Wellcare Patriot Giveback (HMO-POS) Medicare Advantage Plan H2915-013 • 2026 • Bucks County, PA

Wellcare Patriot Giveback Overview

Coverage Overview for Wellcare Patriot Giveback

Wellcare Patriot Giveback is a Medicare Advantage HMO-POS plan that includes Medicare Part A and Part B coverage, with limited access to out-of-network providers in certain situations. The monthly premium is $0.00, and costs are generally lower when services are received from in-network providers.

Primary care visits have a $0 copay, specialist visits come with a $30 copay, urgent care services carry a $40 copay, and ambulance transportation is $260 copay. These costs apply toward the annual maximum out-of-pocket (MOOP) limit of $7550.00. After this limit is reached, in-network services are fully covered.

This plan is listed by CMS under Plan ID H2915-013. A summary of cost sharing is provided below.

Cost-Sharing Overview

Cost-sharing for Wellcare Patriot Giveback includes out-of-pocket expenses for covered healthcare services. The table below provides a summary of typical in-network out-of-pocket costs for plan H2915-013.

Certain preventive services are covered 100% by Wellcare Patriot Giveback as a Part B benefit.

Prescription Drug Coverage

This plan does not include a Medicare Part D plan for prescriptions.

CMS 5-Star Ratings

CMS evaluates Medicare Advantage (Part C) and Part D plans annually using a 5-star rating system. Ratings reflect performance in preventive care, chronic condition management, and member experience.