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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 2025 to people living in Select counties in MI. This plan received an overall rating of 3 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 $112.00. 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 $7550.00 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) prescription drug plan features an annual drug deductible of $615. Plan members enjoy no copay for Tier 1 preferred generic and Tier 2 generic medications when filled through preferred pharmacies or preferred mail-order services. Tier 6 select care drugs are also highly accessible, carrying no copay regardless of the pharmacy or mail-order option chosen. For brand-name and specialty medications, you will pay a percentage of the drug cost, including a 25% coinsurance for Tier 3 preferred brands and Tier 5 specialty drugs. Tier 4 non-preferred drugs require a 36% coinsurance across all standard and preferred pharmacy channels. Standard retail pharmacies and standard mail-order services are also available for Tier 1 and Tier 2 drugs, with copays ranging from $5 to $30 depending on the supply size.
Additional Benefits
The Wellcare Giveback (HMO-POS) plan offers affordable coverage for core medical services, featuring no copay and no coinsurance for primary care visits and home health care. For inpatient hospital stays, members pay a $375 daily copay for the first seven days and no copay for days eight through 90. Emergency room visits require a $115 copay, while urgent care services are available with a $40 copay. Preventive care, including annual physicals and routine dental cleanings, is fully covered with no copay and no coinsurance. Specialist consultations, outpatient hospital services, and durable medical equipment carry no copay but are subject to a 20% coinsurance. Additionally, routine vision exams require no copay and a 20% coinsurance, with a $100 annual limit for eyewear, though the plan does not cover hearing aids or over-the-counter items.
Inpatient Hospital See details
Wellcare Giveback (HMO-POS) covers inpatient hospital services with no coinsurance, requiring prior authorization. Acute care stays require a $375 daily copay for days 1 to 7 and no copay for days 8 to 90, while psychiatric stays require a $295 daily copay for days 1 to 7 and no copay for days 8 to 90. Additional days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Wellcare Giveback (HMO-POS) covers outpatient hospital, ambulatory surgical center, and outpatient substance abuse services with no copay and a 20% coinsurance. Observation services require a $115 copay per stay and 20% coinsurance, while outpatient blood services are covered with no copay and no coinsurance.
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
Ambulance and transportation services are covered by Wellcare Giveback (HMO-POS), featuring a 20% coinsurance and no copay for ground and air ambulance services, which require prior authorization. While some transportation services are covered, transportation to plan-approved health-related locations and any other 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 urgent care with a $40 copay and no coinsurance, with copays waived if admitted to the hospital within 24 hours. Worldwide emergency and urgent care are also 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
Wellcare Giveback (HMO-POS) offers primary care physician services with no copay and no coinsurance, while specialist visits, therapy services, and mental health care feature no copay and 20% coinsurance. Chiropractic benefits are partially covered with no copay and 20% coinsurance (routine care is not covered), podiatry is not covered, and telehealth services range from a $0 to $40 copay with 20% coinsurance.
Preventive Services See details
Preventive Services are partially covered by Wellcare Giveback (HMO-POS), featuring no copay and no coinsurance for annual physicals, fitness benefits, alternative therapies, and screenings, while kidney disease education requires a 20% coinsurance and no copay. Non-covered services include health education, in-home safety assessments, medical nutrition therapy, medication reconciliation, readmission 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
Hearing Services through Wellcare Giveback (HMO-POS) feature no copay for annual routine hearing exams and fitting evaluations, though routine exams require a 20% coinsurance. Medicare-covered exams are covered with a copay and no deductible, while prescription and over-the-counter hearing aids are not covered.
Vision Services See details
Vision services are partially covered by Wellcare Giveback (HMO-POS), offering one annual routine eye exam with no copay and 20% coinsurance, while other eye exam services are not covered. Covered eyewear, including contact lenses and eyeglasses, features no copay and no coinsurance up to a $100 annual maximum plan limit.
Dental Services See details
Dental services are partially covered by Wellcare Giveback (HMO-POS), offering preventive care like exams and cleanings with no copay and no coinsurance, while Medicare-covered dental services carry no copay and a 20% coinsurance. However, this plan does not cover restorative services, endodontics, periodontics, prosthodontics, implants, oral surgery, or orthodontics.
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 chemotherapy, radiation, and other drugs require a 0% to 20% coinsurance, while Medicare Part B insulin is covered with a $35 copay and no coinsurance.
Dialysis Services See details
Dialysis Services are covered by Wellcare Giveback (HMO-POS) with no copay and a 20% coinsurance.
Medical Equipment See details
Wellcare Giveback (HMO-POS) covers medical equipment with no copay, though a 20% coinsurance applies to durable medical equipment (DME), prosthetics, medical supplies, and diabetic therapeutic shoes. Prior authorization is required for these benefits, and diabetic supplies are covered with no copay.
Diagnostic and Radiological Services See details
Wellcare Giveback (HMO-POS) covers diagnostic and radiological services with prior authorization required. Lab services have no copay and no coinsurance, diagnostic tests range from a $0 to $100 copay with no coinsurance, outpatient X-rays have a $25 copay, and other radiological services require a minimum 20% coinsurance with copays starting at $0.
Home Health Services See details
Home Health Services are covered by Wellcare Giveback (HMO-POS) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the Wellcare Giveback (HMO-POS) plan, which does not provide coverage for cardiac, intensive cardiac, pulmonary, or supervised exercise therapy (SET) rehabilitation services.
Skilled Nursing Facility (SNF) See details
Wellcare Giveback (HMO-POS) 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, while days 21 to 60 require a $218 daily copay, and additional days beyond the Medicare limit are not covered.
Other Services See details
Other services are not covered under the Wellcare Giveback (HMO-POS) plan, which does not provide coverage or benefits for acupuncture, over-the-counter (OTC) items, or meals.
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