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Wellcare Giveback Open (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Wellcare 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 Giveback Open (PPO) in 2026, please refer to our full plan details page.
Wellcare 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 Giveback Open (PPO) 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 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 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 $79.00. You must continue to pay paying your reduced Part B Premium.
Deductibles
This plan has a $500.00 health deductible. This means, every calendar year, you pay this amount towards covered services before your insurance coverage kicks in.
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 combined Maximum Out-Of-Pocket cost of $10000.00 (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 $10000.00 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
The Wellcare Giveback Open (PPO) plan features an annual drug deductible of $615. For Tier 1 preferred generics, Tier 2 generics, and Tier 6 select care drugs, you will pay no copay when using a preferred pharmacy or preferred mail-order service. If you choose a standard pharmacy instead, Tier 1 and Tier 2 drugs require a small copay starting at $5 and $10 for a one-month supply, respectively. Higher-tier medications on this plan require coinsurance rather than flat copays. Tier 3 preferred brands and Tier 5 specialty drugs both carry a 25% coinsurance, while Tier 4 non-preferred drugs require 34% coinsurance at preferred locations and 35% at standard locations. These percentage-based costs apply to both retail pharmacies and mail-order fills throughout the initial coverage phase.
Additional Benefits
The Wellcare Giveback Open (PPO) plan offers robust coverage for essential medical services, featuring no copay and no coinsurance for primary care visits, home health services, and annual preventive physical exams. Specialist visits, urgent care, and outpatient mental health services require a $40 copay, while emergency room visits carry a $115 copay with no coinsurance. For hospital stays, members pay a daily copay of $400 for the first five days of an acute inpatient stay and no copay for days six through ninety. Additional health benefits include routine dental, vision, and hearing services, which feature no copay for preventive care and annual routine exams. The plan also covers prescription hearing aids up to $350 per ear and eyewear up to a $200 annual limit with no copay. Durable medical equipment and dialysis services generally require a 20% coinsurance, while over-the-counter items are covered with no copay through reimbursement.
Inpatient Hospital See details
Wellcare Giveback Open (PPO) partially covers inpatient hospital services with no coinsurance, requiring a $400 daily copay for days 1 to 5 (no copay for days 6 to 90) for acute stays, and a $350 daily copay for days 1 to 5 (no copay for days 6 to 90) for psychiatric stays. Prior authorization is required, and additional days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Wellcare Giveback Open (PPO) covers outpatient hospital services with a copay ranging from no copay to $400 and 20% coinsurance, and ambulatory surgical center services with a $250 copay and no coinsurance. Outpatient substance abuse sessions require a $40 copay and no coinsurance, while outpatient blood services are fully covered with no copay and no coinsurance.
Partial Hospitalization See details
Wellcare Giveback Open (PPO) covers partial hospitalization services with a $105.00 copay and no coinsurance. Prior authorization is required to receive this benefit.
Ambulance and Transportation Services See details
Wellcare Giveback Open (PPO) covers ground and air ambulance services with a $280.00 copay and no coinsurance, though prior authorization is required. While transportation services are technically listed, transportation to health-related locations is not covered under this plan.
Emergency Services See details
Wellcare Giveback Open (PPO) covers emergency services with a $115 copay and urgently needed services with a $40 copay, both featuring no coinsurance and waived copays if admitted to the hospital within 24 hours. Worldwide emergency and urgent services are partially covered with a $115 copay, no coinsurance, and a $50,000 maximum benefit, but worldwide emergency transportation is not covered.
Primary Care See details
Wellcare Giveback Open (PPO) covers primary care physician services with no copay and no coinsurance, while specialist visits and mental health services require a $40 copay and no coinsurance. Physical and occupational therapies are covered with a $35 copay and no coinsurance, though chiropractic and podiatry services are not covered.
Preventive Services See details
Wellcare Giveback Open (PPO) covers preventive services with no copay and no coinsurance for annual physical exams, alternative therapies, memory fitness, remote access, and glaucoma screenings, while kidney disease education has no copay and a 20% coinsurance. Additional preventive benefits are partially covered, excluding services like health education, weight management, nutritional benefits, and in-home safety assessments.
Hearing Services See details
Hearing services are partially covered by Wellcare Giveback Open (PPO), offering annual routine hearing exams and fitting evaluations with no copay and no coinsurance, while Medicare-covered exams require a $40 copay and no coinsurance. Prescription hearing aids are covered up to $350 per ear annually 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
Wellcare Giveback Open (PPO) provides partially covered vision services, offering eye exams with a $0 to $40 copay and no coinsurance, though other eye exam services are not covered. Eyewear is covered with no copay and no coinsurance up to a $200 annual combined maximum, and prior authorization is required for both exams and eyewear.
Dental Services See details
Wellcare Giveback Open (PPO) offers partially covered dental services with no copay and no coinsurance for preventive care, and a $40 copay with no coinsurance for Medicare-covered dental. Comprehensive dental services are covered with no copay and 20% coinsurance up to a $1,000 yearly limit, while maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Wellcare Giveback Open (PPO) covers home infusion bundled services with no copay, though prior authorization is required. Under this benefit, Medicare Part B insulin drugs have 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 Giveback Open (PPO) covers Dialysis Services with no copay and a 20% coinsurance.
Medical Equipment See details
Wellcare Giveback Open (PPO) covers durable medical equipment, prosthetics, and medical supplies with a 20% coinsurance and no copay. Diabetic supplies are covered with no copay, while diabetic therapeutic shoes and inserts require a 20% coinsurance, with prior authorization required for these benefits.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered under Wellcare Giveback Open (PPO) with prior authorization required. Lab services feature no copay and no coinsurance, diagnostic procedures and tests have no coinsurance and a copay ranging from no copay to $100, and outpatient X-rays require a $50 copay. Therapeutic radiological services carry a minimum 20% coinsurance, while diagnostic radiological services have a minimum copay of $0.
Home Health Services See details
Wellcare Giveback Open (PPO) covers Home Health Services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by Wellcare Giveback Open (PPO) with no coinsurance, though only some services are covered in practice. Specifically, cardiac rehabilitation ($30 copay), intensive cardiac rehabilitation ($40 copay), pulmonary rehabilitation ($25 copay), and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) ($20 copay) are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by Wellcare Giveback Open (PPO) with no coinsurance, requiring prior authorization but no prior three-day inpatient hospital stay. There is no copay for days 1 to 20 and days 61 to 100, a $218 daily copay for days 21 to 60, and additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Wellcare Giveback Open (PPO) partially covers Other Services, offering over-the-counter (OTC) items with no copay and no coinsurance through reimbursement. Acupuncture, meal benefits, and other additional services are not covered under this plan.
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