Prior Authorization Required [snf] =>
Prior Authorization Required [pcp] => $0.00 Copay [specialist] => $20.00 Copay
Prior Authorization Required [urgent_care] => $40.00 Copay
Prior Authorization Required [er] => $0.00 - $350.00 Copay
Prior Authorization Required [ambulance_ground] => $320.00 Copay
Prior Authorization Required [ambulance_air] => $320.00 Copay
Prior Authorization Required [dental] =>
$ max [vision] => $0.00 Copay
$100.00/yr eyewear, Prior Authorization Required [hearing] => Not Covered [rx] => Array ( [deductible] => $420.00 [tiers] => Array ( [0] => Array ( [order] => 1 [name] => Preferred Generic [deductible] => Excluded [retail_30] => [retail_90] => [mail_30] => [mail_90] => [ltc_30] => [out_network] => [post_oop] => ) [1] => Array ( [order] => 2 [name] => Tier 2 [deductible] => Excluded [retail_30] => [retail_90] => [mail_30] => [mail_90] => [ltc_30] => [out_network] => [post_oop] => ) [2] => Array ( [order] => 3 [name] => Tier 3 [deductible] => Applies [retail_30] => [retail_90] => [mail_30] => [mail_90] => [ltc_30] => [out_network] => [post_oop] => ) [3] => Array ( [order] => 4 [name] => Tier 4 [deductible] => Applies [retail_30] => [retail_90] => [mail_30] => [mail_90] => [ltc_30] => [out_network] => [post_oop] => ) [4] => Array ( [order] => 5 [name] => Tier 5 [deductible] => Applies [retail_30] => [retail_90] => [mail_30] => [mail_90] => [ltc_30] => [out_network] => [post_oop] => ) [5] => Array ( [order] => 6 [name] => Tier 6 [deductible] => Excluded [retail_30] => [retail_90] => [mail_30] => [mail_90] => [ltc_30] => [out_network] => [post_oop] => ) ) ) )
Wellcare Giveback (HMO-POS) (HMO-POS) 2025 Plan Details for Adair County, Kentucky Residents
Wellcare Giveback (HMO-POS) (HMO-POS) 2025 Plan Details for Adair County, Kentucky Residents
Wellcare Giveback (HMO-POS) is a HMO-POS Medicare Advantage plan, from Wellcare, {with_without_pdp} a prescription drug plan. It's CMS Plan ID is: H9730-007-0. It is not available in all areas. The list of locations where this plan is available can be found below.
According to CMS enrollment data (July, 2025), there are approximately 6,251 members enrolled in this plan.
Wellcare Giveback (HMO-POS) (HMO-POS) Overview
CMS Fact | Landscape Value |
---|---|
Health Plan ID: | H9730-007-0 |
CMS Overall Rating: | 0.0 out of 5 stars* |
Medicare Advantage Plan Type: | HMO-POS |
Coverage Year: | CY2026 |
Monthly Premium: | $0.00 Plus your Medicare Part B premium. |
Health Plan Deductible: | $0.00 |
Annual Out-of-Pocket Maximum: | $9000.00 (In-Network) |
Part B Give Back: | $0.00/mo |
Part D Drug Plan Benefit: | Enhanced, $615.00 deductible |
Additional Benefits: | Dental, Vision, Hearing |
Availability: | Adair County, KY |
Insured By: | Wellcare |
Last Plan Content Update: |
Plan Availability by Location
Health Plan Out-of-Pocket Costs
Find out the costs for visiting your primary care doctor and specialists, as well as coverage for wellness and preventive programs.
Service | Enrollee Cost (in-network) |
---|---|
Primary: | $0 Copay |
Specialist: | $40 Copay Prior Authorization Required |
Review the costs for emergency services, urgent care, ambulance services, inpatient hospital stays, and skilled nursing facility care.
Service | Enrollee Cost |
---|---|
Emergency room care: | $125 Copay |
Urgent care: | $30 Copay |
Ground ambulance: | $320 Copay |
Inpatient hospital care: | $450.00 per day for days 1 through 5 $0.00 per day for days 6 and beyond |
Skilled Nursing Facility: | $0.00 per day for days 1 through 20 $214.00 per day for days 21 through 60 $0.00 per day for days 61 and beyond |
This section covers Medicare-approved foot care services, including exams and routine foot care.
Service | Enrollee Cost (in-network) |
---|---|
Foot Exams and Treatments (Medicare-covered): | $40 Copay Prior Authorization Required |
Routine Foot Care: | Not Covered |
Understand the coverage for Medicare-approved chiropractic services and routine chiropractic care.
Service | Enrollee Cost (in-network) |
---|---|
Medicare-covered chiropractic: | $20 Copay Prior Authorization Required |
Routine chiropractic: | Not Covered |
This section explains the costs for mental health services, including individual and group therapy, and inpatient care.
Service | Enrollee Cost (in-network) |
---|---|
Outpatient individual therapy: | $40 Copay |
Outpatient group therapy: | $40 Copay |
Inpatient psychiatric hospital care: | $375.00 per day for days 1 through 5 $0.00 per day for days 6 and beyond |
See the cost details for rehabilitation services, including physical therapy, speech therapy, and occupational therapy.
Service | Enrollee Cost (in-network) |
---|---|
Physical therapy and speech and language therapy: | $40 Copay Prior Authorization Required |
Occupational therapy: | $40 Copay Prior Authorization Required |
Learn about the costs associated with medical equipment and supplies, including diabetes supplies, durable medical equipment, and prosthetics.
Service | Enrollee Cost (in-network) |
---|---|
Diabetes supplies: | $0 Copay Prior Authorization Required |
Durable medical equipment: | 20% Coinsurance Prior Authorization Required |
Prosthetics: | 20% Coinsurance |
This section outlines the costs for diagnostic services, lab tests, x-rays, and other imaging services.
Service | Enrollee Cost (in-network) |
---|---|
Diagnostic radiology services: | $350 Copay Prior Authorization Required |
Lab services: | $50 Copay Prior Authorization Required |
Outpatient x-rays: | $45 Copay Prior Authorization Required |
Diagnostic tests and procedures: | $50 Copay Prior Authorization Required |
Review the cost-sharing details for chemotherapy and other Medicare Part B-covered drugs.
Service | Enrollee Cost (in-network) |
---|---|
Chemotherapy: | 20% Coinsurance |
Other Part B drugs (Medicare-covered): | 20% Coinsurance |
This section details the dental services covered under your plan including, Medicare-covered preventive dental, oral exams, x-rays, dental cleanings, and comprehensive dental.
Service | Member Cost (in-network) |
---|---|
Medicare Covered Preventive Dental | $40 Copay Prior Authorization Required |
Oral exam | |
Dental x-rays | |
Cleaning | |
Periodontics | |
Endodontics | |
Restorative Services |
This section outlines the coverage for hearing-related services, including exams, fittings, and hearing aids.
Service | Member Cost (in-network) |
---|---|
Fitting/evaluation | $0 Copay Prior Authorization Required |
Hearing aids | Covered Limits may apply |
Hearing exam | $0 Copay Prior Authorization Required |
Learn about the costs for vision-related services, including eye exams, eyeglasses, and contact lenses.
Service | Member Cost (in-network) |
---|---|
Medicare-covered eye exam (in-network) | $0 to $40 Copay |
Routine eye exam (in-network) | $0 Copay Prior Authorization Required, 1 Every year |
Eyewear benefits | Eyeglasses: Yes Contact Lenses: Yes Eyeglass Lenses: Yes Eyeglass Frames: Yes Eyewear Upgrades: Yes |
Maximum eyewear benefit: | $100.00 Every year |
Prescription Drug Costs & Benefits
Wellcare Giveback (HMO-POS) includes an enhanced benefit Medicare Part D plan (PDP), which offers greater coverage than basic plans. An enhanced benefit plan has a higher actuarial value, meaning it covers a larger percentage of your healthcare costs.
Part D Plan Premium
The Part D prescription drug plan premium is included in your overall Medicare Advantage plan cost. However, additional expenses or subsidies may apply through the Low-Income Subsidy (LIS) program, also known as Extra Help. LIS, provided by Social Security, helps those with limited income and resources to lower or eliminate Part D costs. LIS benefits are not part of Medicare Advantage coverage.
Basic Part D Premium: | $($3.50) |
---|---|
Supplemental Part D Premium: | $$3.50 |
Total Part D Premium: | $$0.00 |
Low-Income Premium Subsidy: | ${part_d_lips_amount} |
Low-Income Premium Subsidy Paid by CMS: | $$0.00 |
Low-Income Subsidy Premium: | $$0.00 |
For more details, visit the Social Security Extra Help program.
Prescription Drug Plan Deductible
This plan has a $615.00 annual Part D deductible. You'll pay this deductible at the pharmacy before Wellcare starts contributing towards your prescription costs.
Prescription Drug Plan Out-of-Pocket Costs
Beyond premiums and deductibles, Wellcare Giveback (HMO-POS) may have additional costs at pharmacies. The table below outlines out-of-pocket expenses by drug tier.
Drug Tier | Retail | Mail Order |
---|---|---|
Preferred Generic* | $0.00 | $5.00 |
Generic* | $0.00 | $10.00 |
Preferred Brand | 25.00% | 25.00% |
Non-Preferred Drug | 48.00% | 48.00% |
Specialty Tier | 28.00% | 28.00% |
Select Care Drugs* | $0.00 | $0.00 |
*Deductible does not apply. |
CMS 5-Star Rating Marks
Each year, the Centers for Medicare & Medicaid Services (CMS) evaluates health and drug plans using a comprehensive 5-star rating system. These ratings offer valuable insights into the quality of care, member satisfaction, and overall plan performance.
When selecting a Medicare Advantage plan, looking at the star ratings can help you gauge how well a plan might meet your healthcare needs, making it easier to choose a plan with confidence.
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 | |
Drug Plan Customer Service | |
Complaints and Changes in the Drug Plan | |
Member Experience with the Drug Plan | |
Drug Safety and Accuracy of Drug Pricing |
Need Help Enrolling?
Website: | Wellcare Plan Page |
---|---|
Providers: | Wellcare Providers Page |
Formulary: | Wellcare Formulary Page |
Pharmacy: | Wellcare Pharmacy Page |
New Member Health Plan Help: | (800)225-8017 |
New Member Health Plan TTY: | 711 |
New Member Part D Help: | (800)270-5320 |
New Member Part D TTY Users: | 711 |
Frequently Asked Questions
📘 What does Medicare plan code H9730 007 mean?
Wellcare Giveback (HMO-POS) is a Medicare Advantage plan by Wellcare. The code H9730 is the CMS contract ID, whereas 007 is its plan ID.
- Plan Name: Wellcare Giveback (HMO-POS)
- Plan Type: HMO-POS
- Premium: $0.00/mo + your monthly Part B premium
- Out-of-Pocket Max: $9000.00 (in-network)
- Drug Coverage: {pdp_faq_summary}
- CMS Star Rating: 0.0 out of 5
- Contract Year: 2026
This information is based on official CMS data and is provided for educational purposes. Always review your plan’s official documents or contact the provider directly before making enrollment decisions.
📋 What type of plan is H9730 007?
This plan is a HMO-POS — specifically, it's an HMO-POS plan with a Medicare Advantage contract that's offered by Wellcare. It comes with defined provider network rules you should be aware of.
- Plan Marketing Name: Wellcare Giveback (HMO-POS)
- Network Type: {plan_type_expanded}
- Referral Requirement: {referral_required_expanded}
- Prescription Coverage: {pdp_faq_summary}
Plan types like HMOs and PPOs determine whether you can go out-of-network or need referrals to see specialists.
📦 What benefits are included in H9730 007?
This plan covers all Medicare Part A and Part B services. Depending on the plan, it may also include valuable extras like dental, vision, and hearing benefits.
- Medical Services: Hospital, doctor visits, preventive care
- Prescription Drugs: Enhanced, $615.00 deductible
- Dental: {dental_benefit}
- Vision: {vision_benefit}
- Hearing: {hearing_benefit}
Benefit availability may vary by location and plan version. Confirm specific details in your plan's Evidence of Coverage (EOC).