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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 2025, 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 2025.
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 $55.00. 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 $6200.00 (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 $6200.00 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 offers comprehensive coverage with a variety of benefits. This plan includes inpatient hospital stays with a copay, and outpatient services with varying copays. This plan offers coverage for a wide range of services, including primary care, preventive services, vision, dental, and hearing. You will also find coverage for home health, skilled nursing, and ambulance services.
Inpatient Hospital See details
Inpatient Hospital benefits, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, are covered. For Inpatient Hospital-Acute, you'll pay a $500 copay for days 1-3, and no copay for days 4-90; for Inpatient Hospital Psychiatric, you'll pay a $550 copay for days 1-3, and no copay for days 4-90. Additional days, non-Medicare covered stays, and upgrades are not covered for either benefit.
Outpatient Services See details
Outpatient Services includes coverage for Outpatient Hospital Services with a copay between $0 and $300, Observation Services with a copay between $140 and $300, Ambulatory Surgical Center (ASC) Services with a $150 copay, and Outpatient Substance Abuse Services with no copay for individual and group sessions. Outpatient Blood Services are covered with no copay.
Partial Hospitalization See details
Partial Hospitalization is covered with a copay of $85. Prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Wellcare Patriot Giveback Open (PPO) plan. Ground and Air Ambulance Services each have a $250 copay, with no coinsurance, but 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 under the Wellcare Patriot Giveback Open (PPO) plan. Emergency Services and Worldwide Emergency Coverage have a $140 copay, and Urgently Needed Services have a $30 copay, all with no coinsurance. Worldwide Urgent Coverage also has a $140 copay, and Worldwide Emergency Transportation is not covered.
Primary Care See details
The Wellcare Patriot Giveback Open (PPO) plan covers primary care physician services with no copay, chiropractic services with a $20 copay, occupational therapy services with a $25 copay, and specialist services with a $25 copay. Mental health individual and group sessions have no copay, while podiatry services, other health care professional services, and psychiatric services have a $25 copay. Physical therapy and speech-language pathology services have a $25 copay, and telehealth benefits have a copay between $0 and $30. Opioid treatment program services have a $25 copay.
Preventive Services See details
Preventive Services include Medicare-covered services with no copay, an annual physical exam with no copay, and additional preventive services with various copays depending on the service. Kidney Disease Education Services have a 20% coinsurance, while Glaucoma Screenings, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKGs following a Welcome Visit have no copay.
Hearing Services See details
The Wellcare Patriot Giveback Open (PPO) plan covers hearing exams with a $25 copay, routine hearing exams with no copay, and fitting/evaluation for hearing aids with no copay. Prescription hearing aids are covered up to $350 per ear annually, and the plan does not cover prescription hearing aids for the inner ear, outer ear, or over the ear.
Vision Services See details
The Wellcare Patriot Giveback Open (PPO) plan covers vision services, including eye exams with a copay between $0 and $25, and eyewear with a $0 copay. Eyewear has a combined maximum benefit of $100 per year, and covers contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades.
Dental Services See details
The Wellcare Patriot Giveback Open (PPO) plan covers Medicare Dental Services with a $25 copay, oral exams and dental x-rays with no copay, and other preventive dental services with no copay. The plan also covers restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), and oral and maxillofacial surgery with 20% coinsurance, while maxillofacial prosthetics, implant services, and orthodontics are not covered. Orthodontic services have a maximum plan benefit of $1000 per year.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by the Wellcare Patriot Giveback Open (PPO) plan and require prior authorization. Medicare Part B Insulin Drugs have a $35 copay, while Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the Wellcare Patriot Giveback Open (PPO) plan. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical equipment is covered by the Wellcare Patriot Giveback Open (PPO) plan. Durable Medical Equipment (DME) has a 20% coinsurance, while Prosthetic Devices and Medical Supplies have a 20% coinsurance with no copay. Diabetic Supplies have no copay, and 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 between $0 and $50, Lab Services with no copay, Diagnostic Radiological Services with a copay up to $300, Therapeutic Radiological Services with a 20% coinsurance, and Outpatient X-Ray Services with a $25 copay. All services require prior authorization.
Home Health Services See details
Home Health Services are covered by the Wellcare Patriot Giveback Open (PPO) plan with no copay and no coinsurance, though 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 Patriot Giveback Open (PPO) plan. The plan does not offer coverage for Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, or SET for PAD Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, with prior authorization required. For days 1-20 and 51-100, there is no copay, while days 21-50 have a $214 copay.
Other Services See details
Under the Wellcare Patriot Giveback Open (PPO) plan, acupuncture is covered with no copay, and up to 12 treatments per year with prior authorization required. The plan also covers a meal benefit with no copay and a doctor's referral. Other services, including over-the-counter items, are not covered.
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