A non-government entity
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 All counties in KY. 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 $115.00. 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:
Sign up for Wellcare Patriot Giveback Open (PPO)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
Drug Coverage
Prescription drugs are not covered by Wellcare Patriot Giveback Open (PPO).
Additional Benefits
The Wellcare Patriot Giveback Open (PPO) offers comprehensive coverage with no copay or coinsurance for preventive services, primary care visits, and home health care. For specialized medical needs, members pay a $45 copay for specialist visits and a $115 copay for emergency services, both with no coinsurance. Inpatient hospital stays require daily copays for the first seven days of a stay but feature no copay for days eight through ninety. Additional benefits include routine dental, vision, and hearing care, which are all covered with no copay or coinsurance up to specified annual limits. For medical equipment and specialized treatments, dialysis and durable medical equipment require a 20% coinsurance with no copay, while Medicare Part B insulin is covered with a $35 copay. Members also benefit from no copay or coinsurance for over-the-counter items and home infusion services.
Inpatient Hospital See details
Inpatient hospital care is covered by the Wellcare Patriot Giveback Open (PPO) with no coinsurance, requiring a daily copay of $350 for days 1 through 7 of acute stays and $275 for days 1 through 7 of psychiatric stays, with no copay for days 8 through 90. 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 hospital services with no coinsurance and a copay ranging from no copay up to $400, alongside ambulatory surgical center services which carry a $250 copay and no coinsurance. Outpatient substance abuse sessions and outpatient blood services are also covered with no copay and no coinsurance.
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 this benefit.
Ambulance and Transportation Services See details
Wellcare Patriot Giveback Open (PPO) covers ground and air ambulance services with a $325 copay and no coinsurance, which requires prior authorization and is not waived upon hospital admission. Transportation services to plan-approved or other health-related locations are not covered.
Emergency Services See details
Wellcare Patriot Giveback Open (PPO) covers emergency services with a $115 copay and urgently needed services with a $25 copay, both with no coinsurance and copays waived if admitted within 24 hours. Worldwide emergency and urgent services are partially covered up to a $50,000 limit with a $115 copay and no coinsurance, though worldwide emergency transportation is not covered.
Primary Care See details
Wellcare Patriot Giveback Open (PPO) covers primary care, mental health, and psychiatric services with no copay and no coinsurance, while specialist visits require a $45 copay and no coinsurance. Chiropractic services are partially covered with a $15 copay and no coinsurance, as routine and other chiropractic services are not covered, while podiatry services are not covered.
Preventive Services See details
Wellcare Patriot Giveback Open (PPO) covers preventive services, including an annual physical exam, diabetes training, and select supplemental benefits like fitness and PERS, with no copay and no coinsurance. Additional preventive benefits are partially covered, excluding services like health education and nutritional therapy, while kidney disease education is covered with no copay and a 20% coinsurance.
Hearing Services See details
Wellcare Patriot Giveback Open (PPO) provides partially covered hearing services, featuring a $45 copay and no coinsurance for Medicare-covered exams, and no copay or coinsurance for annual routine exams and fitting evaluations. Up to two prescription hearing aids are covered annually up to $1,500 with no copay or coinsurance, but OTC hearing aids and inner-ear, outer-ear, or over-the-ear prescription models are not covered.
Vision Services See details
Wellcare Patriot Giveback Open (PPO) provides partially covered vision services with no coinsurance and copays ranging from no copay to $45, though other eye exam services are not covered. Routine eye exams and eyewear, such as contacts and eyeglasses, are covered with no copay and no coinsurance, with eyewear services subject to a combined maximum benefit of $300 per year.
Dental Services See details
Wellcare Patriot Giveback Open (PPO) offers partially covered dental services, featuring Medicare-covered dental care for a $45 copay and no coinsurance. Preventive and comprehensive dental benefits have no copay and no coinsurance up to a $3,000 annual maximum, though 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 and step therapy may be required. Under this benefit, Medicare Part B chemotherapy and other Part B drugs carry a 0% to 20% coinsurance and no copay, while Medicare Part B insulin is covered with a $35 copay and no coinsurance.
Dialysis Services See details
Wellcare Patriot Giveback Open (PPO) covers dialysis services with no copay and a 20% coinsurance.
Medical Equipment See details
Wellcare Patriot Giveback Open (PPO) covers medical equipment, including durable medical equipment (DME), prosthetics, medical supplies, and diabetic therapeutic shoes or inserts, with no copay and 20% coinsurance. Diabetic supplies are covered with no copay, though manufacturer limits apply, and prior authorization is required for most equipment and supplies.
Diagnostic and Radiological Services See details
Wellcare Patriot Giveback Open (PPO) covers diagnostic and radiological services with prior authorization, offering diagnostic procedures with no coinsurance and copays ranging from $0 to $70, while lab services have no copay. Diagnostic radiological services have copays starting at $0 with no coinsurance, outpatient X-rays require a $30 copay and coinsurance, and therapeutic radiological services carry a 20% coinsurance and a copay.
Home Health Services See details
Home health services are covered by the Wellcare Patriot Giveback Open (PPO) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by Wellcare Patriot Giveback Open (PPO) with no coinsurance. Members are responsible for copays of $30 for standard cardiac rehabilitation, $40 for intensive cardiac rehabilitation, $25 for pulmonary rehabilitation, and $20 for Supervised Exercise Therapy (SET) for symptomatic peripheral artery disease (PAD).
Skilled Nursing Facility (SNF) See details
Wellcare Patriot Giveback Open (PPO) covers Skilled Nursing Facility (SNF) services with no coinsurance and no required prior hospital stay, though prior authorization is needed. Patients pay no copay for days 1 through 20 and 71 through 100, but there is a $218 daily copay for days 21 through 70, and additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Wellcare Patriot Giveback Open (PPO) partially covers other services, offering over-the-counter (OTC) items and chronic illness meal benefits with no copay and no coinsurance. Acupuncture is not covered under this plan, and a referral is required to access the meal benefit.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
*/SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
MedicareAdvantageRX.com is owned and operated by Dog Media Solutions LLC.
This is a promotional communication.
Every year, Medicare evaluates plans based on a 5-star rating system.
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.
* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
Enrollment in Medicare/Medicare Advantage may be limited to certain times of the year unless you qualify for a Special Enrollment Period
We do not offer every plan available in your area. Currently, we represent 18 organizations, which offer 52,101 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
We represent Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan's contract renewal.
Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.
Please contact Medicare.gov ,1-800-MEDICARE , or your local State Health Insurance Program (SHIP) to get information on all of your options.
Medicare has neither approved nor endorsed any information on this site.
Speak with a licensed insurance agent: 1-877-649-2073 / TTY 711 | 8am - 11pm ET | 7 days a week
© 2023 Dog Media Solutions LLC. All rights reserved