Wellcare is a wholly-owned subsidiary of Centene Corp., which purchased it last January. TexanPlus and Allwell were rebranded as Wellcare on Jan. 1, 2022. Wellcare specializes in government-sponsored health insurance like Medicare and Medicaid. The company’s subsidaries are scattered across the country. Wellcare’s health insurance plans differ in each state.
Wellcare serves over 1.2 million Medicare Advantage participants and 4.1 million prescription drug plan (PDP) members in all 50 states. Flex help members with copays, transportation expenses, telehealth services and wellness programs. Supplementary benefits for the chronically ill are accessible through the use of flex cards. Medicare beneficiaries can buy dental, hearing and vision policies.
Benzinga’s review found Wellcare offers Medicare Advantage and Standalone Prescription Drug Plans across a wide area with affordable premiums and added benefits.
- The Flex card adds extra benefits for added savings
- No co-pay for certain Tier 1 drugs with PDP plans
- Dividend payments refund Medicare Part B premiums for certain members in select markets
- Medicare Advantage plan offers free prescriptions for retired veterans
- Mixed customer service reviews
WellCare Medicare Ratings at a Glance
| Wellcare Policy Options | |
| Wellcare Customer Service | |
| Wellcare Pricing | |
| Wellcare Mobile App | |
| Wellcare Overall Rating |
| Offers HMO? | Yes |
| Offers PPO? | Yes |
| Offers EPO? | Yes |
| Offers POS? | Yes |
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.
| BBB Rating | A |
| AM Best Rating | NR (Not rated) |
| NAIC Complaint Index | 0.07 |
| Moody’s Rating | Ba1 outlook stable |
| J.D. Power Rating | 769 |
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.
| Plan type | PPO in-network | PPO out-of-network | HMO D-SNP | HMO in-network | HMO out-of-network |
| Monthly premium | $0 plus $55 returned in Social Security | $0 plus $55 returned in Social Security | N/A | $0 | $0 |
| Maximum out-of-pocket | $7,350 | $10,000 combined | N/A | $4,900 | $3,450 |
| Doctor visits | Primary care: $0 per visit Specialist: $45 per visit | Primary care: 40% per visit Specialist: 40% per visit | Primary care: $0 per visit Specialist: $0 per visit | Primary care: $0 per visit Specialist: $25 per visit | Primary care: $0 per visit Specialist: $0 per visit |
| Hospital stays | $325 copay per day for days 1-6 and $0 copay per day for days 7-90 | 30% of the total cost for days 1-90 | $0 copay up to 90 days per admission | $300 copay per day for days 1-7 and $0 copay per day for days 8-90 | $325 copay per day for days 1-5 and $0 copay per day for days 6-90 |
| Hearing services | $2,000 per year for up to 2 hearing aids, max 1 per ear | 40% coinsurance for hearing services and get up to $2,000 for up 2 hearing aids, max 1 per ear | $4,000 per year for up 2 hearing aids, max 1 per ear | $2,000 per year for up 2 hearing aids, max 1 per ear | $2,000 per year for up 2 hearing aids, max 1 per ear |
| Vision | $0 copay for a routine exam plus get up to $300 for unlimited contacts, glasses, lenses, and/or frames per year | 40% coinsurance for a routine exam; 40% coinsurance for eyewear and services and get up to $300 toward unlimited contacts, glasses, lenses and/or frames per year | $0 copay for a routine exam plus get up to $400 for unlimited contacts, glasses, lenses and/or frames per year | $0 copay for a routine exam plus get up to $300 for unlimited contacts, glasses, lenses and/or frames per year | $0 copay for a routine exam plus get up to $200 for unlimited contacts, glasses, lenses and/or frames per year |
| Dental | $1,500 in preventive and comprehensive dental services, including exams, fillings, minor restorative services and dentures ($0 copay) | $1,500 in preventive and comprehensive dental services, including exams, fillings, minor restorative services and dentures (50% cost share) | Dental services with no annual max, including exams, fillings and dentures and implants ($0 copay) | $1,500 in preventive and comprehensive dental services, including exams, fillings, minor restorative services and dentures ($0 copay ) | $1,500 in preventive and comprehensive dental services, including exams, fillings, minor restorative services and dentures ($0 copay ) |
| Prescription services/deductible | $0 at preferred pharmacies | $0 at preferred pharmacies | Tier 1 - $0 preferred generics Generics: $0 / $1.35 / $3.95 / 15% Brands: $0 / $4.00 / $9.85 / 15% Dependent on level of extra help | $0 | N/A |
| Flex card | $1,000 per year | $1,000 per year | $2,000 per year | $750 per year | $750 per year |
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.
- Best For:Nationwide coverageVIEW PROS & CONS:securely through Blue Cross Blue Shield Health Insurance's website
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
What benefits do flex cards provide?
Wellcare Medicare Advantage members receive anywhere from $200 to $2,500 Visa Flex Cards, depending on program and area. The money can be used to cover out-of-pocket costs for dental, vision or hearing expenses.
What dividend payments does Wellcare provide?
Wellcare offers dividend programs in select areas, with money returned to participants via Social Security checks or Medicare Part B premium statements.
Sources
- Wellcare. "Wellcare About Us." Accessed March 9, 2022.
- Wellcare. "Wellcare About Our Plans." Accessed March 9, 2022.
- JD Power. "2021 US Medicare Advantage Study." Accessed March 9, 2022.
- Google Play. "Google Play MyWellCare App." Accessed March 9, 2022.
User Reviews
Vivian Howard
So far so good. New to Medicare and Wellcare. Have a great cllinic Chen Medical where my primary doctor is and am very happy with the results.
Judith Woods
Worst company ever. Had numerous staff lie to me. was supposed to receive rewards cards but never did. After speaking to numerous people including supervisors found out they were not going to resend the cards they said had been sent.
Margaret Tyler Rubenstein
This was the worst experience I have ever had. WellCare cancelled my 95 y/o mother's coverage with no explanation. I have DPOA and am health Proxy. Horrible experience!!!!
M. D.
Cost of my prescription has increased on an average of 400% and I haven’t been able to get a person in customer service that I can communicate with because of a language barrier.
Earnest Hall
I found that the benefits were hard to access. I coul never get a straight answer every representative gave me a different answer about my question. Also extremely long wait times to speak to someone. I waited upwards to two hrs waiting on a rep.
Christina Germain
Never received flex card
Derek Gilbert
While the benefits are great (better than any other plan in my area), their customer service is atrocious. Foreign based call centers staffed with agents who appear minimally trained. Every call is over an hour long, with multiple holds.
Cathy Bennett
Not that good do not keep you updated to difference offers
Elide Rodrigues
Quoted a price and a month later,not only monthly payment increased but drug moved in to different tier. Bottom line, prices altered and you are unable to change companies until October… WHY? All done without notifications. Will be looking
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About Janet Hunt, Insurance Agent
Janet has been working in, and writing about, the insurance industry for over 20 years.