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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 WA. This plan received an overall rating of 2.5 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 $63.00. 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 combined Maximum Out-Of-Pocket cost of $7900.00 (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 $7900.00 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 provides robust medical coverage with many essential services requiring no copay and no coinsurance. Members enjoy no copay for primary care visits, preventive screenings, diagnostic lab work, and home health services. For other medical needs, specialist visits require a $25 copay, while inpatient hospital stays incur a $550 daily copay for the first three days and no copay for days four through ninety. This plan also features strong dental, vision, and hearing benefits, offering routine exams with no copay alongside allowances for eyewear and prescription hearing aids. Emergency care is accessible with a $130 copay, which is waived upon hospital admission, and urgent care carries a $30 copay. For specialized needs, medical equipment and dialysis services are covered with no copay and a twenty percent coinsurance.
Inpatient Hospital See details
Inpatient hospital care is covered by Wellcare Patriot Giveback Open (PPO) with no coinsurance, requiring a $550 daily copay for days 1 through 3 and no copay for days 4 through 90 per admission. This benefit is partially covered, requiring prior authorization, and does not cover additional days, upgrades, or non-Medicare-covered stays.
Outpatient Services See details
Wellcare Patriot Giveback Open (PPO) covers outpatient services with no coinsurance, featuring a copay of $0 to $450 for outpatient hospital services and $150 for ambulatory surgical center visits. Outpatient substance abuse sessions and blood services are also covered with no copays and no coinsurance.
Partial Hospitalization See details
Partial hospitalization is covered under the Wellcare Patriot Giveback Open (PPO) plan with a $140.00 copay and no coinsurance. Prior authorization is required to receive these services.
Ambulance and Transportation Services See details
Wellcare Patriot Giveback Open (PPO) covers ground and air ambulance services with a $250 copay and no coinsurance, requiring prior authorization. For transportation benefits, some services are covered but transportation to plan-approved or any health-related locations is not covered.
Emergency Services See details
Wellcare Patriot Giveback Open (PPO) covers emergency services with a $130 copay and no coinsurance, and urgently needed services with a $30 copay and no coinsurance, with copays waived if admitted to the hospital within 24 hours. Worldwide emergency and urgent care are partially covered up to a $50,000 maximum with a $130 copay and no coinsurance, though worldwide emergency transportation is not covered.
Primary Care See details
Wellcare Patriot Giveback Open (PPO) covers primary care physician, psychiatric, and mental health services with no copay and no coinsurance, while specialist, physical therapy, and occupational therapy visits require a $25 copay and no coinsurance. Chiropractic services are partially covered, offering routine care for a $15 copay and no coinsurance, though other chiropractic services are not covered.
Preventive Services See details
Wellcare Patriot Giveback Open (PPO) covers preventive services, offering annual physical exams and other preventive screenings with no copay and no coinsurance. Additional preventive benefits are partially covered, featuring fitness benefits, alternative therapies, and remote access technologies with no copay and no coinsurance, while services like health education and weight management are not covered. Kidney disease education is covered with no copay and a 20% coinsurance.
Hearing Services See details
Wellcare Patriot Giveback Open (PPO) provides partially covered hearing services, including annual routine hearing exams and fitting evaluations with no copay and no coinsurance, alongside Medicare-covered exams for a $25 copay and no coinsurance. Prescription hearing aids are covered up to $500 per ear annually with no copay and no coinsurance, but OTC, inner ear, outer ear, and over the ear hearing aids are not covered.
Vision Services See details
Wellcare Patriot Giveback Open (PPO) provides partially covered vision services with no deductibles and no coinsurance, although other eye exam services are not covered. Routine eye exams and eyewear are available with no copay, though exams for other eye services require a $0 to $25 copay, and eyewear has a combined annual limit of $100.
Dental Services See details
Wellcare Patriot Giveback Open (PPO) covers Medicare dental services with a $25 copay and no coinsurance, and preventive dental services with no copay and no coinsurance. Comprehensive dental services are partially covered up to a $1,000 annual limit with no copay and 20% coinsurance, though maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by the Wellcare Patriot Giveback Open (PPO) with no copay, though prior authorization and step therapy may apply. Covered Medicare Part B insulin drugs require a $35 copay and no coinsurance, while Part B chemotherapy, radiation, and other drugs carry a 0% to 20% coinsurance.
Dialysis Services See details
Wellcare Patriot Giveback Open (PPO) covers Dialysis Services with no copay and a 20% coinsurance.
Medical Equipment See details
Medical equipment is covered by Wellcare Patriot Giveback Open (PPO), with prior authorization required for these benefits. Durable medical equipment, prosthetics, medical supplies, and diabetic therapeutic shoes or inserts require no copay and a 20% coinsurance, while diabetic supplies are covered with no copay.
Diagnostic and Radiological Services See details
Wellcare Patriot Giveback Open (PPO) covers diagnostic services with no coinsurance, offering no copay for lab services and a $0 to $50 copay for diagnostic procedures. Radiological services are also covered with a $50 copay for outpatient X-rays, no copay for diagnostic radiology, and a minimum 20% coinsurance for therapeutic radiology, with prior authorization required for both service types.
Home Health Services See details
Home Health Services are covered under the Wellcare Patriot Giveback Open (PPO) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Wellcare Patriot Giveback Open (PPO) features no coinsurance for cardiac rehabilitation, but only some services are covered in practice. Standard cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and SET for PAD services are not covered and require copayments of $40, $50, $35, and $25 respectively.
Skilled Nursing Facility (SNF) See details
Wellcare Patriot Giveback Open (PPO) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring prior authorization but no prior three-day hospital stay. There is no copay for days 1 to 20 and days 51 to 100, a $218 daily copay for days 21 to 50, and additional days beyond the standard Medicare limit are not covered.
Other Services See details
Wellcare Patriot Giveback Open (PPO) partially covers other services, offering acupuncture for up to 12 treatments per year and chronic illness meal benefits with no copay and no coinsurance. Over-the-counter (OTC) items are not covered under this benefit.
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Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
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