HomeFactsWhat Is Wellcare Health Insurance

What Is Wellcare Health Insurance

Finding The Best Wellcare Medicare Plan For You

A Mission To Serve – WellCare Health Plans

To find the WellCare Medicare options available to you, simply visit WellCares website and select state reside in. Next, pick the type of plan you want and enter your zip code.

Youll then see a list of the options available to you. You can click on each one to be taken to a page where you can download the documents related to that specific plan. For instance, if you download its Summary of Benefits, you are provided more information about the plans premium, deductible, copays, and your maximum out-of-pocket responsibility.

The Summary of Benefits also shares what is covered under that plan in relation to preventive care, emergency care, diagnostic services, mental health, physical therapy, and more. If the plan offers coverage for dental, vision, and/or hearing, that information is provided here as well.

WellCares website also lets you compare the WellCare Medicare plans available in your area. Its all presented in an easy-to-read chart that helps you understand how the plans are similar to and different from one another.

Plus, each WellCare plan is shown with a Medicare star rating, which is based on 53 criteria Medicare uses to evaluate all individual plans on a yearly basis. This rating is also based on both quality of the plan and its performance, which gives you an idea of how it compares to all other Medicare plans on the market.

Whats The Bottom Line

WellCares plans can be inexpensive, but it appears to be a case of getting what you pay for. There are no red flags here, but ratings are mediocre and unimpressive. It would likely be beneficial to shop around for an insurance provider with a plan that fits your budget and provides a higher level of service, with additional benefits that provide you with a better health care experience at a price you can afford. There are companies that offer both a great reputation and also a good value for the dollar.

You may wind up choosing an affordable WellCare Medicare plan, but make sure its the best choice first. Compare Medicare quotes right now with our free tool below.

How Do Consumers And Financial Ratings Services Feel About Wellcare

The volume of debt affects WellCare and its parent company Centenes financial ratings.

Moodys and Fitch: Shortly after Centene purchased WellCare, Moodys Investors Service upgraded WellCares senior unsecured debt from Ba1 to Ba2. A year later, Fitch rated Centenes debt BBB. Neither of these ratings are impressive conservative investors might avoid investments in companies with ratings like these because they consider them speculative. But customers shouldnt worry that these companies wont pay their claims because state and federal governments are the ultimate guarantors.

Medicare: In 2020, WellCare got 4 out of 5 stars from the Centers for Medicare and Medicaid Services for its Florida Medicare Advantage plans operations. A 4-star rating is considered above average.

For anyone in need of guidance choosing a Medicare Advantage plan, here are links to information about plans in almost every state.

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What Is Wellcare Medicare Part D

There are a number of WellCare Medicare Rx Part D prescription drug coverage plans available from WellCare in our sample area.

One example, Classic, has a drug plan with a $405 deductible that applies to all tiers of coverage. After that, Tier 1 has a $0 copay Tier 2, $1 and Tier 3, $32. Tier 4 has a coinsurance amount of 44%, and Tier 5 a coinsurance of 25%.

Extra has no copay or deductible for Tiers 1 and 2. Tier 3 has a copay of $36 and Tiers 4 and 5 have coinsurance amounts of 40% and 33%, respectively.

What Is Wellcare Medicare Advantage

WellCare rolls out plan to help

Our sample California ZIP code returned four Medicare Advantage plans. All of the healthcare plans include hearing, vision, and dental.

There are three health plans that have no additional monthly premium beyond the Original Medicare premium. These are Dividend, Best, and Freedom. All of these are HMO plans with no deductible and $0 copays across the board for office visits and specialists. Freedom is an HMO-SNP plan. The Dividend plan is the only one of the three that has an inpatient hospital copay of $125 a day for the first five days.

Each plan also includes some form of prescription drug coverage. There is no prescription deductible and drugs start at $0 for Tier 1 generic drugs, except for the Freedom plan which has a $445 deductible, leaving you responsible for your prescription drug costs until that deductible is met, excluding Tier 1.

The Plus plan is also an HMO, and again has no deductible and no copays for office visits, although there is an $800 a day copay for the first three days of an inpatient hospital stay. There is a prescription deductible of $445 excluding the covered drugs in Tier 1 and prescription coverage copays after that start at $0.

It can be assumed that these different drugs plans require you to use network pharmacies otherwise you could be subject to an additional cost.

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What Health Insurance Plans Does Wellcare Offer

WellCare offers several types of Medicare Advantage plans, including health maintenance organizations , preferred provider organization plans and private fee for service plans .

It also sells Medicare prescription coverage, Part D, which generally people purchase who neither buy additional Medicare coverage beyond the basics nor choose a Medicare supplement plan, which WellCare doesnt sell.

WellCare HMO plans: These plans are generally the least expensive with many of them charging no more than the Medicare Part B fee deducted automatically from a Social Security recipients monthly benefit. WellCare HMOs require patients to select a primary care provider who manages their care. The PCP will make referrals to healthcare specialists who are in the WellCare network. If patients in a WellCare HMO plan choose a healthcare provider who is out of network, they will pay higher or even full costs.

WellCare PPO plans: These plans give a patient more freedom to choose healthcare providers. PPOs dont require a participant to have a primary care physician or get a referral to see a specialist. These plans offer reduced rates for choosing in-network providers, but if you see a doctor outside of the network, youll generally get partial reimbursement. The cost of a WellCare PPO plan depends on where you live and the details of its benefits.

WellCare Medicare Advantage plans: Medicare Advantage offers special needs plans for people in these circumstances:

Competition: Wellcare Vs Unitedhealthcare

WellCare was not directly ranked, but its partner company was. Centene ranked last overall in a study by J.D. Power with a score of 769 out of 1,000. UnitedHealthcare ranks seventh with a score of 795. WellCare is now part of Centene which extends its geographical reach UnitedHealthcare has a broader footprint. UnitedHealthcare offers Medicare Supplement Insurance plans, which WellCare does not. UnitedHealthcare also benefits from its exclusive affiliation with AARP.

UnitedHealthcare has higher average Star Ratings from CMS than WellCare and more plans that rate highly. UnitedHealthcare has four 5.0-Star plans and seven 4.5-Star plans WellCare has one 4.5-Star plan. Those higher-quality UnitedHealthcare plans may cost more WellCare has more $0-premium plans and lower average costs in many areas.

Depending on your priorities, the choice may be clear: UnitedHealthcare wins on quality, WellCare wins on price. But always check the specifics of the plans available in your area. Cost and quality can vary locally.


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Wellcare Health Plans Overview

  • Wellcare Health Plans was first mentioned on PissedConsumer on Feb 16, 2017 and since then this brand received 46 reviews.

  • Wellcare Health Plans ranks 374 of 1196 in Insurance category. The overall rating of the company is 1.2 and consumers are mostly dissatisfied.

  • Recent recommendations regarding this business are as follows: “find another medicare advantage plan”, “Don’t sign up for well carer”, “Find another way to contact Wellcare”, “Shop other prescription plans, but NOT WellCare!”, “Call your lawyers to refer Wellcare to the department of justice create a nationwide case. At some point Medicare will no longer use Wellcare as a vendor and some employees could also face jail time should proof of taking advantage of the elderly is proven”.

Additional Wellcare Medicare Plan Benefits

Are WellCare Medicare Advantage Plans Free?

If you purchase a Medicare plan from WellCare, you also have the benefit of using its Nurse Advice Line thats available 24 hours a day, 7 days a week. If you have questions regarding a specific medical condition, you can call 581-9952 for advice.

WellCare also offers a Medication Therapy Management Program that was designed to help reduce your drug-related risks, increase your prescription awareness, and support healthy prescription drug habits. With this program, you get a comprehensive medication review, which is a one-on-one discussion with a pharmacist to discuss all of your prescription medications, over-the-counter medicines, herbal treatments, and dietary supplements to ensure they all work well together.

You also receive a targeted medication review, which consists of WellCare contacting your doctor to talk about medications that may be more effective or safer for you to take.

To qualify, you must be on at least eight maintenance drugsthey all must be covered by Medicare Part Dand reach yearly prescription drug costs of $4,044 paid by both you and your prescription drug plan. You must also have at least three of the following health conditions:

  • Asthma

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What Is Wellcare Health Plan

Based in Tampa, Florida, Well Care Health Plans Inc. was established in 1985 with the aim of providing Medicaid managed care and Medicare to all people. It is a holding company for several subsidiaries including Harmony, Wellcare Health Plan, HealthEase, and Staywell. It has over 3.9 million members countrywide, over 9,100 partners, and 6,000 associates. The company also has many regional offices in Miami, Manhattan, Florida, Baton Rouge, Connecticut, New York, Chicago, Illinois, Texas, Houston, Georgia, Louisiana, and Marietta.

WellCare Health Plan is just one of the many different insurances Medico MD accepts. Please continue reading to see how WellCare could benefit you!

Common Questions About Oscar And Wellcare Insurance


Is WellCare good insurance?

WellCare received 3.57 stars out of 5 by Medicares rating system. It has an A+ rating with the Better Business Bureau .

Who takes WellCare insurance?

Wellcare has a network of providers. To find a WellCare provider or to see if your doctor accepts Wellcare, visit here.

Are Wellcare and Centene the same?

Centene acquired Wellcare in January 2020.

What coverage do WellCare plans offer?

WellCare offers Medicaid and Medicare plans.

Does WellCare cover dental implants?

Healthplex is WellCare’s dental network provider. They do not cover dental implants.

Check out our full list of common questions about WellCare.


What lab does Oscar insurance cover?

Quest Diagnostics is Oscars preferred lab so your preventive labs will be free if they are processed there. Not all labs participate with your health plan so make sure youre going to a preferred lab.

Where is Oscar insurance available?

Oscar Insurance is available in New York, California, Texas, New Jersey, Ohio, Tennessee, Arizona, Florida, and Michigan.

What do Oscar’s health insurance plans cover?

Oscar’s health insurance plans cover a wide range of medical services and drugs. You have the option of selecting from different tiers, based on the coverage you anticipate needing. Theres an Oscar health insurance plan for every budget. Oscar also offers Medicare Advantage and Medicare Supplements.

Does CVS take Oscar insurance?

CVS pharmacy is Oscars preferred pharmacy in New York.

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What Is Medicare Part C

Medicare Part C is also known as Medicare Advantage or MA plans, which bundles Original Medicare Part A and Part B into one health insurance plan. Original Medicare is a health insurance program administered by the federal government, but Medicare Advantage plans are offered by health insurance companies approved by the federal government.

Most Medicare Advantage plans also bundle Part D – prescription drug coverage.

Medicare Advantage can also include extra services not included in Part A and Part B, such as vision, hearing, dental, and wellness programs.

How To File A Claim With Ambetter And Wellcare Insurance

Wellcare Logos


If you receive non-emergency services from an out-of-network provider, you may be responsible for the entire cost of the medical bill, unless otherwise required by state or federal regulations. To take full advantage of your Ambetter coverage, it is important to only use in-network providers. To appeal a claim that was denied by Ambetter, the member should contact 1-877-687-1197.


Your doctor or care provider should submit a claim to the insurer. You should be covered except for copay. Your insurer will send you an explanation of benefits. If you owe anything, your doctor will send you a bill. If you visit an out-of-network provider, you will not be covered unless it was an emergency. Call 855-672-2755 with any additional questions.

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How Do You File Claims With Wellcare

Filing claims with WellCare is usually the responsibility of your healthcare providers. They file with WellCare and WellCare sends the claim to Medicare and Medicaid.

If either WellCare or the government agency providing the coverage denies your claim, WellCare has procedures in every state to help you appeal.

Ambetter And Wellcare Enrollment Process


Ambetter is available through the health insurance marketplace or you can get several free quotes here. Each state has their own marketplace. If youre not sure where to begin, visit .


You can get several free health insurance quotes here. For Wellcare enrollment forms visit here.

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Prescription Drug Plans Available Through Wellcare

Many WellCare Medicare Advantage plans offer prescription drug coverage, but you can often purchase a stand-alone drug plan if you have Original Medicare and simply want or need this type of coverage, which is generally referred to as Medicare Part D. The three prescription drug plans offered by WellCare are:

WellCare Classic

This PDP is designed for those who only need prescriptions occasionally or for those who only take a few scripts per month. With the WellCare Classic PDP, your premiums for 2019 will range from $23.80 to $39.60 per month and the annual deductible is $415.

WellCare Extra

The WellCare Extra PDP is perfect for you if you take a lot of medications each month because this particular plan has no deductible. The premiums for 2019 range from $60.90 to $81.50 per month.

WellCare Value Script

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How Much Do Wellcare Medicare Advantage Plans Cost

WellCare offers some Medicare Advantage plans at a $0 premium. You must still pay your Medicare Part B premium each month to Medicare but can receive additional services with no monthly premium from WellCare. No matter what premium you pay, you will have deductibles, copayments, or coinsurance for services, as set by your plan and Medicare.

The following are some examples of WellCare Medicare Advantage plans available across the country and what you might pay in 2022.

$0 $35

Available plans and costs can vary from year to year. If you have a particular WellCare Medicare Advantage plan, the plan will notify you in the fall of any changes to costs.

Wellcares Prescription Delivery Options

With WellCare prescription drug coverage, you can often elect to receive your medication by mail. This service is provided by CVS Caremark and you can , by printing and completing a Mail Service Order Form and mailing it in, or by calling FastStart at 875-0867.

If you choose to sign up by phone, you will need your WellCare benefit ID number, your doctors name and phone number, and your payment information. Sign up with the mail-in form and youll need all of this information as well as your complete mailing address, any allergies or other health conditions you may have, and a 90-day original prescription for the medication you want.

If the medication is approved for mail delivery, CVS Caremark will contact your doctor and request a 90-day prescription . Once this is received, the script will be filled and mailed to you at no charge if you choose regular delivery. If you need it quicker, you can always pay for overnight or second-day delivery.

Refills can also be processed online, by phone, or via mail.

If you purchase a Medicare plan from WellCare, you also have the benefit of using its Nurse Advice Line.

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What Are The Wellcare Medicare Rates

As noted above, three of the health plan types do not have an additional cost for a monthly premium beyond what you pay for Original Medicare. The other plan, Plus, costs only $6.70 a month.

The standalone prescription drug plans range in price from $15.20 for the lowest premiums, up to $81 for your monthly premium on the high end.

These rates are specific to the area we sampled them from but, compared to other samples in this area, they are very affordable. It is important to note that these are both HMO plans, which means access is limited to only network providers, including using a retail pharmacy that is part of their pharmacy network. That often means lower rates.

What Are The Member Benefits From Wellcare


Benefits for WellCares Medicare Advantage plans can be attractive because many include some coverage for vision, dental and transportation to care. Drugs delivered via mail is an option, but there is limited telehealth, probably because government reimbursement for it is low or non-existent.

The company also offers something that many other insurance providers dont flexible coverage that you can use to pay for out-of-network coverage as well as dental, hearing or other healthcare for which it otherwise offers no coverage.

This benefit comes in the form of a credit card loaded with a predetermined spending amount that ranges from $200 to $2,500, depending on where you live and what your circumstances are. You use the card to pay for what you need.5

Flexible Coverage Offered

This benefit comes in the form of a credit card loaded with a predetermined spending amount that ranges from $200 to $2,500 and can be used to pay for out-of-network coverage as well as dental, hearing, or other healthcare for which it otherwise offers no coverage.

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