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Wellcare Giveback (HMO-POS)

Wellcare
by Wellcare
2026 Medicare Advantage plan available in Michigan
Plan ID H5475-031-0
Additional coverage:
RxHearingVisionDental
Medicare Advantage HMO $0 premium 3.0 Overall
Monthly plan premium $0 / mo
Annual deductible $400 / yr
Max out-of-pocket · in-network $7,550 / yr
Drug deductible $615 / yr
3.0 Overall Government Star Rating 2026 · out of 5 stars

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Plan Overview

Wellcare Giveback (HMO-POS) is a Medicare Advantage Plan With Part D Prescription Drug Coverage, which is available in Michigan and offered by the health insurance company Wellcare. This plan's network type is HMO, which determines the in-network doctors who accept the plan and whether a referral is needed.

Plan Name Wellcare Giveback (HMO-POS)
Insurance Carrier Wellcare
Plan Type Medicare Advantage Plan With Part D Prescription Drug Coverage
Network Type HMO

Cost Summary

Wellcare Giveback (HMO-POS) has a monthly premium cost of $0 per month, with an annual deductible of $400 In-network and a maximum out-of-pocket cost sharing of $7,550. The most common costs people evaluate when choosing a plan are listed here; a full list of benefit costs is defined below.

Monthly Premium $0 / mo
Health portion of premium $0
Drug portion of premium $0
Annual Deductible $400 In-network / yr
Max Out-of-Pocket · in-network $7,550 / yr
Primary doctor visit $0 copay
Specialist visit 20% coinsurance
ER visit $115 copay
Ambulance 20% coinsurance

Additional Benefits and Coverage

Wellcare Giveback (HMO-POS) is a Medicare Advantage plan which includes Medicare Part D prescription drug coverage. Other common benefits included with Medicare Advantage plans are coverage for dental, vision, and hearing. Wellcare Giveback (HMO-POS) includes coverage for hearing, vision, dental.

Part D Prescription Drug Coverage Yes
Dental Yes
Vision Yes
Hearing Yes
Nationwide Coverage No

Other benefits

Fitness benefit Limited coverage
Over-the-counter drug benefits Not covered
In-home support services Not covered
Home & bathroom safety devices Not covered
Meals for short duration Not covered
Annual physical exams Limited coverage
Telehealth Limited coverage

Medical Benefits

Doctor Services

Primary doctor visit In-network: $0 copay
Out-of-network: $0 copay
Specialist visit In-network: 20% coinsurance
Out-of-network: 20% coinsurance

Tests, labs & imaging

Diagnostic tests & procedures In-network: $0-$100 copay
Out-of-network: $0-$100 copay
Lab services In-network: $0-$50 copay
Out-of-network: $0-$50 copay
Diagnostic radiology services (like MRI) In-network: $0 copay
Out-of-network: $0 copay
Outpatient x-rays In-network: $25 copay
Out-of-network: $25 copay
Emergency care $115 copay
Urgent care $40 copay

Hospital Services

Inpatient hospital coverage In-network:
  Tier 1
  $375 per day for days 1-7
  $0 per day for days 8-90
  $0 per stay
Outpatient hospital coverage In-network: $0 copay
Out-of-network: $0 copay

Skilled nursing facility

Skilled nursing facility In-network:
  Tier 1
  $0 per day for days 1-20
  $218 per day for days 21-60
  $0 per day for days 61-100
Out-of-network:
  $ per stay

Preventive services

Preventive services In-network: $0 copay
Out-of-network: $0 copay

Ambulance

Ground ambulance In-network: 20% coinsurance
Out-of-network: 20% coinsurance

Therapy services

Occupational therapy visit In-network: 20% coinsurance
Out-of-network: 20% coinsurance
Physical therapy & speech & language therapy visit In-network: 20% coinsurance
Out-of-network: 20% coinsurance

Mental health services

Outpatient group therapy with a psychiatrist In-network: 20% coinsurance
Out-of-network: 20% coinsurance
Outpatient individual therapy with a psychiatrist In-network: 20% coinsurance
Out-of-network: 20% coinsurance
Outpatient group therapy visit In-network: 20% coinsurance
Out-of-network: 20% coinsurance
Outpatient individual therapy visit In-network: 20% coinsurance
Out-of-network: 20% coinsurance

Opioid treatment services

Opioid treatment services Covered

Other services

Durable medical equipment (like wheelchairs & oxygen) In-network: 20% coinsurance
Out-of-network: 20% coinsurance
Prosthetics (like braces, artificial limbs) In-network: 20% coinsurance
Out-of-network: 20% coinsurance
Diabetes supplies In-network: $0 copay
Out-of-network: $0 copay

Prescription drugs (Part D benefits)

Drug tier standard retail · 1-month supply Initial coverage Catastrophic
Preferred Generic $5.00 copay $0 copay
Generic $10.00 copay $0 copay
Preferred Brand 25% coinsurance $0 copay
Non-Preferred Drug 36% coinsurance $0 copay
Specialty Tier 25% coinsurance $0 copay

Part B drugs

Chemotherapy drugs In-network: 0%-20% coinsurance
Out-of-network: 0%-20% coinsurance
Other Part B drugs In-network: 0%-20% coinsurance
Out-of-network: 0%-20% coinsurance

Medicare star rating

Each year the federal government rates Medicare Advantage and Part D plans on a 5-star system covering quality of care, chronic-condition management, member experience, and customer service. For 2026, Wellcare Giveback (HMO-POS) earned an overall rating of 3.0 stars — worse than Michigan's state average of 3.9 stars.

Rating category This plan State average
Overall star rating ★ 3.0 3.9
Health plan quality
Summary rating of health plan quality ★ 3.0 4.0
Staying healthy: screenings, tests & vaccines ★ 2.0 3.7
Managing chronic (long-term) conditions ★ 3.0 3.4
Member experience with health plan ★ 2.0 3.9
Member complaints & changes in performance ★ 3.0 4.1
Health plan customer service ★ 4.0 4.1
Drug plan quality
Summary rating of drug plan quality ★ 3.0 3.7
Drug plan customer service ★ 5.0 4.4
Member complaints & changes in performance ★ 3.0 3.8
Member experience with the drug plan 3.8
Drug safety & accuracy of drug pricing ★ 3.0 3.7

Extra Benefits

Hearing

Hearing exam In-network: $0 copay
Out-of-network: $0 copay
Fitting/evaluation In-network: $0 copay
Out-of-network: $0 copay
Hearing aids - prescription Not covered
Hearing aids - over the counter Not covered

Preventive dental

Oral exam In-network: $0 copay
Out-of-network: 25% coinsurance
Cleaning In-network: $0 copay
Out-of-network: 25% coinsurance
Fluoride treatment In-network: $0 copay
Out-of-network: 25% coinsurance
Dental x-rays In-network: $0 copay
Out-of-network: 25% coinsurance

Comprehensive dental

Restorative services Not covered
Endodontics Not covered
Periodontics Not covered
Prosthodontics, removable Not covered
Prosthodontics, fixed Not covered
Maxillofacial prosthetics Not covered
Implant services Not covered
Oral and maxillofacial surgery Not covered
Orthodontics Not covered
Adjunctive general services In-network: $0 copay
Out-of-network: 25% coinsurance

Vision

Routine eye exam In-network: $0 copay
Out-of-network: $0 copay
Contact lenses In-network: $0 copay
Out-of-network: $0 copay
Eyeglasses (frames & lenses) In-network: $0 copay
Out-of-network: $0 copay
Eyeglass frames (only) In-network: $0 copay
Out-of-network: $0 copay
Eyeglass lenses (only) In-network: $0 copay
Out-of-network: $0 copay
Upgrades In-network: $0 copay
Out-of-network: $0 copay

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