Wellcare Giveback Open (PPO)

The Giveback Open PPO is a Medicare Advantage plan offered by Wellcare. It provides coverage for Medicare Part A, Part B and Part D. The Giveback Open PPO is not available in all areas, and costs may vary depending on where you live.

Terry Turner, writer and researcher for RetireGuide
  • Written by
    Terry Turner

    Terry Turner

    Senior Financial Writer and Financial Wellness Facilitator

    Terry Turner has more than 35 years of journalism experience, including covering benefits, spending and congressional action on federal programs such as Social Security and Medicare. He is a Certified Financial Wellness Facilitator through the National Wellness Institute and the Foundation for Financial Wellness and a member of the Association for Financial Counseling & Planning Education (AFCPE®).

    Read More
  • Edited By
    Lamia Chowdhury
    Lamia Chowdhury, editor for RetireGuide.com

    Lamia Chowdhury

    Financial Editor

    Lamia Chowdhury is a financial content editor for RetireGuide and has over three years of marketing experience in the finance industry. She has written copy for both digital and print pieces ranging from blogs, radio scripts and search ads to billboards, brochures, mailers and more.

    Read More
  • Published: September 9, 2022
  • Updated: January 17, 2023
  • 5 min read time
  • This page features 5 Cited Research Articles
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APA Turner, T. (2023, January 17). Wellcare Giveback Open (PPO). RetireGuide.com. Retrieved September 22, 2023, from https://www.retireguide.com/medicare/medicare-advantage-plans/compare/h2775-111/

MLA Turner, Terry. "Wellcare Giveback Open (PPO)." RetireGuide.com, 17 Jan 2023, https://www.retireguide.com/medicare/medicare-advantage-plans/compare/h2775-111/.

Chicago Turner, Terry. "Wellcare Giveback Open (PPO)." RetireGuide.com. Last modified January 17, 2023. https://www.retireguide.com/medicare/medicare-advantage-plans/compare/h2775-111/.

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Wellcare Give Back Open (PPO) CMS Star Ratings

Each year Medicare releases “Star Ratings” for Medicare Advantage plans and Medicare Part D prescription drug plans.

Plans are rated on a one-to-five scale — with one star representing poor performance and five stars representing excellent performance.

2022 Overall Rating - 4 Stars

Wellcare Giveback PPO Health Plan Rating

The Wellcare Giveback Open PPO received an overall rating of 3 1/2 stars for its health plan in 2022.

Health Plan Rating - 3 and a Half Stars

The rating was an average of 33 factors the plans beneficiaries rated through Medicare. Factors ranged from the quality of service, costs, coverage and other factors.

The plan received five-star ratings for getting appointments and care quickly, improvement in the plan’s performance and availability of TTY and foreign language interpretation when beneficiaries called the plan.

It got zero stars for assessment of beneficiaries’ health needs and risks, annual reviews of beneficiaries’ medications and supplements, and yearly pain screening or pain management plans.

Wellcare Giveback PPO Prescription Drug Plan Rating

The Wellcare Giveback Open PPO Medicare Part D prescription drug plan received an overall rating of four stars in 2022.

Prescription Drug Plan Rating - 4 Stars

The rating is an average of 16 factors beneficiaries rated through Medicare. Factors ranged from beneficiaries’ experience with the plan to prescription prices.

The drug plan scored five stars in seven of the 16 categories, including customer service, accuracy in pricing and access to a pharmacist to help them understand and manage their prescriptions.

Its lowest score was two stars for beneficiaries’ rating of the drug plan.

Costs and Coverage

Costs and coverage for the Wellcare Giveback PPO plan vary by location. You should check the costs in your zip code for out-of-pocket costs. As with all Medicare Advantage plans, you have to pay the Medicare Part B premium: $164.90 in 2023.

The term “Giveback” in the plan’s name refers to the amount of discount toward your Medicare Part B premium the plan pays you. It was around $75 for the plans reviewed.

Since it is a PPO, you will have to pay more if you use a doctor, hospital or other health care provider not in the plan’s network.

Example of In-Network Copay for Wellcare Giveback Open (PPO), 2022
DeductibleVaries by ZIP Code ($0 to $300)*
Medical Premiums$0
Drug Plan PremiumIncluded in monthly premium
Prescription PremiumsVaries by ZIP Code ($200 to $325 for Tiers 3, 4 & 5)*
Maximum Out-of-Pocket (in-network)$7,550
Source: Wellcare
*Comparison between plans offered in Albany, New York, and Bryson City, North Carolina
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Health Care Services and DME Coverage

The Wellcare Giveback Open PPO coverage for health care services and durable medical equipment covers everything that Original Medicare covers. It also includes additional services not covered by Original Medicare.

Costs and copays vary depending on your ZIP Code.

Examples of Services and DME Coverage*
Ambulance services$290$290
Ambulatory surgical center$25040%
Chiropractic services (Medicare-covered chiropractic services only)$2040%
Diabetes supplies$020%
Diagnostic tests, lab & radiology, and X-Rays$040%
Specialist visits$5040%
Durable medical equipment20%20%
Emergency care$90$90
Inpatient hospital care$370 copay per day for days 1-5 and $0 copay for days 6-9020% of cost for days 1-90
Renal dialysis20%20%
TransportationNot coveredNot covered
Source: Wellcare
*Based on plan offered in Albany, New York. Your costs could vary.

You should consider out-of-pocket costs for these types of services when you compare Medicare Advantage plans.

Dental, Vision and Hearing Benefits

The Wellcare Giveback Open PPO offers dental, vision and hearing services not offered through Original Medicare. Using out-of-network providers may result in substantially higher out-of-pocket costs. You should check with your plan before scheduling services.

Examples of Services and DME Coverage*
Dental services (comprehensive and preventative)Up to $500Up to $500 with a coinsurance payment of 50%
VisionRoutine eye exams and up to $100 for unlimited contacts, glasses, lenses and/or frames each yearRoutine eye exams and up to $100 with a 40% coinsurance for all services toward unlimited contacts, glasses, lenses and/or frames each year
Hearing ServicesFree annual exams, fittings, evaluation and up to $700 per year for a hearing aid (maximum of one hearing aid per ear each year).Annual exams, fittings and evaluation with a 40% coinsurance — and up to $700 per year for a hearing aid (maximum of one hearing aid per ear each year).
Source: Wellcare
*Based on plan offered in Albany, New York. Your costs could vary.

Prescription Drug Costs and Coverage

The Wellcare Giveback Open PPO plan includes a Part D prescription drug plan as part of your monthly premium. The annual deductible is $325 for 2022 and applies to drugs in Tiers 3, 4 and 5 of the plan.

Copays by Tier, Supply and Pharmacy, 2022
Tier1 Month Preferred Retail 3 Month Preferred Retail 1 Month Standard Retail3 Month Standard Retail1 Month Preferred Mail Order3 Month Preferred Mail Order1 Month Standard Mail Order3 Month Standard Mail Order
Tier 1 Preferred Generic$1$3$6$18$1$0$6$18
Tier 2 Generic $7$21$12$36$7$0$12$36
Tier 3 Preferred Brand Name$37$111$47$141$37$74$47$141
Tier 4 Non- Preferred Brand Name 48%48%50%50%48%48%50%50%
Tier 5 Specialty Drugs 27%N/A27%N/A27%N/A27%N/A
Tier 6 Select Care Drugs$0$0N/AN/A$0$0$0$0
Source: Wellcare
*Based on plan offered in Albany, New York. Your costs could vary.

Your share of the cost may vary based on your choice of pharmacy when you enter another phase of the Medicare Part D benefit. Beneficiaries receiving Extra Help assistance are not required to fill their prescriptions at in-network pharmacies in order to receive Low Income Subsidy copays.

Catastrophic coverage kicks in after your total out-of-pocket costs reach $7,050. At this point you pay either 5% of the drug’s cost or $3.95 for a generic or drug treated as a generic — or 5% or $9.85 for all other drugs. You will pay the greater amount in either case.

Last Modified: January 17, 2023

5 Cited Research Articles

  1. U.S. Centers for Medicare & Medicaid Services. (2022, September 27). 2023 Medicare Parts A and B Premiums and Deductibles 2023 Medicare Part D Income-Related Monthly Adjustment Amounts. Retrieved from https://www.cms.gov/newsroom/fact-sheets/2023-medicare-parts-b-premiums-and-deductibles-2023-medicare-part-d-income-related-monthly
  2. U.S. Centers for Medicare & Medicaid Services. (2022, April 29). CY 2023 Medicare Advantage and Part D Final Rule (CMS-4192-F). Retrieved from https://www.cms.gov/newsroom/fact-sheets/cy-2023-medicare-advantage-and-part-d-final-rule-cms-4192-f
  3. U.S. Centers for Medicare & Medicaid Services. (n.d.). Medicare Costs at a Glance. Retrieved from https://www.medicare.gov/basics/costs/medicare-costs
  4. U.S. Centers for Medicare & Medicaid Services. (n.d.). Your Medicare Costs. Retrieved from https://www.medicare.gov/basics/costs
  5. U.S. Centers for Medicare & Medicaid Services. (n.d.). 2022 Medicare Costs. Retrieved from https://www.medicare.gov/Pubs/pdf/11579-medicare-costs.pdf