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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 KS. This plan received an overall rating of 3 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 $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 a range of benefits with varying cost-sharing. This plan covers inpatient hospital stays with a copay, and outpatient services with copays up to $325. It also includes coverage for primary care with no copay, as well as preventive, hearing, vision, and dental services with no or low copays. Additional benefits include coverage for ambulance services with a copay, and emergency services with a copay. The plan also covers home health services, skilled nursing facility stays, and diagnostic services with no or low copays. With this plan, you will also receive coverage for over-the-counter items.
Inpatient Hospital See details
Inpatient Hospital services, including Acute and Psychiatric, are covered, with a $375 copay for days 1-6 and no copay for days 7-90. Additional days and non-Medicare-covered stays are not covered.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services with a copay between $0 and $325, observation services with a copay between $125 and $325, ambulatory surgical center services with a $275 copay, outpatient substance abuse services with no copay for individual and group sessions, and outpatient blood services with no copay.
Partial Hospitalization See details
Partial hospitalization is covered by the Wellcare Patriot Giveback Open (PPO) plan, with a copay of $105.00. Prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered under the Wellcare Patriot Giveback Open (PPO) plan. Ground and Air Ambulance Services have a $290 copay, with no coinsurance. Transportation Services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Coverage have a copay of $125, $35, and $125 respectively, with no coinsurance. Worldwide Urgent Coverage also has a $125 copay and no coinsurance. 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 have a $20 copay, while routine chiropractic care is not covered. Occupational therapy services, physician specialist services, physical therapy and speech-language pathology services each have a $35 copay. Individual and group mental health and psychiatric sessions have no copay, and other health care professional visits have a copay between $0 and $35. Additional telehealth benefits have a copay between $0 and $35, and Opioid Treatment Program Services have a $35 copay.
Preventive Services See details
The Wellcare Patriot Giveback Open (PPO) plan covers preventive services with no copay for an annual physical exam, glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKG following a Welcome Visit. The plan also covers kidney disease education services with 20% coinsurance.
Hearing Services See details
Hearing exams are covered with a $35 copay. Routine hearing exams and fitting/evaluation for hearing aids have no copay. Prescription hearing aids are covered up to $750 per ear per year, and all types of prescription hearing aids have no copay. However, prescription hearing aids for the inner ear, outer ear, and over the ear are not covered, and OTC hearing aids are also not covered.
Vision Services See details
The Wellcare Patriot Giveback Open (PPO) plan covers vision services including eye exams with a copay of $0-$35. Eyewear is also covered with no copay, including contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades, up to a combined maximum of $400 per year.
Dental Services See details
The Wellcare Patriot Giveback Open (PPO) plan covers dental services, including oral exams and dental X-rays with no copay, as well as other diagnostic and preventive services with no copay. Restorative, adjunctive general, endodontics, periodontics, and oral and maxillofacial surgery services are covered with a 40% coinsurance. The plan also covers orthodontic services with a maximum benefit of $1500 per year. However, some services like prosthodontics, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, with prior authorization required. Medicare Part B Insulin Drugs have a $35 copay. 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 by the Wellcare Patriot Giveback Open (PPO) plan. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment benefits are covered under the Wellcare Patriot Giveback Open (PPO) plan. Durable Medical Equipment (DME) has a 20% coinsurance with no copay, while Prosthetic Devices also has a 20% coinsurance with no copay. Medical Supplies have a 20% coinsurance with no copay. Diabetic Supplies have no copay, and a coinsurance of 20% for Diabetic Therapeutic Shoes/Inserts.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including Diagnostic Procedures/Tests with no copay, Lab Services with no copay, Diagnostic Radiological Services with a copay of up to $325, Therapeutic Radiological Services with coinsurance of at most 20%, 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. Additional hours of care and personal care services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services are not covered. The copay for Cardiac Rehabilitation Services varies, but no additional cost sharing information is provided.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, but prior authorization is required. There is no copay for days 1-20 and days 51-100, but there is a $214 copay for days 21-50.
Other Services See details
The Wellcare Patriot Giveback Open (PPO) plan covers Over-the-Counter (OTC) Items with no copay, up to $50 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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