Wellcare Patriot Giveback (HMO-POS)

South Carolina Medicare Advantage Plan (2024 Plan)


Monthly Premium

Your Cost
$0
by Wellcare

Additional Coverage

HearingVisionDental

Overall Government Star Rating

 3.0
out of 5 stars

Ready to Enroll Online?


Plan Name
Wellcare Patriot Giveback (HMO-POS)
Insurance Carrier
Wellcare
Plan Type
Medicare Advantage Plan Without Prescription Drugs
Network Type
HMO

Wellcare Patriot Giveback (HMO-POS) is a Medicare Advantage Plan Without Prescription Drugs, which is available in South Carolina and offered by the health insurance company Wellcare. This plan’s network type is HMO which determines in-network doctors who accept the health plan and whether a referral is needed.

Monthly Premium
$0
Annual Deductible
$0
Max Out-of-Pocket
$7,550
Primary doctor visit
$0 copay
Specialist visit
$40 copay per visit
ER visit
$100 copay per visit (always covered)
Ambulance
$290 copay

Wellcare Patriot Giveback (HMO-POS) has a monthly premium cost of $0 per month, with an annual deductible of $0 and a maximum out of pocket cost sharing of $7,550 In and Out-of-network $7,550 In-network $7,550 Out-of-network. The most common benefit costs which people evaluate when choosing a plan are costs for a primary doctor visit, specialist doctor visit, emergency room visit, and ambulance. These costs are listed in this summary section and a full list of benefit costs for Wellcare Patriot Giveback (HMO-POS) are defined below.

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

Wellcare Patriot Giveback (HMO-POS) is a Medicare Advantage plan which does not include Medicare Part D Prescription Drug coverage. Other common benefits included with Medicare Advantage plans are coverage for dental, vision, and hearing. Wellcare Patriot Giveback (HMO-POS) includes coverage for hearing, vision, dental.

Medicare Advantage health plans can offer even more additional benefits. Wellcare Patriot Giveback (HMO-POS) includes coverage for the following additional benefits:

Other benefits

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

Each year the federal government evaluates the quality of Medicare Advantage and Part D Prescription Drug plans based on a 5-star scoring system. For 2024, Wellcare Patriot Giveback (HMO-POS) received an overall government quality rating of 3.0 stars out of 5 stars.

Wellcare Patriot Giveback (HMO-POS) performed worse than South Carolina’s State average overall quality score of 3.8 stars.

This Plan’s 5-star Gov’t Quality Score
South Carolina State Average Score
Overall Government 5 Star Quality Rating
 3.0
 3.8
Summary rating of health plan quality
 3
 3.8
Staying healthy: screenings, tests, & vaccines
 3
 3.3
Managing chronic (long term) conditions
 2
 3.2
Member experience with health plan
 4
 3.9
Member complaints & changes in the health plan's performance
 2
 3.7
Health plan customer service
 3
 4.4

The government calculates an “Overall star rating” based on ratings for sub components including “Health plan star rating” and “Drug plan star rating”, which includes further subcomponents of each.

Wellcare Patriot Giveback (HMO-POS) received 3 stars for its health plan quality score which is worse than the South Carolina State average health plan quality score of 3.8 stars.


Monthly Premium
$0
Health Portion of Premium
$0
Drug Portion of Premium
$0
Health Plan Deductible
$0
Health Plan Max Out-of-Pocket
$7,550 In and Out-of-network
$7,550 In-network
$7,550 Out-of-network
Nationwide Coverage included
No
Hearing Coverage included
Yes
Vision Coverage included
Yes
Dental Coverage included
Yes
Doctor Lookup Link

Doctor Services

Primary doctor visit
In-network: $0 copay
Out-of-network: 30% coinsurance per visit
Specialist visit
In-network: $40 copay per visit
Out-of-network: 30% coinsurance per visit

Tests, labs, & imaging

Diagnostic tests & procedures
In-network: $0-100 copay
Out-of-network: 30% coinsurance
Lab services
In-network: $0-50 copay
Out-of-network: 30% coinsurance
Diagnostic radiology services (like MRI)
In-network: $0-300 copay
Out-of-network: 30% coinsurance
Outpatient x-rays
In-network: $0 copay
Out-of-network: 30% coinsurance
Emergency care
$100 copay per visit (always covered)
Urgent care
$35 copay per visit (always covered)

Hospital Services

Inpatient hospital coverage
In-network: $350 per day for days 1 through 5
$0 per day for days 6 through 90
Out-of-network: 30% per day for days 1 through 90
Outpatient hospital coverage
In-network: $0-400 copay per visit
Out-of-network: 30% coinsurance per visit

Skilled nursing facility

Skilled nursing facility
In-network: $0 per day for days 1 through 20
$203 per day for days 21 through 60
$0 per day for days 61 through 100
Out-of-network: 30% per day for days 1 through 100

Preventive services

Preventive services
In-network: $0 copay
Out-of-network: 30% coinsurance

Ambulance

Ground ambulance
In-network: $290 copay
Out-of-network: 30% coinsurance

Therapy services

Occupational therapy visit
In-network: $40 copay
Out-of-network: 30% coinsurance
Physical therapy & speech & language therapy visit
In-network: $40 copay
Out-of-network: 30% coinsurance

Mental health services

Outpatient group therapy with a psychiatrist
In-network: $25 copay
Out-of-network: 30% coinsurance
Outpatient individual therapy with a psychiatrist
In-network: $25 copay
Out-of-network: 30% coinsurance
Outpatient group therapy visit
In-network: $25 copay
Out-of-network: 30% coinsurance
Outpatient individual therapy visit
In-network: $25 copay
Out-of-network: 30% coinsurance

Opioid treatment services

Opioid treatment services
Covered

Other services

Durable medical equipment (like wheelchairs & oxygen)
In-network: 20% coinsurance per item
Out-of-network: 30% coinsurance per item
Prosthetics (like braces, artificial limbs)
In-network: 20% coinsurance per item
Out-of-network: 30% coinsurance per item
Diabetes supplies
In-network: $0 copay per item
Out-of-network: 30% coinsurance per item

Tier drug costs for: Standard retail pharmacy drug cost for 1-month

Part B Drugs

Chemotherapy drugs
In-network: 0-20% coinsurance
Out-of-network: $35 copay or 0-20% coinsurance
Other Part B drugs
In-network: 0-20% coinsurance
Out-of-network: $35 copay or 0-20% coinsurance

Hearing

Hearing exam
In-network: $40 copay
Out-of-network: 30% coinsurance
Fitting/evaluation
In-network: $0 copay
Out-of-network: No Data
Hearing aids - All types
In-network: $0 copay
Out-of-network: No Data

Preventive Dental

Oral exam
In-network: $0 copay
Out-of-network: No Data
Cleaning
In-network: $0 copay
Out-of-network: No Data
Fluoride treatment
In-network: $0 copay
Out-of-network: No Data
Dental x-rays
In-network: $0 copay
Out-of-network: No Data

Comprehensive dental

Non-routine services
In-network: 40% coinsurance
Out-of-network: No Data
Diagnostic services
In-network: 40% coinsurance
Out-of-network: No Data
Restorative services
In-network: 40% coinsurance
Out-of-network: No Data
Endodontics
In-network: 40% coinsurance
Out-of-network: No Data
Periodontics
In-network: 40% coinsurance
Out-of-network: No Data
Extractions
In-network: 40% coinsurance
Out-of-network: No Data
Prosthodontics, other oral/maxillofacial surgery, other services
In-network: 40% coinsurance
Out-of-network: No Data

Vision

Routine eye exam
In-network: $0 copay
Out-of-network: No Data
Contact lenses
In-network: $0 copay
Out-of-network: No Data
Eyeglasses (frames & lenses)
In-network: $0 copay
Out-of-network: No Data
Eyeglass frames (only)
In-network: $0 copay
Out-of-network: No Data
Eyeglass lenses (only)
In-network: $0 copay
Out-of-network: No Data
Upgrades
In-network: $0 copay
Out-of-network: No Data

When Can I Sign Up for Medicare?

Enter your birthday month and year to learn when you can sign up for different Medicare plan options.

 

 


Ready to Enroll Online?

Please Support Our Sponsor

Advertisement

Medicare Health Plans

Get Advice & Sign Up Help

TTY 711

Speak with a Licensed Insurance Agent

Mon-Fri: 8am - 11pm ET
Sat-Sun: 8am - 11pm ET

Medicare65quote

  • Medicare Advantage Plans
  • Medicare Prescription Drug Plans
  • Medicare Supplement Insurance Plans

No obligation to enroll. Find your plan online or speak with a licensed insurance agent to get help signing up for the right plan for you! See www.medicare65quote.com for our Third-Party Marketing Organization disclaimer.

Related Articles
Best South Carolina Medicare Advantage Health Insurance Companies for 2024

In this article we rank South Carolina Medicare Advantage plans based on our evaluation of government 5-star quality scores. Each year the government rates the quality of Medicare Advantage health insurance plans with a 5-star quality score. An overall quality score is assigned to each plan which is based on the scores of various quality metrics.

Read more →