In Their Words: Why You Should Use Wellcare Insurance

WellCare Medicare Ratings at a Glance

Wellcare has various Medicare Advantage programs. Dental, vision, hearing and exercise are common extras in Wellcare Medicare Advantage. Plan availability varies by state.

Health-Maintenance Organizations (HMOs)

The Medicare Advantage HMO plans from Wellcare encourage members to use in-network providers as much as possible; out-of-network doctors are possible but more expensive. To see a specialist, members must be referred by their primary care physician (PCP). Because WellCare's HMO plans include pharmacies, they cannot be paired with stand-alone prescription drug plans.

Preferred-Provider Organizations (PPOs)

Wellcare PPO plans have large provider networks. Because pharmacies are part of those networks, you can't purchase a separate Part D prescription plan with Wellcare PPO. No PCP is necessary for Wellcare PPO subscribers, and no recommendations are needed to see specialists in the network. You can get care outside the network, but you'll likely pay more.

Dual-Eligible Special Needs Plans (D-SNP)

Dual-eligible special needs plans (D-SNP) combine Medicare Advantage with optional private insurer benefits. Medicare and Medicaid often fund these programs' costs. In addition to care coordination, Wellcare D-SNPs may provide members with health coaching. 

These plans also offer over-the-counter benefits, meal delivery and doctor and pharmacy transportation. Others are eligible for Extra Help, a Medicare program that helps low-income people pay for medicines.

Disabilities Care Plans (C-SNP)

In addition, Wellcare offers chronic condition special needs plans (C-SNP) for members with chronic conditions like diabetes and heart failure. C-SNPs, like D-SNPs, offer Medicare Advantage plus. Wellcare provides C-SNP members discounts on essentials like insulin for diabetics. It also assists members with complex medical needs. C-SNP members must have a PCP who coordinates their care. Wellcare C-SNP plans cover prescription drugs with low or no monthly premiums and no copayments.

Return Dividend Plans

A portion or all of the Medicare Part B premiums are refunded to members via Social Security or as a credit on their Part B premium statement. Medicare Advantage Give Back plans are available for retired veterans who receive free prescriptions from the U.S. Department of Veterans Affairs. 

Personal Service Fees

Like PPOs, private-fee-for-service (PFFS) plans don't require a PCP or referrals to specialists. Members of Wellcare PFFS plans can purchase a stand-alone prescription drug plan. These plans are especially helpful if you’re switching over to Medicare and already use specialty medications.

Prescription Drug Plans

Separate prescription drug plans (PDPs) supplement Medicare Parts A and B.

No copays are needed for Tier 1 medicines at 60,000 in-network retail pharmacies nationwide, and discounts on other tiers for mail-order prescriptions are available. Premiums, deductibles and coinsurance levels for higher-tier medicines differ among Wellcare's PDP alternatives.

Extra Benefits

Most Wellcare Medicare Advantage plans offer dental, vision and hearing. Many also provide free gym memberships and fitness regimens at home. In addition to free transportation to and from medical appointments and pharmacies, many Wellcare plans cover telehealth visits.

Wellness items and services such as acupuncture, chiropractic, nutrition and personal training are also discounted in some Wellcare plans. For example, toothpaste, vitamins and over-the-counter medicines or supplies are covered by the plan. Members can shop in-store or online and have items delivered. 

Members of Wellcare's Medicare Advantage program can also get the Flex Card, a pre-loaded Visa debit card worth $200 to $2,000. Contact Wellcare for more information on how these cards are issued. Members can use the Flex Card to pay for non-covered dental, vision or hearing expenses.

Wellcare’s parent company, Centene, received mixed customer service ratings from third-party rating services. The National Association of Insurance Commissioners (NAIC) complaint index for Wellcare is 0.07, which is below the national average of expected customer complaints. However, the J.D. Power 2021 U.S. Medicare Advantage Study gave Centene a 769 overall customer satisfaction rating, the lowest rating (10th) among the insurance companies surveyed.

Getting a quote from Wellcare is fairly straightforward. Here are sample monthly premiums, deductibles and copays for in-network and out-of-network costs by plan and by benefits/services. 

The MyWellcare app is available through Google Play and the App Store to help members keep up with their accounts while on the go. Through the app, members can access ID cards, find a provider and access wellness services. 

Wellcare vs Competitors

Wellcare has many great benefits for its members, including the Flex card, which adds extra benefits for even more savings, no copay for some Tier 1 drugs with PDP plans, dividend payments that refund Medicare Part B premiums for some members in certain markets and the Medicare Advantage plan that gives retired veterans free prescriptions. Here is how Wellcare stacks up against the competition.

WellCare sells Medicare Advantage plans in most parts of the U.S. Some of its membership perks include broad plan availability, flex cards that give members money for extra benefits and dividend plans that refund some Part B premiums. Wellcare, like many other Medicare insurance providers, has a wide range of products and prices with many extra benefits, making it a good choice for seniors. 

Frequently Asked Questions

Sources

1. Wellcare. "Wellcare About Us." Accessed March 9, 2022.
2. Wellcare. "Wellcare About Our Plans." Accessed March 9, 2022.
3. JD Power. "2021 US Medicare Advantage Study." Accessed March 9, 2022.
4. Google Play. "Google Play MyWellCare App." Accessed March 9, 2022.