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Wellcare Patriot Giveback (HMO-POS)

H1416 - 061 - 0
3.5 out of 5 stars (3.5 / 5)

wellcare medicare provider logo

Wellcare Patriot Giveback (HMO-POS) is a Medicare Advantage Plan by Wellcare.

This page features plan details for 2025 Wellcare Patriot Giveback (HMO-POS) H1416 – 061 – 0 available in All counties in TN.

Locations

Wellcare Patriot Giveback (HMO-POS) is offered in the following locations.

Anderson County, Tennessee
Bedford County, Tennessee
Benton County, Tennessee

Click to see more locations

Plan Overview

Wellcare Patriot Giveback (HMO-POS) offers the following coverage and cost-sharing.

Insurer:Wellcare
Health Plan Deductible:$225 In-network
MOOP:$5,000 In-network
Drugs Covered:No

Ready to sign up for Wellcare Patriot Giveback (HMO-POS) ?

Get help from a licensed insurance agent.

Call 1-877-354-4611 / TTY 711.

M-F: 8:00 am – 10:00 pm EST

Sat-Sun: 8:00 am – 9:00 pm EST

Medicare Part B Give Back Benefit

The Part B Premium Reduction (Medicare Part B Give Back Benefit) lowers the cost of some Medicare Advantage plans. 

Wellcare Patriot Giveback (HMO-POS) qualifies for a monthly Medicare Give Back Benefit of $90.00.

Premium Reduction:$90.00

Premium Breakdown

Wellcare Patriot Giveback (HMO-POS) has a monthly premium of $0.00. This amount includes your Part C premium but does not include your Part B premium.
Part B Part C Part B Give Back Total
$185.00 $0.00 $90.00 $
Please Note:
  • Your Part B premium may differ based on factors including late enrollment, income, and disability status.

Additional Benefits

Wellcare Patriot Giveback (HMO-POS) also provides the following benefits.

Additional benefits and/or reduced cost-sharing for enrollees with certain health conditions?

    • In-Network: No

Comprehensive Dental

  • Adjunctive General Services
    • In-Network: No Coins – 0.00 Copay (Authorization Required)
    • Out-of-Network: 25% Coins – No Copay (Authorization Required)
  • Endodontics
    • In-Network: No Coins – 0.00 Copay (Authorization Required)
    • Out-of-Network: 25% Coins – No Copay (Authorization Required)
  • Oral and Maxillofacial Surgery
    • In-Network: No Coins – 0.00 Copay (Authorization Required)
    • Out-of-Network: 25% Coins – No Copay (Authorization Required)
  • Periodontics
    • In-Network: No Coins – 0.00 Copay (Authorization Required)
    • Out-of-Network: 25% Coins – No Copay (Authorization Required)
  • Prosthodontics, fixed
    • In-Network: No Coins – 0.00 Copay (Authorization Required)
    • Out-of-Network: 25% Coins – No Copay (Authorization Required)
  • Prosthodontics, removable
    • In-Network: No Coins – 0.00 Copay (Authorization Required)
    • Out-of-Network: 25% Coins – No Copay (Authorization Required)
  • Restorative Services
    • In-Network: No Coins – 0.00 Copay (Authorization Required)
    • Out-of-Network: 25% Coins – No Copay (Authorization Required)

Diagnostic and Preventive Dental

  • Dental X-Rays
    • In-Network: No Coins – 0.00 Copay (Authorization Required)
    • Out-of-Network: 25% Coins – No Copay (Authorization Required)
  • Fluoride Treatment
    • In-Network: No Coins – 0.00 Copay (Authorization Required)
    • Out-of-Network: 25% Coins – No Copay (Authorization Required)
  • Oral Exams
    • In-Network: No Coins – 0.00 Copay (Authorization Required)
    • Out-of-Network: 25% Coins – No Copay (Authorization Required)
  • Other Diagnostic Dental Services
    • In-Network: No Coins – 0.00 Copay (Authorization Required)
    • Out-of-Network: 25% Coins – No Copay (Authorization Required)
  • Other Preventive Dental Services
    • In-Network: No Coins – 0.00 Copay (Authorization Required)
    • Out-of-Network: 25% Coins – No Copay (Authorization Required)
  • Prophylaxis (cleaning)
    • In-Network: No Coins – 0.00 Copay (Authorization Required)
    • Out-of-Network: 25% Coins – No Copay (Authorization Required)

Diagnostic procedures/lab services/imaging

  • Outpatient x-rays
    • In-Network: $25 copay (Authorization Required)
  • Lab services
    • In-Network: $0-50 copay (Authorization Required)
  • Diagnostic radiology services (e.g., MRI)
    • In-Network: $0-200 copay (Authorization Required)
  • Diagnostic tests and procedures
    • In-Network: $0-20 copay (Authorization Required)

Doctor visits

  • Primary
    • In-Network: $0 copay
  • Specialist
    • In-Network: $25 copay per visit (Authorization Required)

Emergency care/Urgent care

  • Emergency
    • $125 copay per visit (always covered)
  • Urgent care
    • $35 copay per visit (always covered)

Foot care (podiatry services)

  • Foot exams and treatment
    • In-Network: $25 copay (Authorization Required)
  • Routine foot care
    • Not covered

Ground ambulance

    • In-Network: $200 copay

Health plan deductible

    • $225 In-network

Hearing

  • Hearing aids OTC
    • Not covered
  • Fitting/evaluation
    • In-Network: $0 copay (Limits Apply, Authorization Required)
  • Hearing aids
    • In-Network: $0 copay (Limits Apply, Authorization Required)
  • Medicare-Covered Hearing Exam
    • In-Network: $25 copay (Authorization Required)

Inpatient hospital coverage

    • In-Network: $350 per day for days 1 through 5
      $0 per day for days 6 through 90 (Authorization Required)
    • Out-of-Network: Not Applicable (Authorization Required)

Maximum out-of-pocket enrollee responsibility (does not include prescription drugs)

    • $5,000 In-network

Medical equipment/supplies

  • Diabetes supplies
    • In-Network: $0 copay per item (Authorization Required)
  • Durable medical equipment (e.g., wheelchairs, oxygen)
    • In-Network: 20% coinsurance per item (Authorization Required)
  • Prosthetics (e.g., braces, artificial limbs)
    • In-Network: 20% coinsurance per item (Authorization Required)

Medicare Part B drugs

  • Chemotherapy
    • In-Network: 0-20% coinsurance (Authorization Required)
  • Other Part B drugs
    • In-Network: 0-20% coinsurance (Authorization Required)

Mental health services

  • Inpatient hospital – psychiatric
    • In-Network: $325 per day for days 1 through 4
      $0 per day for days 5 through 90 (Authorization Required)
  • Outpatient group therapy visit with a psychiatrist
    • In-Network: $0 copay (Authorization Required)
  • Inpatient hospital – psychiatric
    • Out-of-Network: Not Applicable (Authorization Required)
  • Outpatient group therapy visit
    • In-Network: $0 copay (Authorization Required)
  • Outpatient individual therapy visit
    • In-Network: $0 copay (Authorization Required)
  • Outpatient individual therapy visit with a psychiatrist
    • In-Network: $0 copay (Authorization Required)

Optional supplemental benefits

    • No

Other health plan deductibles?

    • In-Network: No

Outpatient hospital coverage

    • In-Network: $0-200 copay per visit (Authorization Required)

Preventive care

    • In-Network: $0 copay

Rehabilitation services

  • Occupational therapy visit
    • In-Network: $25 copay (Authorization Required)
  • Physical therapy and speech and language therapy visit
    • In-Network: $25 copay (Authorization Required)

Skilled Nursing Facility

    • Out-of-Network: Not Applicable (Authorization Required)
    • In-Network: $0 per day for days 1 through 20
      $214 per day for days 21 through 50
      $0 per day for days 51 through 100 (Authorization Required)

Transportation

    • Not covered

Vision

  • Contact lenses
    • In-Network: $0 copay (Limits Apply, Authorization Required)
  • Eyeglass frames
    • In-Network: $0 copay (Limits Apply, Authorization Required)
  • Eyeglasses (frames and lenses)
    • In-Network: $0 copay (Limits Apply, Authorization Required)
  • Other
    • Not covered
  • Routine eye exam
    • In-Network: $0 copay (Limits Apply, Authorization Required)
  • Eyeglass lenses
    • In-Network: $0 copay (Limits Apply, Authorization Required)
  • Upgrades
    • In-Network: $0 copay (Limits Apply, Authorization Required)

Wellness programs (e.g., fitness, nursing hotline)

    • Covered

Ready to sign up for Wellcare Patriot Giveback (HMO-POS) ?

Get help from a licensed insurance agent.

Call 1-877-354-4611 / TTY 711.

M-F: 8:00 am – 10:00 pm EST

Sat-Sun: 8:00 am – 9:00 pm EST

Need more information on Wellcare Patriot Giveback (HMO-POS)? See 2025 Wellcare Patriot Giveback (HMO-POS) at MedicareAdvantageRX.com.

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Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross Blue Shield, Anthem Blue Cross, Aspire Health Plan, Capital Blue Cross, Cigna Healthcare, Dean Health Plan, Devoted Health, Florida Blue Medicare, GlobalHealth, Health Care Service Corporation, Healthy Blue, Humana, Molina Healthcare, Mutual of Omaha, Premera Blue Cross, Medica Central Health Plan, SCAN Health Plan, Baylor Scott & White Health Plan, Simply, UnitedHealthcare(R), Wellcare, WellPoint

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