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Wellcare Patriot Giveback Open (PPO) Medicare Advantage Plan H5439-010 • 2027 • Lane County, OR

CMS Rating: ☆☆☆☆☆ (3.0 out of 5 stars*)
Monthly Premium
$0.00Plus Part B premium.
Medical Deductible
$200
Maximum Out-of-Pocket
$6750.00In-network
Part B Giveback
−$10.00 reduction
Prescription Coverage
Not Included
Additional Benefits
Dental, Vision, Hearing
Service Area
Lane County, OR
Local Enrollment
44 beneficiaries in Lane County
Last update:

Wellcare Patriot Giveback Open (PPO) Introduction

This Medicare Advantage PPO plan, Wellcare Patriot Giveback Open, is offered by Wellcare By Health Net and uses a Preferred Provider Organization (PPO) provider network. It comes without prescription drug coverage. For the 2027 plan year, the monthly premium is $0.00, the medical deductible is $200, and the in-network maximum out-of-pocket is $6750.00. The plan is identified by CMS Plan ID H5439-010.

Qualifying residents of Lane County, Oregon may enroll in this plan. CMS enrollment data reports 44 plan members in Lane County. New members can call the plan directly at (844)480-0680 (TTY 711) for assistance.

Compare Similar Plans in Lane County

Compare this plan with the two most-enrolled PPO plans available in Lane County, Oregon. Enrollment is based on CMS local enrollment data.

PPO plan comparison for Lane County, Oregon
Plan Detail Wellcare Patriot Giveback Open ATRIO Choice Rx AARP Medicare Advantage from UHC OR-0002
CMS Plan ID H5439-010-0 H7006-018-0 H2406-070-0
Local Enrollment 44 3,919 3,323
Monthly Premium $0.00 $0.00 $0.00
Medical Deductible $200 $0.00 $0.00
Maximum Out-of-Pocket $6,750.00 $5,900.00 $7,150.00
Part B Giveback −$10.00 reduction Not offered Not offered
Primary Care $0 copay $0 copay $0 copay
Specialist $30 copay $45 copay $0-$70 copay
Part D Deductible Not Applicable $400.00 $685.00
CMS Star Rating 3.0 2.5 4.0
Dental $0 copay $0 copay $0 copay
Vision $0 copay $0 copay $0 copay
Hearing $0 copay $0 copay $0 copay

Plan Benefits

Wellcare Patriot Giveback Open includes cost-sharing, which refers to out-of-pocket expenses for covered healthcare services. The tables below outline the most common in-network out-of-pocket costs associated with plan H5439-010.

You can also compare 2027 costs and coverage with last year, side-by-side: Plan H5439-010-0 Cost Compare.

Office Visits

Primary care
In-network: $0 copay
Out-of-network: $30 copay
Specialist
In-network: $30 copay
Out-of-network: $60 copay

Preventive and Wellness Services

Annual wellness exam
In-network: $0 copay
Out-of-network: $0 copay
Telehealth benefit
In-network: $0-$50 copay
Routine chiropractic
In-network: $15 copay
Out-of-network: 20% coinsurance
Fitness benefits
Coming soon
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)
Coming soon

Diagnostic, Lab, and Imaging Services

Diagnostic radiology services
In-network: $0-$500 copay
Out-of-network: 20% coinsurance
Lab services
In-network: $0-$50 copay
Out-of-network: 20% coinsurance
Outpatient x-rays
In-network: $50 copay
Out-of-network: 20% coinsurance
Diagnostic tests and procedures
In-network: 0%-20% coinsurance
Out-of-network: 20% coinsurance

Emergency and Urgent Care Services

Emergency room care
$130 copay
Worldwide emergency care
Coming soon
Urgent care
$50 copay
Inpatient hospital care
In-network:
Tier 1
$525 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
$221 per day for days 21-60
$0 per day for days 61-100
Out-of-network:
30% per day for days 1-100
0% per stay
Ground ambulance
In-network: $175 copay
Out-of-network: $175 copay

Mental Health Services

Outpatient individual therapy
In-network: $0 copay
Out-of-network: 20% coinsurance
Outpatient group therapy
In-network: $0 copay
Out-of-network: 20% coinsurance
Inpatient psychiatric hospital care
In-network:
Tier 1
$525 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

Rehabilitation Services

Physical therapy and speech and language therapy
In-network: $25 copay
Out-of-network: 20% coinsurance
Occupational therapy
In-network: $25 copay
Out-of-network: 20% coinsurance

Medical Equipment and Supplies

Diabetes supplies
In-network: $0 copay
Out-of-network: 20% coinsurance
Durable medical equipment
In-network: 20% coinsurance
Out-of-network: 20% coinsurance
Prosthetics
In-network: 20% coinsurance
Out-of-network: 20% coinsurance

Medicare Part B Drugs

Chemotherapy
In-network: 0%-20% coinsurance
Out-of-network: 0%-20% coinsurance
Other Part B drugs (Medicare-covered)
In-network: 0%-20% coinsurance
Out-of-network: 0%-20% coinsurance

Dental Services

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

Vision Services

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

Hearing Services

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

Additional and Special Needs Services

Adult day health services
Not covered
Home-based palliative care
Not covered
Personal emergency response system
Coming soon
Weight management programs
Not covered
Wigs for chemotherapy-related hair loss
Coming soon
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 5-Star Performance Ratings (Contract ID: H5439)

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.

2027 Medicare Star Ratings for Contract H5439
CMS Measure Star Rating
2027 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 ☆☆☆☆☆
Drug Plan Customer Service ☆☆☆☆☆
Complaints and Changes in the Drug Plan ☆☆☆☆☆
Member Experience with the Drug Plan ☆☆☆☆☆
Drug Safety and Accuracy of Drug Pricing ☆☆☆☆☆
Medicare Plan Data Sources and Methodology
Primary CMS datasets used for this Medicare Advantage Plan resource.
Data Source Publisher CMS Version
Landscape Source Files Centers for Medicare & Medicaid Services CY2027 Landscape (202609.1)
Medicare Part C & D Performance Centers for Medicare & Medicaid Services 2027 Star Ratings Data Tables
Plan Benefits Package Centers for Medicare & Medicaid Services PBP Benefits-2027
Monthly Enrollment by Contract/Plan/State/County Centers for Medicare & Medicaid Services 2026-09

Data sources and methodology documentation.

Official plan information and secondary Medicare references.
Publisher Reference Last Accessed
Wellcare By Health Net (official source) http://go.wellcare.com/OR October 4, 2026
CMS.gov Medicare Advantage Plan Fact Sheet 25 May, 2025
Medicare.gov Joining a plan 25 May, 2025
Medicare.gov Compare Original Medicare & Medicare Advantage 25 May, 2025

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Data provenance is documented in accordance with the U.S. Core Data for Interoperability (USCDI) Provenance standard.