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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 Statewide - Indiana. This plan received an overall rating of 3 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 $105.00. 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 $8950.00 (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 $8950.00 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 affordable access to essential medical services, featuring no copay for primary care visits, mental health sessions, and preventive screenings. For specialized care, members pay a $40 copay for specialists and physical therapy, while emergency room visits carry a $130 copay. Inpatient hospital stays require a $400 copay per day for the first five days of acute care, with no copay for subsequent days. This plan also includes supplemental benefits, including no copay for routine dental, annual vision, and hearing exams, alongside allowance-based coverage for eyewear and hearing aids. Dental care is covered with no copay for preventive and comprehensive services up to a $1,500 annual limit. Additionally, members benefit from home health services and over-the-counter items with no copay, while durable medical equipment requires a 20% coinsurance.
Inpatient Hospital See details
Wellcare Patriot Giveback Open (PPO) covers inpatient hospital services with no coinsurance, requiring a $400 copay for days 1 to 5 of acute care and a $350 copay for days 1 to 5 of psychiatric care, with no copay for subsequent covered days. Prior authorization is required, and upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Wellcare Patriot Giveback Open (PPO) covers outpatient hospital services with no coinsurance and copays ranging from no copay to $350, and ambulatory surgical center services with a $250 copay and no coinsurance. Outpatient substance abuse and blood services are covered with no copay and no coinsurance, while observation services carry a $130 to $350 copay per stay and no coinsurance.
Partial Hospitalization See details
Wellcare Patriot Giveback Open (PPO) covers partial hospitalization services 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 Open (PPO) covers ground and air ambulance services with a $290 copay and no coinsurance, though prior authorization is required. Transportation services, including trips to plan-approved or any health-related locations, are not covered.
Emergency Services See details
Wellcare Patriot Giveback Open (PPO) covers emergency services with a $130 copay and urgently needed services with a $40 copay, both with no coinsurance and waived if admitted to the hospital within 24 hours. Worldwide emergency and urgent services are partially covered up to a $50,000 limit with a $130 copay and no coinsurance, though worldwide emergency transportation is not covered.
Primary Care See details
Primary care benefits under the Wellcare Patriot Giveback Open (PPO) offer primary care physician visits, mental health sessions, and psychiatric services with no copay and no coinsurance. Specialist visits, physical therapy, occupational therapy, and speech therapy require a $40 copay with no coinsurance, while chiropractic and podiatry services are not covered. Telehealth and other health professional services range from no copay to a $40 copay with no coinsurance.
Preventive Services See details
Preventive services are partially covered under the Wellcare Patriot Giveback Open (PPO), offering annual physicals, alternative therapies, memory fitness, and screenings with no copay and no coinsurance, while kidney disease education has no copay and a 20% coinsurance. Sub-services that are not covered include health education, in-home safety assessments, medical nutrition therapy, post-discharge medication reconciliation, readmission prevention, wigs for chemotherapy-related hair loss, weight management, therapeutic massage, adult day health, nutritional/dietary benefits, home-based palliative care, in-home support, caregiver support, additional tobacco cessation counseling, enhanced disease management, telemonitoring, home and bathroom safety devices, and counseling services.
Hearing Services See details
Wellcare Patriot Giveback Open (PPO) hearing services are partially covered with no deductible, offering Medicare-covered exams for a $40 copay and no coinsurance, as well as annual routine exams and fittings with no copay and no coinsurance. Up to two prescription hearing aids are covered annually with no copay or coinsurance up to a $1,000 limit per ear, though OTC hearing aids and inner ear, outer ear, and over-the-ear prescription models are not covered.
Vision Services See details
Wellcare Patriot Giveback Open (PPO) offers partially covered vision services with no coinsurance and copays ranging from $0 to $40 for covered exams, though other eye exam services are not covered. Routine annual eye exams and eyewear are available with no copay, with eyewear coverage limited to a combined maximum of $200 per year.
Dental Services See details
Wellcare Patriot Giveback Open (PPO) covers Medicare-covered dental services for a $40 copay and no coinsurance, and provides other preventive and comprehensive dental services with no copay and no coinsurance up to a $1,500 annual maximum. Dental benefits are partially covered under this plan, as prosthodontics (fixed and removable), maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Wellcare Patriot Giveback Open (PPO) covers home infusion bundled services with no copay and no coinsurance, though prior authorization is required. Under this benefit, Medicare Part B insulin drugs require a $35 copay and no coinsurance, while chemotherapy, radiation, and other Part B drugs have no copay and a coinsurance ranging from 0% to 20%.
Dialysis Services See details
Wellcare Patriot Giveback Open (PPO) covers dialysis services with no copay and a 20% coinsurance.
Medical Equipment See details
Wellcare Patriot Giveback Open (PPO) covers medical equipment, including durable medical equipment (DME), 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 and no copay, with prior authorization required for these benefits.
Diagnostic and Radiological Services See details
Wellcare Patriot Giveback Open (PPO) covers diagnostic and radiological services with prior authorization, offering lab services and diagnostic radiological services with no copay and no coinsurance. Diagnostic tests carry a $0 to $100 copay with no coinsurance, while outpatient X-rays require a $25 copay plus coinsurance and therapeutic radiology requires a copay and at least 20% coinsurance.
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) covers some Cardiac Rehabilitation Services with no coinsurance, but cardiac rehabilitation, intensive cardiac, pulmonary, and SET for PAD services are not covered and require copays 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 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 Medicare-covered limit are not covered.
Other Services See details
Wellcare Patriot Giveback Open (PPO) partially covers other services, providing over-the-counter (OTC) items and chronic illness meal benefits with no copay and no coinsurance, while acupuncture is not covered. The meal benefit requires a referral, and OTC items are obtained through reimbursement.
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