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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 2026 to people living in Select Counties in Louisiana. This plan received an overall rating of 3.5 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 $70.00. 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 $9250.00 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. You can enjoy no copay on Tier 1 preferred generic, Tier 2 generic, and Tier 6 select care drugs when using preferred pharmacies or preferred mail order services. For standard pharmacies, copays remain low, starting at $5 for a one-month supply of Tier 1 drugs and $10 for Tier 2 drugs. For higher-tier medications, coverage transitions to coinsurance, with Tier 3 preferred brands and Tier 5 specialty drugs requiring 25% coinsurance. Tier 4 non-preferred drugs incur a 49% coinsurance at preferred pharmacies and 50% coinsurance at standard pharmacies. Utilizing the plan's preferred network pharmacies and mail-order services offers the most cost-effective way to fill your prescriptions.
Additional Benefits
The Wellcare Giveback (HMO-POS) plan provides comprehensive healthcare coverage with affordable out-of-pocket costs, including no copay and no coinsurance for primary care doctor visits and annual preventive screenings. For more specialized medical care, members pay a $40 copay for specialists and a $115 copay for emergency services, both with no coinsurance. If you require an inpatient hospital stay, you will pay a $495 daily copay for days one through four, followed by no copay for days five through ninety. In addition to core medical care, this plan covers essential everyday health services like routine dental, vision, and hearing exams with no copay and no coinsurance. You can also take advantage of no copay benefits for over-the-counter items, home health care, eyeglasses up to $100 annually, and hearing aids up to $350 per ear. For other specialized needs, diabetic supplies feature no copay, while durable medical equipment and dialysis services require a 20% coinsurance.
Inpatient Hospital See details
Wellcare Giveback (HMO-POS) provides partially covered inpatient acute and psychiatric hospital services with no coinsurance, though prior authorization is required. For both types of stays, you will pay a $495 daily copay for days 1 through 4, followed by no copay for days 5 through 90, while additional days, non-Medicare-covered stays, and room upgrades are not covered.
Outpatient Services See details
Wellcare Giveback (HMO-POS) covers outpatient services with no coinsurance, featuring copays ranging from $0 to $500 for outpatient hospital services and a $350 copay for ambulatory surgical center services, both requiring prior authorization. Outpatient substance abuse sessions require prior authorization and have a $40 copay with no coinsurance, while outpatient blood services are covered with no copay, no coinsurance, and no deductible.
Partial Hospitalization See details
Partial hospitalization is covered by Wellcare Giveback (HMO-POS) with a $105.00 copay and no coinsurance. Prior authorization is required for these services.
Ambulance and Transportation Services See details
Ambulance and transportation services are partially covered by Wellcare Giveback (HMO-POS), with Medicare-covered ground and air ambulance services requiring a $300 copay and no coinsurance. Transportation services to plan-approved or any health-related locations are not covered by the plan.
Emergency Services See details
Wellcare Giveback (HMO-POS) covers emergency services with a $115 copay and urgently needed services with a $40 copay, both featuring no coinsurance and copays waived if admitted within 24 hours. Worldwide emergency and urgent services 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) covers primary care physician services with no copay and no coinsurance, while specialist, physical therapy, and mental health services require a $40 copay and no coinsurance. Occupational therapy is covered with a $35 copay and no coinsurance, but chiropractic and podiatry services are not covered.
Preventive Services See details
Preventive services are partially covered by Wellcare Giveback (HMO-POS), offering no copay and no coinsurance for annual physicals, fitness benefits, alternative therapies, remote access, and most screenings. Kidney disease education is covered with no copay and a 20% coinsurance, while several services such as health education, weight management, and in-home safety assessments are not covered.
Hearing Services See details
Wellcare Giveback (HMO-POS) hearing services are partially covered, featuring Medicare-covered exams for a $40 copay and routine exams or fittings with no copay, all with no coinsurance. Prescription hearing aids are covered up to $350 per ear yearly with no copay or coinsurance, but OTC, inner ear, outer ear, and over-the-ear hearing aids are not covered.
Vision Services See details
Vision Services are partially covered by Wellcare Giveback (HMO-POS), featuring eye exams with a $0 to $40 copay and no coinsurance or deductibles, although other eye exam services are not covered. Eyewear, including contact lenses, eyeglasses, and upgrades, is covered with no copay and no coinsurance up to a combined maximum benefit of $100 per year.
Dental Services See details
Dental services are partially covered by the Wellcare Giveback (HMO-POS) plan, with Medicare-covered dental requiring a $40 copay and no coinsurance, and covered preventive and adjunctive services requiring no copay and no coinsurance. However, restorative services, endodontics, periodontics, prosthodontics, maxillofacial prosthetics, implant services, oral and maxillofacial surgery, and orthodontics are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by Wellcare Giveback (HMO-POS) with no copay, though prior authorization is required. Under this benefit, Medicare Part B insulin drugs have a $35 copay and no coinsurance, while chemotherapy and other Part B drugs have a coinsurance ranging from 0% to 20%.
Dialysis Services See details
Dialysis Services are covered by Wellcare Giveback (HMO-POS) with no copay and a 20% coinsurance.
Medical Equipment See details
Medical equipment benefits under Wellcare Giveback (HMO-POS) cover 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 no copay and a 20% coinsurance, with prior authorization required for these services.
Diagnostic and Radiological Services See details
Wellcare Giveback (HMO-POS) covers diagnostic and radiological services, with prior authorization required. Lab services have no copay and no coinsurance, diagnostic tests range from no copay to a $50 copay with no coinsurance, and radiological services range from no copay up to a $50 copay for X-rays, with therapeutic services requiring a 20% coinsurance.
Home Health Services See details
Home Health Services are covered by Wellcare Giveback (HMO-POS) 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, but only some services are covered in practice. Standard cardiac rehabilitation (with a $30 copay), intensive cardiac rehabilitation (with a $40 copay), pulmonary rehabilitation (with a $25 copay), and SET for PAD services (with a $20 copay) are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by Wellcare Giveback (HMO-POS) with no coinsurance, featuring no copay for days 1 to 20 and 71 to 100, and a $218 daily copay for days 21 to 70. Prior authorization is required, a prior three-day hospital stay is not needed, and additional days beyond the standard 100-day limit are not covered.
Other Services See details
Wellcare Giveback (HMO-POS) partially covers Other Services, providing over-the-counter (OTC) items with no copay and no coinsurance, while acupuncture and meal benefits are not covered. Covered OTC items, including nicotine replacement therapy and naloxone, are available through reimbursement.
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