Wellcare Patriot Giveback Open (PPO) 2024 Benefit Details for Plan H6348-005-0 by Wellcare by Allwell
Wellcare Patriot Giveback Open is a 2024 PPO Medicare Advantage plan {with_without_pdp} prescription drug plan benefits (Part D).
This Wellcare by Allwell option offers the same basic benefits as Original Medicare, but out-of-pocket costs are different. It may also include additional, valuable benefits not covered by Part A or Part B.
Plan Basics | |
---|---|
Plan ID: | H6348 005 0 |
Plan Type: | Local PPO |
Plan Year: | 2024 |
Premium: | $0.00/mo Plus your Medicare Part B premium. |
Health Plan Deductible: | $0.00 |
Out-of-Pocket Maximum: | $5,500/yr |
Part B Reduction: | $60.00/mo |
Drug Plan Benefit: | Not Included |
Rx Gap Coverage: | No |
Supplemental Benefits: | Vision, Hearing |
Availability: | See List |
Insured By: | Wellcare by Allwell |
Summary of Benefits |
---|
Health Plan Cost Sharing
This Wellcare by Allwell Medicare Advantage plan has cost-sharing. These are costs you must pay out-of-pocket when you use approved health services.
NOTE: Most preventive services are covered 100% by the plan as a Part B benefit.
The following table summarizes the most common out-of-pocket costs you will incur if you join this plan unless you go out-of-network:
Healthcare Service | Member Cost |
---|---|
Doctor Visits (In-Network) | |
Primary: | $5 Copay |
Specialist: | $40 Copay Authorization Required |
Wellness programs (e.g., fitness, nursing hotline): | None |
Preventive care: | $0 Copay |
Foot Care (In-Network) | |
Foot exams and treatment (Medicare-covered): | $40 Copay Authorization Required |
Routine foot care: | Not Covered |
Chiropractic Care (In-Network) | |
Medicare-covered chiropractic care: | $20 Copay Authorization Required |
Routine chiropractic care: | Not Covered |
Emergency Care / Urgent Care | |
Emergency room care: | $120 Copay |
Urgent care: | $40 Copay |
Ground ambulance: | $290 Copay |
Inpatient hospital coverage: | $400.00 per day for days 1 through 5 $0.00 per day for days 6 and beyond |
Outpatient hospital coverage: | $250 Copay Authorization Required |
Skilled Nursing Facility: | $0.00 per day for days 1 through 20 $203.00 per day for days 21 through 50 $0.00 per day for days 51 and beyond |
Optional supplemental benefits: | |
Mental Health Services (In-Network) | |
Outpatient individual therapy visit with a psychiatrist: | $25 Copay |
Outpatient group therapy visit with a psychiatrist: | $25 Copay |
Inpatient hospital - psychiatric: | $350.00 per day for days 1 through 5 $0.00 per day for days 6 and beyond |
Outpatient group therapy visit: | $25 Copay |
Outpatient individual therapy visit: | $0 |
Rehabilitation Services (In-Network) | |
Physical therapy and speech and language therapy visit: | $40 Copay Authorization Required |
Occupational therapy visit: | $40 Copay Authorization Required |
Medical Equipment / Supplies (In-Network) | |
Diabetes supplies: | $0 Copay Authorization Required |
Durable medical equipment (e.g., wheelchairs, oxygen): | 20% Coinsurance Authorization Required |
Prosthetics (e.g., braces, artificial limbs): | 20% Coinsurance |
Diagnostic Procedures / Lab Services / Imaging (In-Network) | |
Diagnostic radiology services (e.g., MRI): | $350 Copay Authorization Required |
Lab services: | $50 Copay Authorization Required |
Outpatient x-rays: | $0 Copay Authorization Required |
Diagnostic tests and procedures: | $100 Copay Authorization Required |
Medicare Part B Drugs (In-Network) | |
Chemotherapy: | 20% Coinsurance |
Other Part B drugs (Medicare-covered) | 20% Coinsurance |
Feel free to download our Wellcare Patriot Giveback Open Summary of Benefits information.
Supplemental Benefits
The following is a summary of the supplemental benefits Wellcare by Allwell includes with this plan:
Supplemental Healthcare Service | Member Cost |
---|---|
Preventive Dental | |
Oral exam (In-Network) | Not Covered |
Fluoride treatment (In-Network) | Not Covered |
Dental x-ray(s) (In-Network) | Not Covered |
Cleaning (In-Network) | Not Covered |
Comprehensive Dental | |
Periodontics (In-Network) | Not Covered |
Non-routine services (In-Network) | Not Covered |
Diagnostic services (In-Network) | Not Covered |
Extractions (In-Network) | Not Covered |
Endodontics (In-Network) | Not Covered |
Restorative services (In-Network) | Not Covered |
Prosthodontics, other oral/maxillofacial surgery, other services (In-Network) | Not Covered |
Hearing Aids | |
Fitting/evaluation (In-Network) | $0 Copay Authorization Required |
Hearing aids (In-Network) | Covered Limits may apply |
Hearing exam (In-Network) | $0 Copay Authorization Required |
Vision | Maximum vision benefit: | $200.00 Every year |
Eyeglasses (frames and lenses) (In-Network) | $0 Copay |
Routine eye exam (In-Network) | $0 Copay Authorization Required |
Contact lenses (In-Network) | $0 Copay |
Additional Benefits
None specified.
Prescription Drug Plan Costs & Benefits
This plan does not include a Medicare Part D plan for prescriptions.
CMS Rating Marks for 2024
The following table shows the quality ratings for this Wellcare by Allwell plan. Each year CMS rates health plans (Part C) in five broad categories and drug plans (Part D) in four broad categories based on a 5-star rating system. Here are the most recent ratings for Wellcare Patriot Giveback Open.
CMS Measure | Star Rating |
---|---|
2024 Overall Rating | |
Staying Healthy: Screenings, Tests, Vaccines | |
Managing Chronic (Long Term) Conditions | |
Member Experience with Health Plan | |
Complaints and Changes in Plans Performance | |
Health Plan Customer Service | Not enough data available |
Drug Plan Customer Service | |
Complaints and Changes in the Drug Plan | |
Member Experience with the Drug Plan | |
Drug Safety and Accuracy of Drug Pricing |
Think twice before joining this sub-par Medicare Advantage plan. If you're looking for a Medicare Advantage plan that prioritizes preventive health (i.e., screenings, tests, vaccines, etc.), you may be disapointed with Wellcare Patriot Giveback Open because the plan's score is below average. This plan is below average at managing chronic (long-term) health conditions.
The member experience with this Wellcare by Allwell plan is average. Complaints and changes in performance with this plan are average.
Wellcare Patriot Giveback Open offers some vision and hearing benefits, but not dental.
With no additional monthly premium, this plan can save you money if you're healthy. If you're looking for all the savings you can get, this Local PPO plan has a Part B reduction benefit, often called a giveback, of $60.00 per month. Potential members should carefully factor in the maximum out-of-pocket limit of $5,500 per year. In most cases, a plan limit this high will cost members more than Original Medicare for a 5-day hospital stay. Even though members have copays with this health plan, they don't have to worry about a deductible.
Plan Availability
Wellcare Patriot Giveback Open (H6348-005-0) is available in the following locations (click to open):
Additional Medicare Advantage Plan Options
The Medicare Advantage program offers a myriad of options, including these plans:
- H6348-007-0: Wellcare Low Premium Open (PPO)
- H6348-005-0: Wellcare Patriot Giveback Open (PPO)
- H6348-002-0: Wellcare No Premium Open (PPO)
Contact Wellcare by Allwell
Plan Website: | http://www.wellcare.com/allwellIN |
---|---|
Formulary Information: | http://www.wellcare.com/allwellIN |
Pharmacy Information: | Wellcare by Allwell Pharmacy Page |
Prospective Members: | (844)917-0175 |
TTY Users: | 711 |
If you qualify for Medicare benefits but have not yet enrolled or verified your enrollment status, you can do so on the Social Security Administration website. You can learn more about the Medicare Advantage program on www.medicare.gov.
Plans Offered
Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross Blue Shield, Aspire Health Plan, Dean Health Plan, Devoted Health, GlobalHealth, Health Care Service Corporation, Cigna Healthcare, Humana, Molina Healthcare, Mutual of Omaha, Premera Blue Cross, Medica Central Health Plan, SCAN Health Plan, Scott and White Health Plan now part of Baylor Scott & White Health, UnitedHealthcare(R), and Wellcare.
Citations & References
- Wellcare by Allwell, http://www.wellcare.com/allwellIN, Last Accessed February 20, 2024
- Medicare.gov, "Understanding Medicare Advantage Plans", Last Accessed January 21, 2024
- Medicare.gov, "Compare Original Medicare & Medicare Advantage", Last Accessed February 19, 2024
- Medicare.gov, "Medicare & You in Different Formats", Last Accessed February 19, 2024
- Medicare.gov, "Is Your Test, Item, or Service Covered?", Last Accessed June 3, 2023
- CMS.gov, Landscape Source Files, Last Accessed February 21, 2024
- CMS.gov, Medicare Part C & D Performance, Last Accessed February 21, 2024
- CMS.gov, Plan Benefits Package, Last Accessed February 21, 2024
About This H6348-005-0 Plan Detail Page
The data on this Wellcare Patriot Giveback Open plan detail page is derived from the 2024 Landscape Source Files, Plan Benefit Package, and Medicare Part C and Part D Performance Data published by CMS.
The author interprets these files, and their associated data dictionary, with great care, making every attempt to communicate the data submitted by Wellcare by Allwell to CMS as clearly and accurately as possible. Given the complexity of the data, the author recommends that all potential enrollees request an official Summary of Benefits from Wellcare by Allwell, at (844)917-0175, prior to enrollment.