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Wellcare Complete - Giveback (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Wellcare Complete - 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 Complete - Giveback (HMO-POS) in 2025, please refer to our full plan details page.
Wellcare Complete - Giveback (HMO-POS) is a HMO-POS plan offered by Centene Corporation available for enrollment in 2025 to people living in Select Counties in Kansas. This plan received an overall rating of 3 out of 5 stars in 2025.
It's important to know that Wellcare Complete - 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 Complete - 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 Complete - 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 $138.50. 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 $420.00 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 $5000.00 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 Complete - Giveback (HMO-POS) plan has a $420 deductible for prescription drugs. After the deductible, you will pay a copay or coinsurance depending on the drug tier and pharmacy. For preferred generic drugs, there is no copay at preferred and mail order pharmacies, while standard pharmacies have a $10 copay. Standard generic drugs have 25% coinsurance, preferred brands have 41% coinsurance, and non-preferred drugs have 28% coinsurance. Specialty tier drugs have no copay.
Additional Benefits
The Wellcare Complete - Giveback (HMO-POS) plan offers a range of benefits with varying cost-sharing. You will have no copay for primary care, routine eye exams, and many dental services, as well as over-the-counter items (up to $40 every three months). Inpatient hospital stays have a copay of $420-$435 for the first five days, then no copay for the rest of the stay, and emergency services have a $125 copay. The plan also covers outpatient services with copays ranging from $0 to $350, and hearing aids with a maximum benefit of $350 per ear. Additionally, the plan provides coverage for vision services, including eye exams and eyewear, with no copay for routine eye exams and eyewear. There are also cost-sharing requirements for services like ambulance, dialysis, and medical equipment.
Inpatient Hospital See details
Inpatient Hospital benefits, including acute and psychiatric care, are covered. For acute care, you pay a copay of $420 for days 1-5, and no copay for days 6-90; for psychiatric care, you pay a copay of $435 for days 1-5, and no copay for days 6-90.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services with a copay between $0 and $350, observation services with a copay between $125 and $350, ambulatory surgical center (ASC) services with a $250 copay, outpatient substance abuse services with a $40 copay for both individual and group sessions, and outpatient blood services with no copay.
Partial Hospitalization See details
Partial Hospitalization is covered by the Wellcare Complete - Giveback (HMO-POS) plan. You will pay a $105 copay for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Wellcare Complete - Giveback (HMO-POS) plan. Both ground and air ambulance services have a $295 copay, with no coinsurance, but transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services are covered under the Wellcare Complete - Giveback (HMO-POS) plan, with a $125 copay and no coinsurance, and urgently needed services have a $45 copay and no coinsurance. Worldwide Emergency Coverage and Worldwide Urgent Coverage have a $125 copay, while Worldwide Emergency Transportation is not covered.
Primary Care See details
The Wellcare Complete - Giveback (HMO-POS) plan covers primary care physician services with no copay. Chiropractic services have a $20 copay, while occupational therapy services have a $45 copay.
Preventive Services See details
Preventive Services include coverage for Medicare-covered services, annual physical exams with no copay, and additional preventive services, with specific services like Health Education, In-Home Safety Assessment, and others not covered. Kidney Disease Education Services have a 20% coinsurance, and Other Preventive Services include coverage for Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit, all with no copay.
Hearing Services See details
Hearing services include hearing exams with a $50 copay, routine hearing exams with no copay, fitting/evaluation for hearing aids with no copay, and prescription hearing aids with a maximum benefit of $350 per ear. Prescription hearing aids (all types) have no copay, but prescription hearing aids for the inner ear, outer ear, and over the ear are not covered. OTC hearing aids are not covered.
Vision Services See details
The Wellcare Complete - Giveback (HMO-POS) plan covers vision services, including eye exams and eyewear. Eye exams have a copay between $0 and $50, and routine eye exams have no copay. Eyewear, including contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades, also have no copay, with a combined maximum benefit of $300 every year.
Dental Services See details
Dental Services include coverage for Medicare Dental Services with a $50 copay, Oral Exams with no copay, Dental X-Rays with no copay, Other Diagnostic Dental Services with no copay, Prophylaxis (Cleaning) with no copay, Fluoride Treatment with no copay, Other Preventive Dental Services with no copay, Adjunctive General Services with no copay. Orthodontic Services are covered, and Restorative Services, Endodontics, Periodontics, Prosthodontics, Maxillofacial Prosthetics, Implant Services, Prosthodontics, Oral and Maxillofacial Surgery, and Orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, with prior authorization required. Medicare Part B Insulin Drugs have a $35 copay, while 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 by the Wellcare Complete - Giveback (HMO-POS) plan. There is a 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with 20% coinsurance and Prosthetics/Medical Supplies with 20% coinsurance. Diabetic Supplies have no copay, and Diabetic Therapeutic Shoes/Inserts have 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services, including diagnostic procedures, tests, and lab services, are covered. Diagnostic Procedures/Tests have a copay of $0-$100, Lab Services have no copay, Diagnostic Radiological Services have a copay of up to $350, Therapeutic Radiological Services have a coinsurance of 20% (minimum), and Outpatient X-Ray Services have a copay of $50.
Home Health Services See details
Home Health Services are covered by the Wellcare Complete - 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 covered, but there is no information about the cost sharing for these services, including copay and coinsurance. However, Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, and Additional Cardiac Rehabilitation Services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, but require prior authorization. For days 1-20, there is no copay; for days 21-50, the copay is $214; and for days 51-100, there is no copay. Additional days beyond Medicare-covered and non-Medicare-covered stays for SNF are not covered.
Other Services See details
Other Services includes coverage for Over-the-Counter (OTC) Items with no copay, with a maximum benefit of $40 every three months. Acupuncture, Meal Benefit, 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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