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Wellcare TexanPlus Patriot Giveback (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Wellcare TexanPlus Patriot 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 TexanPlus Patriot Giveback (HMO-POS) in 2025, please refer to our full plan details page.
Wellcare TexanPlus Patriot Giveback (HMO-POS) is a HMO-POS plan offered by Centene Corporation available for enrollment in 2025 to people living in Select counties in TX. This plan received an overall rating of 3.5 out of 5 stars in 2025.
It's important to know that Wellcare TexanPlus Patriot Giveback (HMO-POS) 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 TexanPlus Patriot 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 TexanPlus Patriot 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 $95.00. 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 Maximum Out-Of-Pocket cost of $3000.00 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
Prescription drugs are not covered by Wellcare TexanPlus Patriot Giveback (HMO-POS).
Additional Benefits
The Wellcare TexanPlus Patriot Giveback (HMO-POS) plan offers a variety of benefits with varying costs. Inpatient hospital stays have a copay, while outpatient services, including substance abuse and blood services, have no copay. Emergency services and primary care visits have copays, and preventive services include an annual physical exam with no copay. This plan covers hearing, vision, and dental services, with no copays for routine hearing exams and eyewear, including contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades. It also covers home health services with no copay, and skilled nursing facility services with a copay for certain days. Additional benefits include coverage for ambulance and transportation services, and medical equipment.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, both requiring prior authorization and a doctor's referral. For Inpatient Hospital-Acute, there is a $350 copay per admission or stay for Medicare-covered stays, and additional days (91-999) have no copay. Inpatient Hospital Psychiatric has a $300 copay per admission or stay for Medicare-covered stays. Non-Medicare-covered stays and upgrades for both Inpatient Hospital-Acute and Psychiatric are not covered, as are Additional Days for Inpatient Hospital Psychiatric.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services, observation services, ambulatory surgical center services, outpatient substance abuse services, and outpatient blood services. Outpatient Hospital Services have a copay between $0 and $225, Observation Services have a copay between $140 and $225, Ambulatory Surgical Center Services have a $100 copay, and Outpatient Blood Services have no copay. Outpatient Substance Abuse Services include Individual Sessions and Group Sessions, both with no copay.
Partial Hospitalization See details
Partial Hospitalization is covered under the Wellcare TexanPlus Patriot Giveback (HMO-POS) plan. You will pay a $130 copay for this benefit, and prior authorization and a doctor referral are required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Wellcare TexanPlus Patriot Giveback (HMO-POS) plan. Ground and air ambulance services have a $250 copay, while transportation services to a plan-approved health-related location have no copay. Transportation to any other health-related location is not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Coverage are covered under the Wellcare TexanPlus Patriot Giveback (HMO-POS) plan. Emergency Services and Worldwide Emergency Coverage have a $140 copay, and Urgently Needed Services has a $25 copay, with no coinsurance for any of these services. Worldwide Emergency Transportation is not covered.
Primary Care See details
The Wellcare TexanPlus Patriot Giveback (HMO-POS) plan covers primary care physician services with no copay, chiropractic services with a $20 copay, occupational therapy services with a $10 copay, and physician specialist services with a $35 copay. Mental health, psychiatric, and other health care professional services have varying copays, and physical therapy and speech-language pathology services have a $10 copay. The plan also covers additional telehealth benefits with copays ranging from $0 to $35, and opioid treatment program services with a $35 copay.
Preventive Services See details
The Wellcare TexanPlus Patriot Giveback (HMO-POS) plan covers preventive services, including an annual physical exam with no copay. Other preventive services may have a copay, and kidney disease education services have a 20% coinsurance.
Hearing Services See details
Hearing Services include hearing exams with a $35 copay, routine hearing exams with no copay, and fitting/evaluation for hearing aids with no copay. Prescription hearing aids are covered, with a maximum plan benefit of $750 per year, and prescription hearing aids (all types) are covered with no copay, while prescription hearing aids for the inner, outer, and over the ear are not covered. OTC hearing aids are not covered.
Vision Services See details
Vision Services include eye exams with a copay of $0-$35, and eyewear, including contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades, all with no copay. Routine eye exams are covered with no copay. Eyewear has a combined maximum benefit of $100 per year.
Dental Services See details
Dental Services include coverage for Medicare Dental Services with a $35 copay, and other dental services including oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatment, other preventive dental services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), and oral and maxillofacial surgery with no copay. Orthodontic services are covered with a maximum benefit of $1500 per year, while maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, with prior authorization required. The plan covers Medicare Part B Insulin Drugs with a $35 copay. 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 under the Wellcare TexanPlus Patriot Giveback (HMO-POS) plan. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical equipment, including durable medical equipment, prosthetics, medical supplies, and diabetic equipment are covered by the Wellcare TexanPlus Patriot Giveback (HMO-POS) plan. Durable medical equipment has a 20% coinsurance, while prosthetics and medical supplies have a 20% coinsurance and diabetic supplies have no copay, and diabetic therapeutic shoes/inserts have a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services include coverage for all diagnostic services, diagnostic procedures and tests with no copay, and lab services with no copay. Radiological services include a copay of up to $200 for diagnostic services, a 20% coinsurance for therapeutic services, and a $25 copay for outpatient X-rays.
Home Health Services See details
Home Health Services are covered under the Wellcare TexanPlus Patriot Giveback (HMO-POS) plan with no copay and no coinsurance. However, 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 TexanPlus Patriot Giveback (HMO-POS) plan. Although the plan covers Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services, none of these sub-services are covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered with prior authorization and a doctor referral. There is no copay for days 1-20 and days 51-100, but there is a $214 copay for days 21-50.
Other Services See details
The Wellcare TexanPlus Patriot Giveback (HMO-POS) plan does not cover acupuncture, over-the-counter items, 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, or Self-Directed Personal Assistance Services. The plan covers a meal benefit with no copay, and a doctor referral is required.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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