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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 OR. 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 $50.00. You must continue to pay paying your reduced Part B Premium.
Deductibles
This plan has a $200.00 health deductible. This means, every calendar year, you pay this amount towards covered services before your insurance coverage kicks in.
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 $9200.00 (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 $9200.00 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 with no copay and no coinsurance for primary care visits, preventive screenings, and home health services. For inpatient hospital stays, members pay a daily copay of $525 for days one through five, while emergency room visits carry a $130 copay and urgent care costs $50. Specialist visits and physical therapy require a $25 copay, and outpatient services feature copays ranging from no copay up to $500 with no coinsurance. This plan also includes key supplemental benefits, such as routine dental, vision, and hearing exams with no copay or coinsurance, alongside a $1,000 comprehensive dental allowance subject to a 40% coinsurance. Prescription hearing aids are covered up to $500 per ear annually, and routine eyewear features a $100 annual limit. Additionally, diagnostic lab services and over-the-counter items are available with no copay, while durable medical equipment and dialysis services require a 20% coinsurance.
Inpatient Hospital See details
Inpatient hospital care is covered by Wellcare Patriot Giveback Open (PPO) with no coinsurance, requiring a copay of $525 per day for days 1 through 5 of an acute stay and $400 per day for days 1 through 5 of a psychiatric stay, with no copay for days 6 through 90. This benefit is partially covered because 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 copays ranging from $0 to $500, alongside observation services with a copay of $130 to $500 per stay. Ambulatory surgical center services require a $200 copay and no coinsurance, while outpatient substance abuse sessions and blood services are covered with no copays and no coinsurance.
Partial Hospitalization See details
Wellcare Patriot Giveback Open (PPO) covers partial hospitalization services with a $140.00 copay and no coinsurance, though prior authorization is required.
Ambulance and Transportation Services See details
Wellcare Patriot Giveback Open (PPO) covers ground and air ambulance services with a $175 copay and no coinsurance, though prior authorization is required. Transportation services to plan-approved or other health-related locations are not covered under this plan.
Emergency Services See details
Emergency services are covered by Wellcare Patriot Giveback Open (PPO) with a $130 copay and no coinsurance, which is waived if admitted to the hospital within 24 hours, while urgently needed services require a $50 copay and no coinsurance. Worldwide emergency and urgent care are also covered up to a $50,000 limit with a $130 copay and no coinsurance, although worldwide emergency transportation is not covered.
Primary Care See details
Wellcare Patriot Giveback Open (PPO) primary care benefits feature no copay and no coinsurance for primary care visits, mental health specialty services, and psychiatric services. Specialist visits, physical therapy, and occupational therapy require a $25 copay with no coinsurance, while chiropractic care is partially covered with a $15 copay and no coinsurance, excluding other chiropractic services. Podiatry services are not covered.
Preventive Services See details
Preventive services are covered by Wellcare Patriot Giveback Open (PPO) with no copay and no coinsurance for annual physicals, select screenings, and memory fitness, while kidney disease education requires a 20% coinsurance with no copay. Additional supplemental benefits are partially covered; excluded services include health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, medication reconciliation, re-admission prevention, wigs, weight management, therapeutic massage, adult day health, nutritional benefits, palliative care, in-home support, caregiver support, smoking cessation, disease management, telemonitoring, home safety devices, and counseling.
Hearing Services See details
Wellcare Patriot Giveback Open (PPO) covers hearing services, including Medicare-covered exams for a $25 copay and no coinsurance, alongside annual routine exams and fitting evaluations with no copay or coinsurance. Prescription hearing aids are partially covered with no copay or coinsurance up to $500 per ear annually, but inner ear, outer ear, over the ear, and over-the-counter hearing aids are not covered.
Vision Services See details
Vision services are partially covered by Wellcare Patriot Giveback Open (PPO) because other eye exam services are not covered. Covered routine eye exams (limited to one per year) and eyewear, including contacts and eyeglasses, feature no copay and no coinsurance, with a combined annual eyewear benefit limit of $100.
Dental Services See details
Wellcare Patriot Giveback Open (PPO) offers partially covered dental services, featuring Medicare-covered dental at a $25 copay and no coinsurance, and preventive services with no copay and no coinsurance. Comprehensive dental benefits are covered up to a $1,000 annual maximum with no copay and 40% coinsurance, though implant services, orthodontics, and maxillofacial prosthetics are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by Wellcare Patriot Giveback Open (PPO) with no copay, though prior authorization is required. Covered Part B insulin drugs have a $35 copay and no coinsurance, while chemotherapy, radiation, and other Part B drugs carry no copay and a coinsurance ranging from 0% to 20%.
Dialysis Services See details
Dialysis Services are covered by Wellcare Patriot Giveback Open (PPO) 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, and diabetic therapeutic shoes or inserts, with no copay and a 20% coinsurance. Diabetic supplies are covered with no copay, and prior authorization is required for these medical equipment benefits.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered under the Wellcare Patriot Giveback Open (PPO) with prior authorization required. There is no copay for lab services, diagnostic procedures, and diagnostic radiological services, though diagnostic procedures and therapeutic radiological services require a 20% coinsurance, and outpatient X-rays incur a $50 copay.
Home Health Services See details
Wellcare Patriot Giveback Open (PPO) covers Home Health Services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Wellcare Patriot Giveback Open (PPO) covers Cardiac Rehabilitation Services with no coinsurance, but some services are covered while standard cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered. These specific services require copays of $40 for cardiac, $50 for intensive cardiac, $35 for pulmonary, and $25 for SET for PAD rehabilitation.
Skilled Nursing Facility (SNF) See details
Wellcare Patriot Giveback Open (PPO) covers Skilled Nursing Facility (SNF) care with no coinsurance, requiring prior authorization but no prior three-day hospital stay. There is no copay for days 1 to 20 and days 61 to 100, a $218 daily copay for days 21 to 60, 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 acupuncture for up to 24 treatments per year and over-the-counter (OTC) items with no copay and no coinsurance. Meal benefits are not covered under this plan, and prior authorization is required for acupuncture services.
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1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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