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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 2025, 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 2025.
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 $108.60. 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 $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) plan has a $420 deductible for prescription drugs. After the deductible, you will pay either a copay or coinsurance depending on the drug tier and the pharmacy you use. For the initial coverage phase, you will pay no copay for preferred generic and specialty tier drugs at preferred pharmacies. Standard generic drugs have a 25% coinsurance, while preferred brand drugs have a 37% coinsurance. After your total drug costs reach $2000, you enter the catastrophic coverage phase where you pay nothing for Medicare Part D covered drugs.
Additional Benefits
The Wellcare Giveback (HMO-POS) plan offers coverage for a wide range of services. This plan includes no copays for primary care physician services, preventive services, and home health services. This plan has coinsurance for outpatient services, specialist services, and hearing and vision services. Emergency services have a $110 copay, and inpatient hospital stays have a $1,500 copay.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, with a copay of $1,500 per admission or stay for Inpatient Hospital-Acute and a copay of $1,872 per admission or stay for Inpatient Hospital Psychiatric. Additional days, non-Medicare stays, and upgrades for both Inpatient Hospital-Acute and Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services includes coverage for Outpatient Hospital Services with a 20% coinsurance and no copay, Observation Services with a 20% coinsurance and a $110 copay, Ambulatory Surgical Center (ASC) Services with 20% coinsurance, Outpatient Substance Abuse Services with 20% coinsurance for individual and group sessions, and Outpatient Blood Services with no copay.
Partial Hospitalization See details
Partial Hospitalization is covered under the Wellcare Giveback (HMO-POS) plan, with a copay of $80.00. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
For the Wellcare Giveback (HMO-POS) plan, ambulance services are covered with no copay, but with a 20% coinsurance for both ground and air ambulance services. Transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Coverage are covered by the Wellcare Giveback (HMO-POS) plan, with a $110 copay for Emergency Services and Worldwide Emergency Coverage, and a $45 copay for Urgently Needed Services. Worldwide Emergency Transportation is not covered.
Primary Care See details
The Wellcare Giveback (HMO-POS) plan covers primary care physician services with no copay, but chiropractic services have a 20% coinsurance and routine care is not covered. Occupational therapy services, physician specialist services, physical therapy, and speech-language pathology services have a 20% coinsurance. Mental health specialty services and psychiatric services have a 20% coinsurance for individual and group sessions, and other healthcare professionals have a 20% coinsurance with no copay. Additional telehealth benefits have a 20% coinsurance and a copay between $0 and $45, and opioid treatment program services have a minimum coinsurance of 20% and a maximum coinsurance of 20%.
Preventive Services See details
Preventive services include an annual physical exam with no copay, and additional preventive services that may have a copay. Kidney disease education services have a 20% coinsurance, while other preventive services such as glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKG following Welcome Visit have no copay.
Hearing Services See details
Hearing exams are covered with a coinsurance of at most 20% and a copay for Medicare-covered benefits and fitting/evaluation for hearing aids, and routine hearing exams have no copay. Prescription and OTC hearing aids are not covered.
Vision Services See details
Vision Services include eye exams with a 20% coinsurance and no copay, and eyewear with no copay. Eyewear includes contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades.
Dental Services See details
The Wellcare Giveback (HMO-POS) plan covers dental services, including Medicare Dental Services with 20% coinsurance. Oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatment, and other preventive dental services are covered with no copay. However, restorative services, endodontics, periodontics, prosthodontics, maxillofacial prosthetics, implant services, oral and maxillofacial surgery, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, but require prior authorization. Medicare Part B Insulin Drugs have a $35 copay, while the coinsurance for Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs ranges from 0% to 20%.
Dialysis Services See details
Dialysis Services are covered under the Wellcare Giveback (HMO-POS) plan. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment benefits under the Wellcare Giveback (HMO-POS) plan include Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment. DME has a 20% coinsurance, while Durable Medical Equipment for use outside the home is not covered. Prosthetics/Medical Supplies have a 20% coinsurance, and Diabetic Supplies have no copay, while Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including Diagnostic Procedures/Tests with a copay ranging from $0 to $100, Lab Services with no copay, Diagnostic Radiological Services with a coinsurance of at most 20% and no copay, Therapeutic Radiological Services with a coinsurance of at most 20%, and Outpatient X-Ray Services with a $25 copay. Prior authorization is required for all diagnostic and radiological services.
Home Health Services See details
Home health services are covered by the Wellcare Giveback (HMO-POS) plan with no copay and no coinsurance, but additional hours of care and personal care services are not covered. Authorization is required for this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the Wellcare Giveback (HMO-POS) plan. The plan does not cover Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, or Additional Cardiac Rehabilitation Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Wellcare Giveback (HMO-POS) plan, but require prior authorization. For days 1-20 and 61-100, there is no copay, while days 21-60 have a $214 copay. Additional days beyond Medicare-covered for SNF and non-Medicare-covered stays for SNF are not covered.
Other Services See details
Other Services, offered by the Wellcare Giveback (HMO-POS) plan, are not covered, including Acupuncture, Over-the-Counter (OTC) Items, Meal Benefit, and Dual Eligible SNPs with Highly Integrated Services, as well as 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. No authorization or referral is required for these services.
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