Wellcare Patriot Giveback Open (PPO)
Medicare Advantage Plan H7518-002 • 2026 • Phelps County, MO
Wellcare Patriot Giveback Open (PPO) Medicare Advantage Plan H7518-002 • 2026 • Phelps County, MO
CMS Plan ID H7518-002 identifies the Medicare Advantage plan Wellcare Patriot Giveback Open, a PPO Part C plan offered by Wellcare 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 H7518-002-0 |
|
|---|---|
| CMS Plan ID: | H7518-002-0 |
| Plan Type: | PPO |
| Plan Year: | 2026 |
| Monthly Premium: | $0.00 Plus your Medicare Part B premium. |
| Medical Deductible: | $0.00 |
| Maximum Out-of-Pocket: | $4000.00 (In-Network) |
| Part B Give Back: | −$165.00 reduction |
| Prescription Drug Coverage: | Not Included |
| Additional Benefits: | Dental, Vision, Hearing |
| Service Area: | Phelps County, MO |
| Enrollment (Nationwide) | 1,368 beneficiaries |
| Enrollment (CMS – Local) | 23 beneficiaries in Phelps County |
| Provided By: | Wellcare |
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: $35 copay, specialist visits come with a $10 copay | Out-of-network: $70 copay, lab services cost {lab_services_cost}, urgent care services carry a $30 copay, and ambulance transportation is $250 copay | Out-of-network: $250 copay. These costs apply toward the plan’s annual maximum out-of-pocket (MOOP) limit of $4000.00. 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 {title_plan_id}. 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 H7518-002.
This section outlines in-network costs for primary care and specialist office visits, along with related preventive services.
| Covered Service | In-Network Cost |
|---|---|
| Primary: | In-network: $0 copay | Out-of-network: $35 copay |
| Specialist: | In-network: $10 copay | Out-of-network: $70 copay |
This section outlines in-network costs for preventive and wellness services included in the plan.
| Covered Service | In-Network Cost |
|---|---|
| Annual wellness exam: | In-network: $0 copay |
| Telehealth benefit: | In-network: $0-$30 copay |
| Routine chiropractic: | In-network: $10 copay | Out-of-network: 40% coinsurance |
| Fitness benefits: | In-network: $0 copay | Out-of-network: $0 copay |
| Health education: | Not covered |
| Counseling services: | Not covered |
| Over-the-counter drug benefits: | In-network: $0 copay | Out-of-network: $0 copay |
| Health transportation (non-emergency): | In-network: $0 copay | Out-of-network: 75% coinsurance |
This section outlines in-network costs for diagnostic services, lab tests, x-rays, and other imaging services.
| Covered Service | In-Network Cost |
|---|---|
| Diagnostic radiology services: | In-network: $0-$200 copay | Out-of-network: 40% coinsurance |
| Lab services: | In-network: $0-$50 copay | Out-of-network: 40% coinsurance |
| Outpatient x-rays: | In-network: $20 copay | Out-of-network: 40% coinsurance |
| Diagnostic tests and procedures: | In-network: $0-$50 copay | Out-of-network: 40% coinsurance |
This section outlines in-network costs for emergency services, urgent care, ambulance transportation, inpatient hospital stays, and skilled nursing facility care.
| Covered Service | In-Network Cost |
|---|---|
| Emergency room care: | $150 copay |
| Worldwide emergency care: | $150 copay |
| Urgent care: | $30 copay |
| Inpatient hospital care: | In-network: | Tier 1 | $325 per day for days 1-5 | $0 per day for days 6-90 | $0 per stay | Out-of-network: | 30% per day for days 1-90 | 0% per stay |
| Skilled Nursing Facility: | In-network: | Tier 1 | $0 per day for days 1-20 | $218 per day for days 21-40 | $0 per day for days 41-100 | Out-of-network: | 30% per day for days 1-100 | 0% per stay |
| Ground ambulance: | In-network: $250 copay | Out-of-network: $250 copay |
This section outlines in-network costs for mental health services, including outpatient therapy and inpatient psychiatric care.
| Covered Service | In-Network Cost |
|---|---|
| Outpatient individual therapy: | In-network: $0 copay | Out-of-network: 40% coinsurance |
| Outpatient group therapy: | In-network: $0 copay | Out-of-network: 40% coinsurance |
| Inpatient psychiatric hospital care: | In-network: | Tier 1 | $325 per day for days 1-5 | $0 per day for days 6-90 | $0 per stay | Out-of-network: | 30% per day for days 1-90 | 0% per stay |
This section outlines in-network costs for rehabilitation services, including physical therapy, speech and language therapy, and occupational therapy.
| Covered Service | In-Network Cost |
|---|---|
| Physical therapy and speech and language therapy: | In-network: $25 copay | Out-of-network: 40% coinsurance |
| Occupational therapy: | In-network: $25 copay | Out-of-network: 40% coinsurance |
This section outlines in-network costs for medical equipment and supplies, including diabetes supplies, durable medical equipment, and prosthetics.
| Covered Service | In-Network Cost |
|---|---|
| Diabetes supplies: | In-network: $0 copay | Out-of-network: 40% coinsurance |
| Durable medical equipment: | In-network: 20% coinsurance | Out-of-network: 40% coinsurance |
| Prosthetics: | In-network: 20% coinsurance | Out-of-network: 40% coinsurance |
This section outlines in-network cost sharing for chemotherapy and other Medicare Part B-covered drugs.
| Covered Service | In-Network Cost |
|---|---|
| Chemotherapy: | In-network: 0%-20% coinsurance | Out-of-network: 0%-40% coinsurance |
| Other Part B drugs (Medicare-covered): | In-network: 0%-20% coinsurance | Out-of-network: 0%-40% coinsurance |
This section outlines in-network cost sharing for dental services, including preventive care, exams, x-rays, cleanings, and comprehensive dental procedures.
| Covered Service | In-Network Cost |
|---|---|
| Oral exam: | In-network: $0 copay | Out-of-network: 50% coinsurance |
| Dental x-rays: | In-network: $0 copay | Out-of-network: 50% coinsurance |
| Cleaning: | In-network: $0 copay | Out-of-network: 50% coinsurance |
| Periodontics: | In-network: $0 copay | Out-of-network: 50% coinsurance |
| Endodontics: | In-network: $0 copay | Out-of-network: 50% coinsurance |
| Restorative services: | In-network: $0 copay | Out-of-network: 50% coinsurance |
| Implant services: | Not covered |
| Orthodontics: | Not covered |
| Oral/Maxillofacial surgery: | In-network: $0 copay | Out-of-network: 50% coinsurance |
This section outlines in-network cost sharing for vision services, including eye exams, eyeglasses, and contact lenses.
| Covered Service | In-Network Cost |
|---|---|
| Routine eye exam: | In-network: $0 copay | Out-of-network: 40% coinsurance |
| Contact lenses: | In-network: $0 copay | Out-of-network: 40% coinsurance |
| Eyeglass frames only: | In-network: $0 copay | Out-of-network: 40% coinsurance |
| Eyeglass lenses only: | In-network: $0 copay | Out-of-network: 40% coinsurance |
| Eyeglasses (frames & lenses): | In-network: $0 copay | Out-of-network: 40% coinsurance |
| Upgrades: | In-network: $0 copay | Out-of-network: 40% coinsurance |
This section outlines in-network cost sharing for hearing-related services, including exams, fittings, and hearing aids.
| Covered Service | In-Network Cost |
|---|---|
| Hearing exam: | In-network: $0 copay | Out-of-network: 40% coinsurance |
| Fitting/evaluation: | In-network: $0 copay | Out-of-network: 40% coinsurance |
| Prescription hearing aids: | In-network: $0 copay | Out-of-network: 40% coinsurance |
| OTC hearing aids: | Not covered |
This section outlines in-network cost sharing for additional and special needs services that may be included in the plan.
| Covered Service | In-Network Cost |
|---|---|
| Adult day health services: | Not covered |
| Home-based palliative care: | Not covered |
| Personal emergency response system: | In-network: $0 copay | Out-of-network: $0 copay |
| Weight management programs: | Not covered |
| Wigs for chemotherapy-related hair loss: | Not covered |
| Alternative therapies: | In-network: $0 copay | Out-of-network: $0 copay |
| Massage therapy: | Not covered |
| Home/bathroom safety devices: | Not covered |
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 | Not enough data available |
| Complaints and Changes in the Drug Plan | |
| Member Experience with the Drug Plan | Not enough data available |
| Drug Safety and Accuracy of Drug Pricing |
How much does plan H7518-002 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 $4000.00. Once this limit is reached, covered in-network costs are fully covered.
How many beneficiaries are enrolled in this plan?
CMS reports 1,368 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
| Contact Type | Details |
|---|---|
| Website: | Wellcare Plan Page |
| New Members: | 1-844-480-0680 |
| Existing Members: | 1-833-444-9088 |
| Plan Address: | PO Box 31392 | Tampa, FL 33631 |
Enrollment status and eligibility information are available through the Social Security Administration. Additional information about Medicare Advantage is available at medicare.gov.
- CMS.gov, Landscape Source Files — Last accessed May 2, 2026
- CMS.gov, Medicare Part C & D Performance — Last accessed May 2, 2026
- CMS.gov, Plan Benefits Package — Last accessed May 2, 2026
- CMS.gov, Monthly Enrollment by Contract/Plan/State/County — Last accessed May 2, 2026
Data sources and methodology documentation..
- Wellcare (official source), http://www.wellcare.com/medicare — Last accessed October 13, 2025
- Medicare.gov, "Understanding Medicare Advantage Plans" — Last accessed 25 May, 2025
- NCOA.org, "5 Steps to Choosing the Right Medicare Plan for You" — Last accessed 25 May, 2025
- Medicare.gov, "Compare Original Medicare & Medicare Advantage" — Last accessed 25 May, 2025
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