Wellcare Patriot Giveback Open (PPO) Medicare Advantage Plan H9387-002 • 2026 • Marion County, KS
CMS Plan ID H9387-002 identifies the Medicare Advantage plan Wellcare Patriot Giveback Open, a PPO Part C plan offered by Wellcare By Allwell for the 2026 plan year. This plan uses a Preferred Provider Organization (PPO) provider network and comes without Part D prescription drug coverage.
Wellcare Patriot Giveback Open Overview
Plan Overview for
H9387-002-0
|
|
|---|---|
| CMS Plan ID: |
H9387-002-0
|
| Plan Type: | PPO |
| Plan Year: | 2026 |
| Monthly Premium: |
$0.00
Plus your Medicare Part B premium. |
| Medical Deductible: | $0.00 |
| Maximum Out-of-Pocket: | $5400.00 (In-Network) |
| Part B Give Back: | −$105.00 reduction |
| Prescription Drug Coverage: | Not Included |
| Additional Benefits: | Dental, Vision, Hearing |
| Service Area: | Marion County, KS |
| Enrollment (Nationwide): | 67 beneficiaries |
| Enrollment (CMS – Local) | 0 beneficiaries in Marion County |
| Provided By: | Wellcare By Allwell |
Plan Overview for Wellcare Patriot Giveback Open
This Medicare Advantage PPO plan covers Medicare Part A and Part B services and allows access to Medicare-approved providers. The monthly premium is $0.00, with lower costs when using in-network providers.
Primary care visits have a $0 copay | Out-of-network: $40 copay, specialist visits come with a $35 copay | Out-of-network: $75 copay, urgent care services carry a $35 copay, and ambulance transportation is $290 copay | Out-of-network: $290 copay. These costs apply toward the plan’s annual maximum out-of-pocket (MOOP) limit of $5400.00. After this limit is reached, in-network services are fully covered for the remainder of the year.
This plan is listed by CMS under Plan ID H9387-002. Cost-sharing details for key services are provided below.
Cost Sharing Expenses
Wellcare Patriot Giveback Open has cost-sharing, meaning there are out-of-pocket costs when receiving covered healthcare services. The table below details the most common in-network out-of-pocket expenses for plan H9387-002.
Certain preventive services are covered 100% by Wellcare Patriot Giveback Open as a Part B benefit.
Prescription Drug Coverage
This plan does not include a Medicare Part D plan for prescriptions.
CMS Star Ratings
The Centers for Medicare & Medicaid Services (CMS) rates Medicare Advantage (Part C) and Part D prescription drug plans each year using a 5-star system. These ratings measure plan performance in areas such as preventive care, management of chronic conditions, and member experience.
| CMS Measure | Star Rating |
|---|---|
| 2026 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 |
How much does plan H9387-002 cost per month?
The plan’s monthly premium is $0.00 for 2026. The Part B premium is not included.
What is the MOOP for Wellcare Patriot Giveback Open in 2026?
The 2026 in-network MOOP is $5400.00. Once this limit is reached, covered in-network costs are fully covered.
How many beneficiaries are enrolled in this plan?
CMS reports 67 beneficiaries enrolled in this plan.
What is the prescription drug deductible for 2026?
For 2026, the prescription drug deductible is $0.00.
Contact Information for Wellcare By Allwell
| Contact Type | Details |
|---|---|
| Website: | Wellcare By Allwell Plan Page |
| New Members: | 1-844-480-0680 |
| Existing Members: | 1-800-977-7522 |
| Plan Address: | PO Box 10420 | Van Nuys, CA 91410 |
Enrollment status and eligibility information are available through the Social Security Administration. Additional information about Medicare Advantage is available at medicare.gov.
| Data Source | Publisher | Last Accessed |
|---|---|---|
| Landscape Source Files | Centers for Medicare & Medicaid Services | September 8, 2026 |
| Medicare Part C & D Performance | Centers for Medicare & Medicaid Services | September 8, 2026 |
| Plan Benefits Package | Centers for Medicare & Medicaid Services | September 8, 2026 |
| Monthly Enrollment by Contract/Plan/State/County | Centers for Medicare & Medicaid Services | September 8, 2026 |
Data sources and methodology documentation.
| Publisher | Reference | Last Accessed |
|---|---|---|
| Wellcare By Allwell (official source) | http://www.wellcare.com/allwellKS | October 13, 2025 |
| Medicare.gov | Understanding Medicare Advantage Plans | 25 May, 2025 |
| NCOA.org | 5 Steps to Choosing the Right Medicare Plan for You | 25 May, 2025 |
| Medicare.gov | Compare Original Medicare & Medicare Advantage | 25 May, 2025 |
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