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Wellcare Patriot Giveback (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Wellcare Patriot Giveback (HMO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Wellcare Patriot Giveback (HMO) in 2026, please refer to our full plan details page.
Wellcare Patriot 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 Patriot Giveback (HMO) 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 (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 Patriot 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 $120.00. 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.
Drugs are not covered by this plan, so a prescription drug deductible is not applicable.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $5500.00 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
Prescription drugs are not covered by Wellcare Patriot Giveback (HMO).
Additional Benefits
The Wellcare Patriot Giveback (HMO) plan offers robust medical coverage with no copay and no coinsurance for primary care doctor visits, home health care, and routine preventive services. Specialist office visits require a $40 copay, while inpatient hospital stays feature daily copays for the first six days followed by no copay for days 7 through 90. Emergency room visits carry a $130 copay, and outpatient hospital services range from no copay up to a $400 copay, all with no coinsurance. Ancillary benefits include dental, vision, and hearing coverage with no copays for routine annual exams, alongside a $2,000 annual maximum for dental care and $200 for eyewear. Prescription hearing aids are covered up to $1,000 per ear annually with no copay, while durable medical equipment and dialysis services require a 20% coinsurance. Please note that this plan does not cover acupuncture, over-the-counter items, meal benefits, or routine transportation.
Inpatient Hospital See details
Wellcare Patriot Giveback (HMO) covers inpatient acute and psychiatric hospital stays with no coinsurance, requiring a $425 daily copay for days 1 through 6 of acute stays and a $375 daily copay for days 1 through 6 of psychiatric stays, with no copay for days 7 through 90. This benefit is partially covered, as additional days, upgrades, and non-Medicare-covered stays are not covered, and prior authorization is required.
Outpatient Services See details
Wellcare Patriot Giveback (HMO) covers outpatient services with no coinsurance, featuring outpatient hospital copays ranging from $0 to $400 and ambulatory surgical center services with a $300 copay. Outpatient substance abuse and blood services are offered with no copay and no coinsurance, while observation services carry a copay of $130 to $400 per stay.
Partial Hospitalization See details
Partial hospitalization is covered by the Wellcare Patriot Giveback (HMO) with a $140.00 copay and no coinsurance. Prior authorization is required to access this benefit.
Ambulance and Transportation Services See details
Wellcare Patriot Giveback (HMO) partially covers ambulance and transportation services, featuring a $325 copay and no coinsurance for ground and air ambulance services. Transportation services to plan-approved or any health-related locations are not covered.
Emergency Services See details
Wellcare Patriot Giveback (HMO) covers emergency services with a $130 copay and urgently needed services with a $50 copay, both featuring no coinsurance and waived copays if admitted to the hospital within 24 hours. Worldwide emergency and urgent care are also covered up to a $50,000 maximum limit with a $130 copay and no coinsurance, though worldwide emergency transportation is not covered.
Primary Care See details
Wellcare Patriot Giveback (HMO) features primary care physician visits with no copay and no coinsurance, while specialist visits require a $40 copay and no coinsurance. Physical, occupational, and speech therapy services cost a $35 copay with no coinsurance, but podiatry is not covered, and some chiropractic services are covered for a $15 copay and no coinsurance though routine and other chiropractic services are not covered. Mental health and psychiatric sessions are covered with no copay and no coinsurance, while additional telehealth benefits range from a $0 to $50 copay with no coinsurance.
Preventive Services See details
Wellcare Patriot Giveback (HMO) preventive services are widely covered with no copay and no coinsurance, including annual physical exams, fitness benefits, alternative therapies, and remote access technologies. Kidney disease education requires a 20% coinsurance with no copay, and several supplemental benefits such as health education, in-home safety assessments, and nutritional services are not covered.
Hearing Services See details
Hearing services are covered by Wellcare Patriot Giveback (HMO) with no coinsurance, featuring a $40 copay for Medicare-covered exams and no copay for annual routine exams and fitting evaluations. Prescription hearing aids are partially covered up to $1,000 per ear annually with no copay or coinsurance, though OTC hearing aids and inner ear, outer ear, or over-the-ear prescription hearing aid models are not covered.
Vision Services See details
Vision services are partially covered by Wellcare Patriot Giveback (HMO) with no deductible and no coinsurance, offering one routine eye exam per year with no copay and other exams for a $0 to $40 copay, though other eye exam services are not covered. Eyewear is covered with no copay and no coinsurance up to a $200 annual maximum for contacts, frames, lenses, and upgrades.
Dental Services See details
Wellcare Patriot Giveback (HMO) provides partially covered dental services, featuring Medicare-covered dental for a $40 copay and no coinsurance, and preventive and comprehensive dental with no copay and no coinsurance up to a $2,000 yearly maximum. While most services are covered, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by Wellcare Patriot Giveback (HMO) with no copay, though prior authorization is required. Medicare Part B insulin is covered with a $35 copay and no coinsurance, while chemotherapy and other Part B drugs require a coinsurance of 0% to 20%.
Dialysis Services See details
Dialysis services are covered under the Wellcare Patriot Giveback (HMO) with no copay and a 20% coinsurance.
Medical Equipment See details
Wellcare Patriot Giveback (HMO) covers medical equipment, including durable medical equipment (DME), prosthetics, and diabetic supplies, subject to prior authorization. These benefits feature no copay, with a 20% coinsurance applying to DME, prosthetics, medical supplies, and diabetic therapeutic shoes or inserts.
Diagnostic and Radiological Services See details
Wellcare Patriot Giveback (HMO) covers diagnostic and radiological services with prior authorization, offering diagnostic lab services with no copay or coinsurance. Diagnostic procedures and tests carry a $0 to $100 copay with no coinsurance, while radiological services require a $50 copay for X-rays, a 20% coinsurance for therapeutic radiology, and copays starting at $0 for diagnostic radiology.
Home Health Services See details
Home health services are covered by Wellcare Patriot Giveback (HMO) with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Wellcare Patriot Giveback (HMO) covers some cardiac rehabilitation services with no coinsurance, though standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for peripheral artery disease (PAD) services are not covered.
Skilled Nursing Facility (SNF) See details
Wellcare Patriot Giveback (HMO) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring no copay for days 1 to 20 and days 51 to 100, and a $218 daily copay for days 21 to 50. Prior authorization is required, and additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Other Services are not covered under the Wellcare Patriot Giveback (HMO), with acupuncture, over-the-counter (OTC) items, and meal benefits all excluded from coverage.
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