open (PPO) offers partially covered vision services with no deductibles and no coinsurance. Routine eye exams are available once per year with no copay, while other eye exam services are not covered, and eyewear is covered with no copay up to a combined annual limit of $300.
Dental Services See details
Wellcare Patriot Giveback Open (PPO) offers partially covered dental services, featuring a $30 copay and no coinsurance for Medicare-covered dental, and no copay and no coinsurance for preventive and most comprehensive services up to a $3,000 annual maximum. 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 and no coinsurance, 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 have no copay and a 0% to 20% coinsurance.
Dialysis Services See details
Wellcare Patriot Giveback Open (PPO) covers dialysis services with no copay and a 20% coinsurance.
Medical Equipment See details
Medical Equipment covered by the Wellcare Patriot Giveback Open (PPO) requires prior authorization and generally features no copay. Durable medical equipment, prosthetic devices, medical supplies, and diabetic therapeutic shoes or inserts incur a 20% coinsurance, while diabetic supplies are covered with no copay.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Wellcare Patriot Giveback Open (PPO) with prior authorization required. Lab and diagnostic radiological services have no copay and no coinsurance, while other diagnostic tests range from a $0 to $100 copay with no coinsurance, outpatient X-rays cost a $25 copay, and therapeutic radiology requires a 20% coinsurance.
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
Cardiac Rehabilitation Services are not covered under the Wellcare Patriot Giveback Open (PPO) plan, as standard cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are all not covered. The plan features no coinsurance, but copays for these individual services range from $25 to $50.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by Wellcare Patriot Giveback Open (PPO) with no coinsurance, featuring no copay for days 1 to 20 and days 51 to 100, and a $218 copay per day for days 21 to 50. Prior authorization is required, a prior three-day hospital stay is not required, and additional days beyond the standard Medicare limit are not covered.
Other Services See details
Other Services are partially covered under the Wellcare Patriot Giveback Open (PPO), providing over-the-counter (OTC) items and chronic illness meal benefits with no copay and no coinsurance. Acupuncture is not covered under this plan, and the meal benefit requires a referral.
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Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
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