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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 All counties in KY. 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 $84.00. 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 $9000.00 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 annual drug deductible of $615. For Tier 1 preferred generics and Tier 2 generics, you will pay no copay when using a preferred pharmacy or preferred mail-order service. Additionally, Tier 6 select care drugs require no copay across all pharmacy options and supply lengths. For higher-tier medications, costs transition to coinsurance rather than flat copays. You will pay a 25% coinsurance for Tier 3 preferred brands and Tier 5 specialty drugs, while Tier 4 non-preferred drugs carry a 36% coinsurance. Standard pharmacies and standard mail-order services charge copays ranging from $5 to $30 for generic tiers depending on the tier and supply length.
Additional Benefits
The Wellcare Giveback (HMO-POS) plan offers affordable healthcare coverage with no copays or coinsurance for primary care visits, routine preventive care, and home health services. Specialist visits and urgent care require copays ranging from $30 to $40, while emergency services carry a $115 copay with no coinsurance. Inpatient hospital stays and outpatient hospital services are also covered with set copays and no coinsurance, protecting you from unexpected medical bills. Additionally, the plan features essential dental, vision, and hearing benefits, including routine exams and preventive dental care with no copay. You also get coverage for over-the-counter items with no copay, while durable medical equipment and dialysis services are subject to a 20% coinsurance. Diagnostic laboratory services and skilled nursing facility stays for the first 20 days are also provided with no copay, ensuring comprehensive support for your ongoing health needs.
Inpatient Hospital See details
Inpatient hospital services are partially covered by Wellcare Giveback (HMO-POS) with no coinsurance, though prior authorization is required. Acute stays require a $475 copay for days 1 through 5 and no copay for days 6 through 90, while psychiatric stays require a $325 copay for days 1 through 6 and no copay for days 7 through 90; however, additional days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Wellcare Giveback (HMO-POS) covers outpatient hospital services with no coinsurance and a copay ranging from no copay to $450, and ambulatory surgical center services with a $200 copay and no coinsurance. Outpatient substance abuse services require a $40 copay with no coinsurance, while outpatient blood services are provided with no copay and no coinsurance.
Partial Hospitalization See details
Partial hospitalization services are covered by the Wellcare Giveback (HMO-POS) plan with a $105.00 copay and no coinsurance, though prior authorization is required.
Ambulance and Transportation Services See details
Wellcare Giveback (HMO-POS) partially covers ambulance and transportation services, offering Medicare-covered ground and air ambulance services for a $350 copay and no coinsurance, with prior authorization required. Transportation services to plan-approved or other health-related locations are not covered.
Emergency Services See details
Wellcare Giveback (HMO-POS) covers emergency services with a $115 copay and no coinsurance, and urgently needed services with a $30 copay and no coinsurance, with copays waived if admitted to the hospital within 24 hours. Worldwide emergency and urgent care are partially covered up to a $50,000 lifetime maximum with a $115 copay and no coinsurance, though worldwide emergency transportation is not covered.
Primary Care See details
Wellcare Giveback (HMO-POS) provides primary care physician visits with no copay and no coinsurance, while specialist visits, physical therapy, occupational therapy, and mental health services require a $35 to $40 copay and no coinsurance. Chiropractic and podiatry services are not covered, but additional telehealth benefits are available with a $0 to $40 copay and no coinsurance.
Preventive Services See details
Preventive Services are partially covered by Wellcare Giveback (HMO-POS), offering annual physicals, alternative therapies, memory fitness, remote access, and various screenings with no copay and no coinsurance, while kidney disease education requires no copay and a 20% coinsurance. Not covered under this plan are health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, readmission prevention, chemotherapy wigs, weight management, therapeutic massage, adult day health, nutritional benefits, palliative care, in-home support, caregiver support, smoking cessation, disease management, telemonitoring, home modifications, and counseling.
Hearing Services See details
Wellcare Giveback (HMO-POS) hearing services include Medicare-covered exams for a $40 copay and no coinsurance, plus annual routine exams and fitting evaluations with no copay and no coinsurance. Prescription hearing aids are partially covered with no copay and no coinsurance up to a $500 maximum per ear yearly, though OTC, inner ear, outer ear, and over-the-ear hearing aids are not covered.
Vision Services See details
Wellcare Giveback (HMO-POS) offers partially covered vision services with no deductibles and no coinsurance, though prior authorization is required. Routine eye exams are covered once annually with no copay, while other eye exam services are not covered, and eyewear is covered with no copay up to a $100 yearly limit.
Dental Services See details
Dental services are partially covered by Wellcare Giveback (HMO-POS), featuring a $40 copay and no coinsurance for Medicare-covered dental, and no copay and no coinsurance for preventive and other covered dental services up to a $1,000 annual limit. 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 no copay, though prior authorization is required. Associated Medicare Part B chemotherapy, radiation, and other drugs carry a 0% to 20% coinsurance, while Part B insulin is covered with a $35 copay and no coinsurance.
Dialysis Services See details
Dialysis Services are covered under the Wellcare Giveback (HMO-POS) plan with no copay and a 20% coinsurance.
Medical Equipment See details
Medical equipment is covered under the Wellcare Giveback (HMO-POS) plan with no copay and a 20% coinsurance for durable medical equipment, prosthetics, medical supplies, and diabetic therapeutic shoes or inserts. Diabetic supplies are covered with no copay, and prior authorization is required for these medical equipment benefits.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Wellcare Giveback (HMO-POS) subject to prior authorization, offering lab services and diagnostic radiology with no copays or coinsurance. Diagnostic procedures and tests range from no copay to a $50 copay with no coinsurance, while outpatient X-rays require a $50 copay plus coinsurance, and therapeutic radiology carries a 20% coinsurance.
Home Health Services See details
Home Health Services are covered by Wellcare Giveback (HMO-POS) with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Wellcare Giveback (HMO-POS) covers Cardiac Rehabilitation Services with no coinsurance, but only some services are covered. Under this plan, Cardiac Rehabilitation (which has a $30 copay), Intensive Cardiac Rehabilitation ($40 copay), Pulmonary Rehabilitation ($25 copay), and Supervised Exercise Therapy for PAD services ($20 copay) are not covered.
Skilled Nursing Facility (SNF) See details
Wellcare Giveback (HMO-POS) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring prior authorization and allowing admission without a prior three-day inpatient hospital stay. There is no copay for days 1 through 20 and days 71 through 100, while days 21 through 70 require a $218 copay, with additional days beyond the Medicare-covered limit not covered.
Other Services See details
Wellcare Giveback (HMO-POS) provides partial coverage for other services, which includes over-the-counter (OTC) items with no copay and no coinsurance. Acupuncture, meal benefits, and other additional services are not covered under this plan.
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