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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 2026, 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 Statewide in AR. This plan received an overall rating of 3.5 out of 5 stars in 2026.
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 $83.00. 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.
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 Maximum Out-Of-Pocket cost of $8000.00 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 features an Enhanced Alternative drug benefit with an annual prescription drug deductible of $615.00. During the initial coverage phase, you will pay no copay for Tier 1 preferred generic drugs at preferred pharmacies, while standard pharmacies require a $10.00 copay. Tier 2 standard generics and Tier 4 non-preferred drugs both carry a 25% coinsurance at both preferred and standard pharmacies. Tier 3 preferred brand drugs require a 48% coinsurance at preferred pharmacies and 49% at standard pharmacies, while Tier 5 specialty drugs have no copay at either pharmacy type. Once your yearly out-of-pocket drug costs reach $2,100.00, you enter the catastrophic coverage phase and pay nothing for covered Part D prescriptions. Additionally, individuals who qualify for the low-income subsidy can reduce their Part D premium to $0.00.
Additional Benefits
The Wellcare Giveback (HMO-POS) plan offers affordable healthcare coverage with no copay for primary care visits, annual physicals, and home health services. For specialized care, members pay copays ranging from $15 to $40 for specialists, $115 for emergency room visits, and a $475 daily copay for the first five days of acute inpatient hospital stays. Most outpatient and emergency services require no coinsurance, helping you keep your out-of-pocket costs predictable. This plan also includes essential routine benefits, featuring no copay for annual eye exams, routine hearing tests, and preventive dental care. While comprehensive dental services require a 40% coinsurance, you can get routine eyewear and prescription hearing aids covered up to annual plan limits with no copay. Durable medical equipment and dialysis services are covered with a standard 20% coinsurance and no copay.
Inpatient Hospital See details
Wellcare Giveback (HMO-POS) partially covers inpatient hospital services with no coinsurance, requiring a $475 daily copay for days 1-5 of acute stays (no copay for days 6-90) and a $440 daily copay for days 1-4 of psychiatric stays (no copay for days 5-90). Prior authorization is required, and additional days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Wellcare Giveback (HMO-POS) covers outpatient services with no coinsurance, featuring copays ranging from no copay to $350 for outpatient hospital services and $115 to $350 for observation services. Additionally, ambulatory surgical center services require a $300 copay, outpatient substance abuse sessions have a $40 copay, and outpatient blood services are covered with no copay.
Partial Hospitalization See details
Partial hospitalization benefits are covered under the Wellcare Giveback (HMO-POS) plan with a $105.00 copay and no coinsurance. Prior authorization is required to receive these services.
Ambulance and Transportation Services See details
Wellcare Giveback (HMO-POS) partially covers ambulance and transportation services, providing ground and air ambulance coverage with a $290 copay and no coinsurance. Transportation services to plan-approved or any health-related locations are not covered under this plan.
Emergency Services See details
Wellcare Giveback (HMO-POS) covers emergency services with a $115 copay and no coinsurance, and urgently needed services with a $40 copay and no coinsurance. Worldwide emergency and urgent care are also covered with a $115 copay and no coinsurance up to a $50,000 maximum, but worldwide emergency transportation is not covered.
Primary Care See details
Primary Care benefits are partially covered by Wellcare Giveback (HMO-POS) with no coinsurance, featuring no copay for primary care provider visits and copays ranging from $15 to $40 for specialists, therapies, and mental health services. Podiatry and routine chiropractic care are not covered under this plan.
Preventive Services See details
Preventive services are partially covered by Wellcare Giveback (HMO-POS), offering no copay and no coinsurance for annual physical exams, fitness benefits, PERS, and select screenings. Kidney disease education is covered with a 20% coinsurance and no copay, while multiple sub-services, including health education, weight management, and in-home safety assessments, are not covered.
Hearing Services See details
Hearing services are partially covered by Wellcare Giveback (HMO-POS), excluding OTC hearing aids as well as inner ear, outer ear, and over-the-ear prescription hearing aids. Covered routine exams, fittings, and prescription hearing aids (up to $500 per ear annually) feature no copay and no coinsurance, while Medicare-covered hearing exams require a $40 copay and no coinsurance.
Vision Services See details
Wellcare Giveback (HMO-POS) covers vision services with no coinsurance, offering annual routine eye exams and eyewear with no copay. Other eye exams have a copay ranging from $0 to $40, and eyewear coverage includes a $200 annual maximum limit, with prior authorization required.
Dental Services See details
Wellcare Giveback (HMO-POS) partially covers dental services, offering preventive care like cleanings and exams with no copay or coinsurance, and Medicare dental services for a $40 copay and no coinsurance. Comprehensive services like restorative care and periodontics require a 40% coinsurance and no copay up to a $1,000 annual limit, while prosthodontics, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Wellcare Giveback (HMO-POS) covers home infusion bundled services with prior authorization, featuring Medicare Part B insulin for a $35 copay and no coinsurance. Covered chemotherapy, radiation, and other Part B drugs require no copay and have coinsurance ranging from no coinsurance to 20%.
Dialysis Services See details
Wellcare Giveback (HMO-POS) covers dialysis services with no copay and a 20% coinsurance.
Medical Equipment See details
Wellcare Giveback (HMO-POS) covers durable medical equipment, prosthetics, medical supplies, and diabetic therapeutic shoes or inserts with a 20% coinsurance and no copay. Diabetic supplies are covered with no copay, and prior authorization is required for most of these medical equipment benefits.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Wellcare Giveback (HMO-POS) with prior authorization. Lab services have no copay or coinsurance, outpatient X-rays require a $25 copay and no coinsurance, diagnostic tests and radiology cost up to $50 and $350 in copays respectively with no coinsurance, and therapeutic radiology requires a 20% coinsurance and no copay.
Home Health Services See details
Wellcare Giveback (HMO-POS) covers Home Health Services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the Wellcare Giveback (HMO-POS) plan, as Cardiac Rehabilitation, Intensive Cardiac Rehabilitation, Pulmonary Rehabilitation, and SET for PAD services are all excluded from coverage.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) benefits are partially covered by Wellcare Giveback (HMO-POS) with prior authorization, though additional days beyond the Medicare-covered limit are not covered. There is no coinsurance for this benefit, which features no copay for days 1 to 20 and days 61 to 100, and a $218 copay for days 21 to 60.
Other Services See details
Wellcare Giveback (HMO-POS) partially covers other services, providing over-the-counter (OTC) items with no copay and no coinsurance. Acupuncture, meal benefits, and dual eligible SNPs are not covered under this plan.
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