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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 Statewide in SC. This plan received an overall rating of 4 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 $55.00. 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) plan features an annual prescription drug deductible of $615. For Tier 1 preferred generics and Tier 2 generics, members enjoy no copay when using a preferred pharmacy or preferred mail-order service. Additionally, Tier 6 select care drugs are covered with no copay across all preferred and standard pharmacies. For higher-tier medications, coverage transitions to coinsurance, requiring 25% coinsurance for Tier 3 preferred brands and Tier 5 specialty drugs. Tier 4 non-preferred drugs carry a 35% coinsurance at preferred pharmacies and a 36% coinsurance at standard pharmacies. Standard pharmacies also charge copays ranging from $5 to $30 for Tier 1 and Tier 2 medications depending on the supply duration.
Additional Benefits
The Wellcare Giveback (HMO-POS) plan offers affordable essential medical coverage featuring no copay and no coinsurance for primary care visits, while specialist visits require a $50 copay. For hospital stays, inpatient acute care requires a $390 daily copay for days 1 through 6, with no copay for days 7 through 90. Outpatient hospital services and emergency care are also covered with varying copays and no coinsurance, though routine transportation is not included. Preventive dental care and routine vision exams are highly accessible with no copay and no coinsurance, though advanced restorative dental services and hearing aids are not covered. Diagnostic lab tests, home health services, and select skilled nursing facility days are also available with no copay, while durable medical equipment and dialysis require a 20% coinsurance. Overall, this plan minimizes out-of-pocket coinsurance for many primary services while utilizing fixed copays for specialized and emergency care.
Inpatient Hospital See details
Inpatient hospital care is partially covered by Wellcare Giveback (HMO-POS), as additional days, upgrades, and non-Medicare-covered stays are excluded. Covered acute stays require no coinsurance with a $390 daily copay for days 1 through 6 and no copay for days 7 through 90, while psychiatric stays have no coinsurance and a $1,750 copay per admission.
Outpatient Services See details
Wellcare Giveback (HMO-POS) covers outpatient services with no coinsurance, including outpatient hospital services with copays ranging from no copay to $475 and ambulatory surgical center services with a $325 copay. Outpatient substance abuse services require a $40 copay per session with no coinsurance, while outpatient blood services are covered with no copay, no coinsurance, and no deductible.
Partial Hospitalization See details
Wellcare Giveback (HMO-POS) 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 Giveback (HMO-POS) covers ground and air ambulance services with a $350.00 copay and no coinsurance per service, with prior authorization required. Some transportation services are covered, but transportation to plan-approved health-related locations and any health-related locations are not covered.
Emergency Services See details
Wellcare Giveback (HMO-POS) covers emergency services with a $115 copay and no coinsurance, and urgently needed services with a $40 copay and no coinsurance, with copays waived if admitted within 24 hours. Worldwide emergency and urgent care are partially covered up to a $50,000 maximum with a $115 copay and no coinsurance, but worldwide emergency transportation is not covered.
Primary Care See details
Primary care services under the Wellcare Giveback (HMO-POS) plan are covered with no copay and no coinsurance, while specialist visits require a $50 copay and no coinsurance. Physical, occupational, and speech therapy services require a $35 copay with no coinsurance, podiatry is not covered, and some chiropractic services are covered but routine and other chiropractic services are not covered.
Preventive Services See details
Wellcare Giveback (HMO-POS) covers preventive services, including annual physical exams, fitness benefits, alternative therapies, and glaucoma screenings, with no copay and no coinsurance. Kidney disease education is covered with no copay and a 20% coinsurance, but several supplemental options like health education, weight management, and nutritional benefits are not covered.
Hearing Services See details
Wellcare Giveback (HMO-POS) covers hearing exams with a $50 copay and no coinsurance, though prior authorization is required, and routine hearing exams and fitting evaluations are not covered. Prescription and over-the-counter (OTC) hearing aids are also not covered under this plan.
Vision Services See details
Wellcare Giveback (HMO-POS) vision services are partially covered with no coinsurance, offering one routine eye exam per year with no copay, though other eye exam services are not covered. Eyewear is covered with no copay and no coinsurance up to a $100 annual maximum, and prior authorization is required.
Dental Services See details
Wellcare Giveback (HMO-POS) dental services are partially covered, featuring no copay and no coinsurance for preventive care such as exams, cleanings, and x-rays, while Medicare-covered dental services require a $50 copay and no coinsurance. Restorative services, endodontics, periodontics, prosthodontics, implants, oral surgery, and orthodontics are not covered.
Home Infusion bundled Services See details
Wellcare Giveback (HMO-POS) 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 feature no copay and a coinsurance ranging from 0% to 20%.
Dialysis Services See details
Dialysis Services are covered by the Wellcare Giveback (HMO-POS) plan with no copay and a 20% coinsurance.
Medical Equipment See details
Wellcare Giveback (HMO-POS) covers 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 a 20% coinsurance, with prior authorization required for these benefits.
Diagnostic and Radiological Services See details
Wellcare Giveback (HMO-POS) covers diagnostic and radiological services, requiring prior authorization for all services. Lab services are available with no copay and no coinsurance, diagnostic tests range from a $0 to $100 copay with no coinsurance, while radiological services vary from a $0 copay for diagnostic imaging, a $50 copay for X-rays, and a 20% coinsurance for therapeutic radiology.
Home Health Services See details
Wellcare Giveback (HMO-POS) covers home health services 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, although some services are not covered, including standard cardiac, intensive cardiac, pulmonary, and SET for PAD services, which require copays ranging from $20 to $40.
Skilled Nursing Facility (SNF) See details
Wellcare Giveback (HMO-POS) covers skilled nursing facility (SNF) services with no coinsurance, requiring prior authorization but allowing admission without a prior three-day hospital stay. There is no copay for days 1 to 20 and days 71 to 100, a $218 daily copay for days 21 to 70, and additional days beyond the standard 100-day Medicare limit are not covered.
Other Services See details
Wellcare Giveback (HMO-POS) covers some services, but acupuncture, over-the-counter (OTC) items, and meal benefits are not covered.
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