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Wellcare Giveback (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Wellcare Giveback (HMO-POS). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Wellcare Giveback (HMO-POS) in 2025, please refer to our full plan details page.
Wellcare Giveback (HMO-POS) is a HMO-POS plan offered by Centene Corporation available for enrollment in 2025 to people living in Select counties in KS. This plan received an overall rating of 3 out of 5 stars in 2025.
It's important to know that Wellcare Giveback (HMO-POS) 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 (HMO-POS).
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 (HMO-POS), 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 $52.70. 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.
This plan has a $420.00 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 Maximum Out-Of-Pocket cost of $6350.00 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
The Wellcare Giveback (HMO-POS) plan has an enhanced alternative drug benefit. The plan has a deductible of $420. In the initial coverage phase, you'll pay a copay or coinsurance depending on the drug tier and pharmacy. For preferred generic drugs, you'll have no copay at preferred pharmacies and preferred mail order, and a $10 copay at standard pharmacies and standard mail order. For specialty tier drugs, you will have no copay. After your yearly out-of-pocket drug costs reach $2000, you pay nothing for covered drugs.
Additional Benefits
The Wellcare Giveback (HMO-POS) plan offers comprehensive coverage, including inpatient hospital stays with a $400 copay for the first few days, outpatient services, and emergency care with a $125 copay. The plan includes coverage for primary care with no copay and offers additional benefits like hearing, vision, and dental services. This plan provides coverage for preventive services with no copay, such as an annual physical exam. It also covers services like home health, skilled nursing facilities, and durable medical equipment, but copays and coinsurance amounts vary depending on the service.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric services. For Inpatient Hospital-Acute, you will pay a $400 copay for days 1-6, and no copay for days 7-90, and no copay for days 91-999; for Inpatient Hospital Psychiatric, you will pay a $370 copay for days 1-5, and no copay for days 6-90. Non-Medicare-covered Stay for Inpatient Hospital-Acute, Upgrades for Inpatient Hospital-Acute, and Additional Days for Inpatient Hospital Psychiatric and Non-Medicare-covered Stay for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services include coverage for Outpatient Hospital Services with a copay between $0 and $335, Observation Services with a copay between $125 and $335, Ambulatory Surgical Center (ASC) Services with a $285 copay, Outpatient Substance Abuse Services with a $40 copay for both individual and group sessions, and Outpatient Blood Services with no copay.
Partial Hospitalization See details
Partial Hospitalization is covered by the Wellcare Giveback (HMO-POS) plan with a $105 copay, and prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Wellcare Giveback (HMO-POS) plan. Ground and Air Ambulance Services have a $285 copay, but no coinsurance. Transportation Services to any health-related location are not covered.
Emergency Services See details
The Wellcare Giveback (HMO-POS) plan covers emergency services with a $125 copay and no coinsurance, and urgently needed services with a $40 copay and no coinsurance. Worldwide emergency coverage and worldwide urgent coverage are covered with a $125 copay and no coinsurance, but worldwide emergency transportation is not covered.
Primary Care See details
The Wellcare Giveback (HMO-POS) plan covers primary care physician services with no copay, chiropractic services with a $20 copay, occupational therapy services with a $45 copay, physician specialist services with a $50 copay, and physical therapy/speech-language pathology services with a $35 copay. Mental health and psychiatric individual and group sessions have a $40 copay, while other health care professional services have a copay between $0 and $50. Additionally, it offers telehealth benefits with a copay between $0 and $50, and opioid treatment program services with a $50 copay. Podiatry services are not covered.
Preventive Services See details
The Wellcare Giveback (HMO-POS) plan covers preventive services, including an annual physical exam with no copay. Other preventive services are covered, including Medicare-covered glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKG following a welcome visit, all with no copay. Kidney disease education services are covered with 20% coinsurance.
Hearing Services See details
The Wellcare Giveback (HMO-POS) plan covers hearing exams with a $50 copay. Routine hearing exams and fitting/evaluation for hearing aids have no copay, and prescription hearing aids are covered up to $750 per year.
Vision Services See details
The Wellcare Giveback (HMO-POS) plan covers vision services, including eye exams with a copay between $0 and $50, and eyewear with no copay. Routine eye exams are covered with no copay, and eyewear has a combined maximum benefit of $200 per year.
Dental Services See details
The Wellcare Giveback (HMO-POS) plan covers Medicare Dental Services with a $50 copay and other dental services, including oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatment, and other preventive dental services with no copay. Restorative services, adjunctive general services, endodontics, periodontics, and oral and maxillofacial surgery are covered with a 40% coinsurance, while orthodontics has a maximum benefit of $1,000 per year. Prosthodontics (removable and fixed), maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs with a $35 copay, and Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs with coinsurance between 0% and 20%. Prior authorization is required.
Dialysis Services See details
Dialysis Services are covered under the Wellcare Giveback (HMO-POS) plan. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with 20% coinsurance, Prosthetic Devices with 20% coinsurance, and Medical Supplies with 20% coinsurance. Diabetic Supplies have no copay, while Diabetic Therapeutic Shoes/Inserts have 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including diagnostic procedures/tests with a copay between $0 and $10, and lab services with no copay. Diagnostic Radiological Services have a maximum copay of $335, and Therapeutic Radiological Services have 20% coinsurance. Outpatient X-Ray Services have a $25 copay.
Home Health Services See details
Home Health Services are covered by the Wellcare Giveback (HMO-POS) plan with no copay and no coinsurance. Additional hours of care and personal care services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by the Wellcare Giveback (HMO-POS) plan, but the specific services, including Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services, are not covered. There is a copay for some services, but the exact amount is not specified.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered under the Wellcare Giveback (HMO-POS) plan, but require prior authorization. For days 1-20 and 71-100, there is no copay, but for days 21-70, the copay is $214.
Other Services See details
The Wellcare Giveback (HMO-POS) plan covers Over-the-Counter (OTC) items with no copay, up to a maximum of $40 every three months. Acupuncture, Meal Benefit, Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, and Self-Directed Personal Assistance Services are not covered.
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