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Wellcare Giveback (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Wellcare Giveback (HMO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Wellcare Giveback (HMO) in 2026, please refer to our full plan details page.
Wellcare Giveback (HMO) is a HMO plan offered by Centene Corporation available for enrollment in 2026 to people living in Select counties in IL. This plan received an overall rating of 3 out of 5 stars in 2026.
It's important to know that Wellcare Giveback (HMO) 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).
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), 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 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 $7500.00 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) prescription drug plan features an annual drug deductible of $615. For Tier 1 (Preferred Generic) and Tier 2 (Generic) medications, members enjoy no copay when using a preferred pharmacy or preferred mail-order service. Standard pharmacies charge a low copayment starting at $5 for Tier 1 and $10 for Tier 2 drugs. For higher-tier medications, Tier 3 (Preferred Brand) and Tier 5 (Specialty) drugs require a 25% coinsurance, while Tier 4 (Non-Preferred) drugs carry a 46% to 47% coinsurance depending on your pharmacy choice. Additionally, Select Care Drugs in Tier 6 are highly affordable, offering no copay across all standard and preferred pharmacy options.
Additional Benefits
The Wellcare Giveback (HMO) plan offers affordable coverage with no copay and no coinsurance for primary care visits, routine annual physicals, and home health services. For specialist visits, urgent care, and Medicare-covered dental or hearing exams, members will pay a predictable $40 copay with no coinsurance. Inpatient hospital stays require a copay of $375 per day for the first six days of acute care, after which there is no copay for days seven through ninety. Routine vision exams, preventive dental care, and annual hearing fittings are also covered with no copay and no coinsurance, alongside allowances for eyewear and hearing aids. Diagnostic lab tests and diabetic supplies also feature no copay, while services like dialysis and durable medical equipment require no copay and a 20% coinsurance. Overall, this plan minimizes out-of-pocket costs by eliminating coinsurance on many core services, though some specialized benefits require copays or prior authorization.
Inpatient Hospital See details
Wellcare Giveback (HMO) partially covers inpatient hospital services with no coinsurance, charging a $375 copay for days 1 to 6 of acute stays and a $325 copay for days 1 to 6 of psychiatric stays, with no copay for days 7 to 90. Additional days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Wellcare Giveback (HMO) covers outpatient services with no coinsurance, featuring a $0 to $350 copay for outpatient hospital visits and a $115 to $350 copay per stay for observation services. Ambulatory surgical center services require a $300 copay, outpatient substance abuse sessions carry a $40 copay, and outpatient blood services are covered with no copay, no coinsurance, and no deductible.
Partial Hospitalization See details
Partial hospitalization is covered by the Wellcare Giveback (HMO) plan, requiring a $105.00 copay and no coinsurance. Prior authorization is required to receive these services.
Ambulance and Transportation Services See details
Ambulance and transportation services are partially covered by Wellcare Giveback (HMO), which offers ground and air ambulance services with a $325 copay and no coinsurance, subject to prior authorization. Non-emergency transportation services to plan-approved or other health-related locations are not covered under this plan.
Emergency Services See details
Wellcare Giveback (HMO) covers emergency services with a $115 copay and no coinsurance, and urgently needed services with a $40 copay and no coinsurance, with both copays waived if admitted to the hospital within 24 hours. Worldwide emergency services are partially covered up to a $50,000 maximum with a $115 copay and no coinsurance for emergency and urgent care, though worldwide emergency transportation is not covered.
Primary Care See details
Wellcare Giveback (HMO) provides primary care physician visits with no copay and no coinsurance, while specialist visits and outpatient mental health services require a $40 copay and no coinsurance. Physical and occupational therapy services have a $35 copay with no coinsurance, but podiatry and routine chiropractic services are not covered.
Preventive Services See details
Wellcare Giveback (HMO) covers preventive services, including annual physicals, fitness benefits, alternative therapies, and remote access technologies, with no copay and no coinsurance, while kidney disease education has no copay and a 20% coinsurance. Additional preventive benefits are partially covered, excluding services such as health education, weight management, therapeutic massage, personal emergency response systems, and in-home safety assessments.
Hearing Services See details
Hearing services are partially covered by Wellcare Giveback (HMO), offering Medicare-covered exams for a $40 copay and no coinsurance, alongside annual routine exams and fitting evaluations with no copay and no coinsurance. Prescription hearing aids are covered up to $500 per ear every year with no copay and no coinsurance, but OTC hearing aids and inner ear, outer ear, or over-the-ear prescription models are not covered.
Vision Services See details
Vision services are partially covered by Wellcare Giveback (HMO) with no coinsurance, offering a $0 copay for one routine eye exam annually and a $0 to $40 copay for other covered exams, though other eye exam services are not covered. Covered eyewear, including contacts, eyeglasses, lenses, frames, and upgrades, has no copay and no coinsurance up to a $100 annual limit.
Dental Services See details
Wellcare Giveback (HMO) partially covers dental services, with no coverage for maxillofacial prosthetics, implant services, and orthodontics. Medicare-covered dental requires a $40 copay and no coinsurance, preventive services have no copay and no coinsurance, and covered comprehensive services have no copay and a 40% coinsurance up to a $1,000 annual limit.
Home Infusion bundled Services See details
Wellcare Giveback (HMO) covers home infusion bundled services with no copay, though prior authorization is required. Covered Medicare Part B chemotherapy, radiation, and other drugs carry a 0% to 20% coinsurance, while Part B insulin is available for a $35 copay with no coinsurance.
Dialysis Services See details
Dialysis Services are covered by Wellcare Giveback (HMO) with no copay and a 20% coinsurance.
Medical Equipment See details
Wellcare Giveback (HMO) covers medical equipment, including 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 no copay. Prior authorization is required for these benefits.
Diagnostic and Radiological Services See details
Wellcare Giveback (HMO) covers diagnostic and radiological services, with prior authorization required. Diagnostic lab services have no copay or coinsurance, diagnostic tests carry a $0 to $50 copay with no coinsurance, and radiological services require a $50 copay plus coinsurance for X-rays, a copay starting at $0 for diagnostic radiology, and a minimum 20% coinsurance for therapeutic radiology.
Home Health Services See details
Home Health Services are covered under the Wellcare Giveback (HMO) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Wellcare Giveback (HMO) covers Cardiac Rehabilitation Services with no coinsurance, though only some services are covered in practice. Standard cardiac rehabilitation ($30 copay), intensive cardiac rehabilitation ($40 copay), pulmonary rehabilitation ($25 copay), and supervised exercise therapy for peripheral artery disease ($20 copay) are not covered under this plan.
Skilled Nursing Facility (SNF) See details
Wellcare Giveback (HMO) covers Skilled Nursing Facility (SNF) services with no coinsurance and does not require a prior three-day inpatient hospital stay. There is no copay for days 1 to 20 and days 61 to 100, but a $218 daily copay applies for days 21 to 60, and prior authorization is required.
Other Services See details
Wellcare Giveback (HMO) does not provide coverage for other services, as acupuncture, over-the-counter (OTC) items, and meal benefits are all excluded from this plan.
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