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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 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 Select counties in OK. This plan received an overall rating of 3.5 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 $125.00. 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 robust coverage for essential medical needs with predictable out-of-pocket costs, often featuring no coinsurance. Primary care visits, home health care, and routine preventive services require no copay, while specialist visits require a $30 copay. Inpatient hospital stays require a copay of $400 per day for the first six days, and emergency room visits carry a $130 copay, which is waived if you are admitted. For additional healthcare needs, the plan provides dental, vision, and hearing benefits with no copays for routine services, including up to a $2,000 annual limit for covered dental care and a $200 annual limit for eyewear. Skilled nursing facility stays have no copay for the first 20 days, and medical equipment and dialysis services generally require a 20% coinsurance with no copay. While many essential diagnostic and laboratory services feature no copay, some benefits like acupuncture, over-the-counter items, and routine transportation are not covered.
Inpatient Hospital See details
Inpatient hospital care under the Wellcare Patriot Giveback Open (PPO) is covered with no coinsurance, requiring a $400 copay for days 1 through 6 of an acute stay (no copay for days 7 through 90) and a $350 copay for days 1 through 5 of a psychiatric stay (no copay for days 6 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 services with no coinsurance, featuring a $0 to $500 copay for outpatient hospital services and a $130 to $500 copay per stay for observation services. Ambulatory surgical center services require a $250 copay and no coinsurance, while outpatient substance abuse and blood services are covered with no copays, no coinsurance, and no deductibles.
Partial Hospitalization See details
Wellcare Patriot Giveback Open (PPO) covers partial hospitalization services with a $140.00 copay and no coinsurance. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Wellcare Patriot Giveback Open (PPO) covers ground and air ambulance services with a $290 copay and no coinsurance, requiring prior authorization. Transportation services to health-related locations are not covered.
Emergency Services See details
Emergency services under the Wellcare Patriot Giveback Open (PPO) are covered with a $130 copay and no coinsurance, while urgently needed services require a $40 copay and no coinsurance, with both copays waived if admitted to the hospital within 24 hours. Worldwide emergency and urgent care are partially covered up to a $50,000 limit with a $130 copay and no coinsurance, though worldwide emergency transportation is not covered.
Primary Care See details
Wellcare Patriot Giveback Open (PPO) covers primary care physician services with no copay and no coinsurance, and specialist visits with a $30 copay and no coinsurance. Therapy and mental health services are also covered with no coinsurance and copays ranging from $0 to $40, though podiatry and routine chiropractic services are not covered.
Preventive Services See details
Preventive services are partially covered under the Wellcare Patriot Giveback Open (PPO), offering no copay and no coinsurance for annual physical exams, fitness benefits, alternative therapies, and remote access technologies. Kidney disease education is covered with no copay and a 20% coinsurance, while several sub-services—including health education, nutritional benefits, and weight management programs—are not covered.
Hearing Services See details
Wellcare Patriot Giveback Open (PPO) provides partially covered hearing services, including one annual routine exam and fitting evaluation with no copay and no coinsurance, while Medicare-covered exams require a $30 copay and no coinsurance. Prescription hearing aids are covered up to $350 per ear annually with no copay or coinsurance, though 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 Patriot Giveback Open (PPO) with no deductible and no coinsurance, although prior authorization is required. Routine eye exams are covered with no copay once per year, while other eye exam services are not covered, and covered eyewear has no copay up to a combined annual limit of $200.
Dental Services See details
Dental services are partially covered under the Wellcare Patriot Giveback Open (PPO), with Medicare-covered dental services requiring a $30 copay and no coinsurance. Preventive and covered comprehensive services feature no copay and no coinsurance up to a $2,000 yearly maximum, though orthodontics, implants, maxillofacial prosthetics, and fixed or removable prosthodontics 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 are required. Under this benefit, Medicare Part B insulin is covered with a $35 copay and no coinsurance, while chemotherapy, radiation, and other Part B drugs require 0% to 20% coinsurance and no copay.
Dialysis Services See details
Dialysis services are covered by the Wellcare Patriot Giveback Open (PPO) with no copay and a 20% coinsurance.
Medical Equipment See details
Wellcare Patriot Giveback Open (PPO) covers durable medical equipment, prosthetic devices, medical supplies, and diabetic therapeutic shoes or inserts with no copay and a 20% coinsurance. Diabetic supplies are covered with no copay, though prior authorization is required for most equipment and diabetic supplies are limited to specified manufacturers.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by the Wellcare Patriot Giveback Open (PPO) with prior authorization required. Lab services feature no copay and no coinsurance, diagnostic tests range from a $0 to $100 copay with no coinsurance, and radiological services require a $0 minimum copay for diagnostic imaging, a $50 copay for X-rays, and a minimum 20% coinsurance for therapeutic services.
Home Health Services See details
Home Health Services are covered under the Wellcare Patriot Giveback Open (PPO) plan with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Wellcare Patriot Giveback Open (PPO) offers Cardiac Rehabilitation Services with no coinsurance; however, only some services are covered, while standard cardiac rehabilitation (with a $40 copay), intensive cardiac rehabilitation (with a $50 copay), pulmonary rehabilitation (with a $35 copay), and SET for PAD services (with a $25 copay) are not covered.
Skilled Nursing Facility (SNF) See details
Wellcare Patriot Giveback Open (PPO) covers Skilled Nursing Facility (SNF) services with no coinsurance and no prior hospital stay required, though prior authorization is necessary. There is no copay for days 1 to 20 and days 51 to 100, a $218 daily copay for days 21 to 50, and additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Wellcare Patriot Giveback Open (PPO) partially covers other services, offering a chronic illness meal benefit with no copay and no coinsurance, though a referral is required. Acupuncture and over-the-counter (OTC) items are not covered under this plan.
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