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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 MO. 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 $165.00. 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) offers robust medical coverage with affordable out-of-pocket costs, featuring no copay and no coinsurance for primary care visits, home health services, and annual preventive screenings. Specialist visits, routine dental, vision, and hearing exams also require no copay or low copays, with generous annual allowances for eyewear, hearing aids, and comprehensive dental care. Inpatient hospital stays require a daily copay for the first five days but no copay for subsequent days, while emergency care carries a flat copay that is waived if you are admitted. For auxiliary care, members benefit from no copay on diagnostic lab tests, routine transportation up to 24 one-way trips, and over-the-counter items. Services like dialysis, durable medical equipment, and certain Part B drugs require a standard 20% coinsurance with no copay. Skilled nursing facility stays are also highly affordable, requiring no copay for days 1 to 20 and days 41 to 100.
Inpatient Hospital See details
Wellcare Patriot Giveback Open (PPO) partially covers inpatient hospital services with no coinsurance, requiring a $325 daily copay for days 1 through 5 of an acute stay and a $300 daily copay for days 1 through 5 of a psychiatric stay, with no copay for days 6 through 90. Prior authorization is required, and additional days, non-Medicare-covered stays, and acute upgrades are not covered.
Outpatient Services See details
Wellcare Patriot Giveback Open (PPO) covers outpatient hospital services with no coinsurance and copays ranging from $0 to $200, alongside observation services which carry a $150 to $200 copay per stay. Ambulatory surgical center services require a $100 copay and no coinsurance, while outpatient blood and substance abuse services are covered with no copays and no coinsurance.
Partial Hospitalization See details
Wellcare Patriot Giveback Open (PPO) covers partial hospitalization services with a $175.00 copay and no coinsurance. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Wellcare Patriot Giveback Open (PPO) covers ground and air ambulance services with a $250 copay and no coinsurance per trip. Transportation services are partially covered, offering up to 24 one-way trips per year to plan-approved locations with no copay and no coinsurance, while trips to any other health-related locations are not covered.
Emergency Services See details
Wellcare Patriot Giveback Open (PPO) covers emergency services with a $150 copay and urgently needed services with a $30 copay, both with no coinsurance and copays waived if admitted to the hospital within 24 hours. Worldwide emergency services are partially covered up to a $50,000 maximum benefit with a $150 copay and no coinsurance, though worldwide emergency transportation is not covered.
Primary Care See details
Wellcare Patriot Giveback Open (PPO) offers primary care physician services with no copay and no coinsurance, while specialist visits, routine podiatry, and opioid treatment require a $10 copay and no coinsurance. Chiropractic services are partially covered, offering up to 12 routine visits per year for a $10 copay and no coinsurance, while other chiropractic services are not covered. Physical, occupational, and speech therapies are covered with a $25 copay and no coinsurance, and telehealth benefits range from a $0 to $30 copay with no coinsurance.
Preventive Services See details
Wellcare Patriot Giveback Open (PPO) covers annual physical exams and most preventive screenings with no copay and no coinsurance, while kidney disease education has no copay but requires a 20% coinsurance. Additional preventive benefits are partially covered with no copay and no coinsurance for fitness, remote access, PERS, and alternative therapies, though several services like health education and nutritional counseling are not covered.
Hearing Services See details
Hearing services under the Wellcare Patriot Giveback Open (PPO) are covered with no coinsurance, featuring a $10 copay for Medicare-covered exams and no copay for annual routine exams and fitting evaluations. Prescription hearing aids are partially covered with no copay up to a $2,500 annual maximum, though inner ear, outer ear, over-the-ear, and OTC hearing aids are not covered.
Vision Services See details
Wellcare Patriot Giveback Open (PPO) offers partially covered vision services with no coinsurance, featuring one annual routine eye exam with no copay, though other eye exam services are not covered. Covered eyewear, including eyeglasses and contact lenses, has no copay and no coinsurance up to a $600 yearly limit, with prior authorization required.
Dental Services See details
Wellcare Patriot Giveback Open (PPO) partially covers dental services, offering Medicare-covered dental services for a $10 copay and no coinsurance, alongside other preventive and comprehensive dental services with no copay and no coinsurance. While there is a $5,000 annual maximum benefit, 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, though prior authorization and step therapy are required. Under this benefit, Medicare Part B insulin has a $35 copay and no coinsurance, while chemotherapy, radiation, and other Part B drugs require no copay and 0% to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered under the Wellcare Patriot Giveback Open (PPO) with no copay and a 20% coinsurance.
Medical Equipment See details
Wellcare Patriot Giveback Open (PPO) covers durable medical equipment, prosthetic devices, and medical supplies with no copay and a 20% coinsurance. Diabetic supplies are covered with no copay, while diabetic therapeutic shoes or inserts require a 20% coinsurance, and prior authorization is required for these benefits.
Diagnostic and Radiological Services See details
Wellcare Patriot Giveback Open (PPO) covers diagnostic and radiological services with prior authorization required. Diagnostic services have no coinsurance, featuring no copay for lab services and a copay of up to $50 for diagnostic procedures. Radiological services feature no copay for diagnostic radiology, a $20 copay for outpatient X-rays, and a 20% coinsurance for therapeutic radiology.
Home Health Services See details
Wellcare Patriot 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 the Wellcare Patriot Giveback Open (PPO) plan with no coinsurance, though copayments apply depending on the specific service. Members will pay a $30 copay for SET for PAD, $40 for pulmonary rehabilitation, $50 for standard cardiac rehabilitation, and $65 for intensive cardiac rehabilitation.
Skilled Nursing Facility (SNF) See details
Wellcare Patriot Giveback Open (PPO) covers Skilled Nursing Facility (SNF) services with no coinsurance, offering no copay for days 1 to 20 and days 41 to 100, and a $218 daily copay for days 21 to 40. Prior authorization is required, a prior three-day inpatient hospital stay is not required, and additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Other services are partially covered by the Wellcare Patriot Giveback Open (PPO), which offers over-the-counter (OTC) items and chronic illness meal benefits with no copay and no coinsurance. However, acupuncture is not covered under this plan.
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1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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