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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 All counties in KY. This plan received an overall rating of 3.5 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 $105.00. 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 $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 cost-sharing. This plan includes coverage for inpatient hospital stays with copays, outpatient services with copays, and emergency services with a $125 copay. Preventive services and home health services are offered with no copay. The plan also covers vision, dental, and hearing services, with copays for some services, and no copays for others. Prescription hearing aids have a maximum coverage of $1,000 per ear. Additionally, the plan provides coverage for home infusion, dialysis, medical equipment, and diagnostic services, with either copays or coinsurance.
Inpatient Hospital See details
Inpatient Hospital coverage includes Inpatient Hospital-Acute and Inpatient Hospital Psychiatric services. For Inpatient Hospital-Acute, you will pay a $350 copay for days 1-7, and no copay for days 8-90; for Inpatient Hospital Psychiatric, you will pay a $275 copay for days 1-7, and no copay for days 8-90. Additional days, non-Medicare covered stays, and upgrades for both Inpatient Hospital-Acute and Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services with a copay between $0 and $400, observation services with a copay between $125 and $400, ambulatory surgical center services with a $250 copay, and outpatient substance abuse services with no copay for individual and group sessions. Outpatient blood services are covered with no copay.
Partial Hospitalization See details
Partial Hospitalization is covered under the Wellcare Patriot Giveback Open (PPO) plan with a $70 copay. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Wellcare Patriot Giveback Open (PPO) plan. This plan has a $325 copay for both Medicare-covered ground and air ambulance services, with no coinsurance. Transportation services to any health-related location are not covered.
Emergency Services See details
Emergency services, urgently needed services, and worldwide emergency coverage are covered by the Wellcare Patriot Giveback Open (PPO) plan. Emergency services have a $125 copay and no coinsurance, while urgently needed services have a $25 copay and no coinsurance. Worldwide emergency coverage has a $125 copay and no coinsurance, while worldwide urgent coverage has 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 $15 copay, occupational therapy services with a $40 copay, physician specialist services with a $45 copay, and mental health specialty services with no copay for individual and group sessions. Additionally, physical therapy and speech-language pathology services have a $40 copay, and additional telehealth benefits range from no copay to a $45 copay. Routine chiropractic care and podiatry services are not covered.
Preventive Services See details
Preventive services, including annual physical exams and additional preventive services, are covered by the Wellcare Patriot Giveback Open (PPO) plan. Annual physical exams have no copay, and other preventive services may have a copay. Kidney disease education services have a 20% coinsurance.
Hearing Services See details
The Wellcare Patriot Giveback Open (PPO) plan covers hearing exams with a $45 copay, routine hearing exams with no copay, and fitting/evaluation for hearing aids with no copay. Prescription hearing aids are covered up to $1,000 per ear, while inner ear, outer ear, and over-the-ear prescription hearing aids, as well as OTC hearing aids, are not covered.
Vision Services See details
The Wellcare Patriot Giveback Open (PPO) plan covers vision services, including eye exams with a copay of $0-$45, and eyewear with no copay. Eyeglasses, eyeglass lenses, eyeglass frames, contact lenses, and upgrades are covered with no copay, with a combined maximum of $200 per year for eyewear.
Dental Services See details
Dental Services include coverage for Medicare Dental Services with a $45 copay, and other services such as oral exams, dental x-rays, and cleanings with no copay. Orthodontic Services are covered up to a maximum of $2000 per year, while other services like maxillofacial prosthetics, implants, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs with a $35 copay, and Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs with a coinsurance between 0% and 20%. Prior authorization is required.
Dialysis Services See details
Dialysis Services are covered under the Wellcare Patriot Giveback Open (PPO) plan. You will pay 20% coinsurance for these services.
Medical Equipment See details
The Wellcare Patriot Giveback Open (PPO) plan covers Durable Medical Equipment (DME) with a 20% coinsurance and requires authorization, but does not cover Durable Medical Equipment for use outside the home. Prosthetic Devices and Medical Supplies are covered with a 20% coinsurance. Diabetic Supplies are covered with no copay, and Diabetic Therapeutic Shoes/Inserts are covered with a 20% coinsurance.
Diagnostic and Radiological Services See details
The Wellcare Patriot Giveback Open (PPO) plan covers diagnostic and radiological services, including diagnostic procedures and tests with a copay between $0 and $70, and lab services with no copay. Therapeutic radiological services have a coinsurance of at least 20%, while outpatient X-ray services have no copay.
Home Health Services See details
Home Health Services are covered by the Wellcare Patriot Giveback Open (PPO) plan with no copay and no coinsurance. Additional hours of care and personal care services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the Wellcare Patriot Giveback Open (PPO) plan. While the plan mentions copays, the specific cost sharing information is not provided.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Wellcare Patriot Giveback Open (PPO) plan, but prior authorization is required. There is no copay for days 1-20 and days 61-100, but there is a $203 copay for days 21-60. Additional days beyond Medicare-covered and non-Medicare-covered SNF stays are not covered.
Other Services See details
The Wellcare Patriot Giveback Open (PPO) plan covers over-the-counter (OTC) items with no copay, and a maximum plan benefit coverage amount of $40.00 every three months. 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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1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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