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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 2025, 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 2025.
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 $100.00. 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 offers a range of benefits with varying costs. This plan includes coverage for inpatient and outpatient services, with copays ranging from $0 to $350 depending on the service. It also provides coverage for hearing, vision, and dental services, and includes additional benefits such as home health services with no copay, and an allowance for over-the-counter items.
Inpatient Hospital See details
Inpatient Hospital services are covered under the Wellcare Patriot Giveback Open (PPO) plan. For Inpatient Hospital-Acute, you will pay a copay of $350 for days 1-6 and no copay for days 7-90; for Inpatient Hospital Psychiatric, you will pay a copay of $300 for days 1-6 and no copay for days 7-90.
Outpatient Services See details
Outpatient services are covered, including outpatient hospital services with a copay of $0-$280, observation services with a copay of $125-$280, ambulatory surgical center services with a $175 copay, and outpatient substance abuse services with no copay for individual and group sessions. Outpatient blood services have no copay.
Partial Hospitalization See details
Partial Hospitalization is covered by the Wellcare Patriot Giveback Open (PPO) plan with a $105 copay, and prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Wellcare Patriot Giveback Open (PPO) plan. Ground and air ambulance services have a $225 copay, with no coinsurance. Transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services are covered under the Wellcare Patriot Giveback Open (PPO) plan, with a $125 copay and no coinsurance, and the copay is waived if admitted to the hospital within 24 hours. Urgently Needed Services have a $50 copay and no coinsurance, and the copay is waived if admitted to the hospital within 24 hours. Worldwide Emergency Coverage and Worldwide Urgent Coverage have a $125 copay and no coinsurance, and Worldwide Emergency Transportation is not covered.
Primary Care See details
The Wellcare Patriot Giveback Open (PPO) plan covers primary care physician services with no copay, chiropractic services with a $20 copay, occupational therapy services with a $30 copay, physician specialist services with a $30 copay, mental health specialty services with no copay for individual and group sessions, other health care professional services with a copay between $0 and $30, psychiatric services with no copay for individual and group sessions, physical therapy and speech-language pathology services with a $30 copay, additional telehealth benefits with a copay between $0 and $50, and opioid treatment program services with a $30 copay. Routine chiropractic care and podiatry services are not covered.
Preventive Services See details
Preventive services include an annual physical exam with no copay, as well as additional preventive services that may have a copay. Kidney disease education services have a 20% coinsurance. Other preventive services such as Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit have no copay.
Hearing Services See details
The Wellcare Patriot Giveback Open (PPO) plan covers hearing exams with a $30 copay, routine hearing exams with no copay, and fitting/evaluation for hearing aids with no copay. Prescription hearing aids (all types) are covered with a maximum benefit of $1,000 per year, and a $0 copay. Prescription hearing aids - inner ear, outer ear, and over the ear, as well as OTC hearing aids, are not covered.
Vision Services See details
Vision services are covered, including eye exams and eyewear. Eye exams have a copay of $0-$30, while routine eye exams have no copay. Eyewear, including contact lenses, eyeglasses, eyeglass lenses, eyeglass frames, and upgrades, have no copay, with a combined maximum benefit of $300 per year.
Dental Services See details
Dental services are covered by the Wellcare Patriot Giveback Open (PPO) plan, with a $30 copay for Medicare dental services. Oral exams, dental x-rays, other diagnostic services, cleaning, fluoride treatment, other preventive 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 $3000 per year, and 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 Open (PPO) 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 by the Wellcare Patriot Giveback Open (PPO) plan with a coinsurance between 20% and 20%.
Medical Equipment See details
Medical Equipment is covered, including Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment. DME has a 20% coinsurance, and Prosthetic Devices and Medical Supplies have a 20% coinsurance. Diabetic Supplies have no copay, and Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered by the Wellcare Patriot Giveback Open (PPO) plan. Diagnostic Procedures/Tests have a copay between $0 and $100, while Lab Services have no copay. Diagnostic Radiological Services have a copay of up to $280, 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 under the Wellcare Patriot Giveback Open (PPO) plan with no copay and no coinsurance, but additional hours of care and personal care services are not covered. Authorization is required for this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the Wellcare Patriot Giveback Open (PPO) plan. This includes Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, and Additional Cardiac Rehabilitation Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Wellcare Patriot Giveback Open (PPO) plan, but require prior authorization. For days 1-20 and 51-100, there is no copay, while days 21-50 have a $214 copay. Additional days beyond Medicare-covered for SNF and Non-Medicare-covered stays for SNF are not covered.
Other Services See details
The Wellcare Patriot Giveback Open (PPO) plan offers Other Services, including Over-the-Counter (OTC) Items with no copay, and a meal benefit with no copay, but other services are not covered. Acupuncture, 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, and Self-Directed Personal Assistance Services are not covered.
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