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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 OK. This plan received an overall rating of 2.5 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 $68.50. 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 $7550.00 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 a $420 deductible for prescription drugs. After the deductible, you'll pay varying costs depending on the drug tier and pharmacy. For example, preferred generic drugs have no copay at preferred pharmacies and mail order, but a $10 copay at standard pharmacies. This plan offers an initial coverage phase up to $2000 in total drug costs. Once you reach the $2000 out-of-pocket limit, you enter the catastrophic coverage phase, where you pay nothing for covered Part D drugs.
Additional Benefits
The Wellcare Giveback (HMO-POS) plan offers a range of benefits including inpatient and outpatient hospital care, with varying copays depending on the service. You'll find no copays for many preventive services, home health, and some vision and dental services. The plan also includes coverage for hearing aids, ambulance services, and emergency care, while some services like dental, vision, and OTC items have annual limits. This plan requires copays for specialist visits, and some other services, like outpatient services, have varying copays. The plan also includes coverage for prescription hearing aids, with a maximum benefit of $500 per year. You'll pay coinsurance for services like dialysis, medical equipment, and some drugs.
Inpatient Hospital See details
Inpatient Hospital coverage includes Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, both of which require prior authorization. For Inpatient Hospital-Acute, you pay a $350 copay for days 1-7, and no copay for days 8-90. For Inpatient Hospital Psychiatric, you pay a $350 copay for days 1-5, and no copay for days 6-90. Additional days and non-Medicare-covered stays for both Inpatient Hospital-Acute and Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services include coverage for outpatient hospital services with a copay between $0 and $500, observation services with a copay between $110 and $500, Ambulatory Surgical Center (ASC) services with a $250 copay, and outpatient substance abuse services, with a copay of $25 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 an $80 copay. 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 copay of $275, and there is no coinsurance; however, transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Coverage are covered under the Wellcare Giveback (HMO-POS) plan. Emergency Services and Worldwide Emergency Coverage have a $110 copay, while Urgently Needed Services have a $45 copay, and all three have no coinsurance. 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 $15 copay (routine care is not covered), Occupational Therapy Services with a $35 copay, and Physician Specialist Services with a $50 copay. Mental Health Specialty Services, Psychiatric Services, and Other Health Care Professional services have varying copays depending on the service, while Podiatry Services are not covered. Additional Telehealth Benefits have a copay between $0 and $50, Physical Therapy and Speech-Language Pathology Services have a $35 copay, and Opioid Treatment Program Services have a $50 copay.
Preventive Services See details
Preventive services include an annual physical exam with no copay, and other services such as glaucoma screenings, diabetes self-management training, barium enemas, digital rectal exams, and EKGs following a welcome visit, all with no copay. Kidney disease education services have a 20% coinsurance. Health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge in-home medication reconciliation, readmission prevention, wigs for hair loss related to chemotherapy, weight management programs, therapeutic massage, adult day health services, nutritional/dietary benefits, home-based palliative care, in-home support services, support for caregivers of enrollees, additional sessions of smoking and tobacco cessation counseling, enhanced disease management, telemonitoring services, home and bathroom safety devices and modifications, and counseling services are not covered.
Hearing Services See details
The Wellcare Giveback (HMO-POS) plan covers hearing exams with a $50 copay, routine hearing exams with no copay, and fitting/evaluation for hearing aids with no copay. This plan also provides coverage for prescription hearing aids, with a maximum benefit of $500 per year, but does not cover inner ear, outer ear, or over the ear prescription hearing aids.
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, with a combined maximum benefit of $100 per year. Routine eye exams are covered with no copay, and eyewear such as contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades are covered with no copay.
Dental Services See details
The Wellcare Giveback (HMO-POS) plan covers Medicare Dental Services with a $50 copay, Oral Exams, Dental X-Rays, Other Diagnostic Dental Services, Prophylaxis (Cleaning), Fluoride Treatment, Other Preventive Dental Services, and Adjunctive General Services, all with no copay. Restorative Services, Endodontics, Periodontics, Prosthodontics, removable, Maxillofacial Prosthetics, Implant Services, Prosthodontics, fixed, Oral and Maxillofacial Surgery, and Orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services, including Medicare Part B Insulin Drugs, Medicare Part B Chemotherapy/Radiation Drugs, and Other Medicare Part B Drugs, are covered with prior authorization. Medicare Part B Insulin Drugs have a $35 copay, while the coinsurance for Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs ranges from 0% to 20%.
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 is covered by the Wellcare Giveback (HMO-POS) plan, including Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment. DME has a 20% coinsurance, while medical supplies have a 20% coinsurance, and Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance. Diabetic Supplies have no copay. Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including diagnostic procedures and tests with a copay between $0 and $50, and lab services with no copay. Radiological services are covered with a copay up to $350 for diagnostic services, a 20% coinsurance for therapeutic services, and a $50 copay for outpatient X-ray services.
Home Health Services See details
Home Health Services are covered by the Wellcare Giveback (HMO-POS) plan with no copay and no coinsurance, but additional hours of care and personal care services are not covered. Prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by the Wellcare Giveback (HMO-POS) plan, but the specific services of Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, and Additional Cardiac Rehabilitation Services are not covered. There is a copay for covered services, but the amount is not specified in the provided information.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, but require prior authorization. For days 1-20 and days 61-100, there is no copay, while days 21-60 have a $214 copay; there is no coinsurance. Additional days beyond Medicare-covered SNF and non-Medicare-covered SNF stays are not covered.
Other Services See details
The Wellcare Giveback (HMO-POS) plan covers Over-the-Counter (OTC) Items with no copay, up to a maximum of $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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