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What Do You Need to Know About Wellcare Medicare

What Do You Need to Know About Wellcare Medicare

Wellcare was founded in 1985 in Florida and was recently acquired by Centene in 2020. This acquisition created the largest Medicaid plan in the United States. WellCare offers Medicare Advantage Plans, Private Fee-for-Service Plans, and stand-alone prescription drug plans in a wide geographic footprint. The insurance company offers a range of insurance products and prices with extra benefits.

Wellcare Medicare

WellCare Medicare Advantage Plan Options

There are several types of Medicare Advantage Plans that may be available in a certain service area. Plans are typically specific to the region and not all plan types are offered in each service area.

WellCare HMO Plans: A typical Health Maintenance Organization (HMO) the plan involves the selection of a primary care provider (PCP) to manage patient care. The PCP makes referrals to in-network specialists who can provide the necessary care.

WellCare PPO Plans: Preferred Provider Organization (PPO) plans are offered in Florida, Georgia, New York, and South Carolina. These plan types give reduced rates for in-network providers and reimbursement for out-of-network providers. Patients don't need a referral to see a specialist with a PPO plan, but it's encouraged to obtain either a referral or pre-authorization.

Medicare Advantage Special Needs Plans: Special Needs Plans (SNPs) are Medicare Advantage plans designed for patients with specific medical conditions or financial situations. There are different types of SNPs available for eligible participants including Chronic Condition (C-SNP), Institutional (I-SNP), and Dual Eligible Special Needs Plans (D-SNPs).

WellCare Private Fee-for-Service Plans: PFFS plans are offered in select regions. This plan type features a set rate that hospitals and doctors will be paid for medical services and a set coinsurance or copayment paid by the policyholder. A PFFS plan works with a provider network and allows patients to choose their own provider.

It's always a good idea to research different health plans and shop around insurance providers. provides a review of Wellcare Medicare plans and coverage options. The provider has an A+ rating with the Better Business Bureau and has 51 complaints on file. Of the 10 customer reviews, most are grievances about poor customer service and the denial of coverage for prescription medications and medical services.

Not all plan types and extra benefits are available in coverage areas, such as vision, dental, and hearing coverage. The best way to determine what plan types are available, such as Medicare Part A, Part B, and Part D prescription drug coverage plans, is to search your zip code. Overall, the monthly premium of Medicare Advantage Plans is inexpensive. While there are no red flags regarding plans, Medicare star ratings are mediocre.

The Pros of WellCare Health Plans

The acquisition of WellCare by Centene helped both companies increase their position in the Medicare Advantage market. Some WellCare plans come with extra benefits such as the Flex Card. This preloaded card allows members to pay for dental, vision, and hearing services when they exhaust their plan coverage. Some health plans include a no-copayment meal delivery service for a specific number of days. Certain health plans include a benefit that refunds some or all of Part B's premium coverage.

The Cons of WellCare Health Plans

WellCare's the average Medicare star rating is lower when compared to the overall average of all Medicare Advantage plans. WellCare health plans also receive poor scores on several individual factors such as the percentage of WellCare members who get flu shots and customer service. The health plan provider has the lowest customer satisfaction rating of all Medicare Advantage companies. Medicare Advantage plans are only offered in 27 states, while Special Needs Plans (SNPs) are only offered in 25 states.

WellCare Advantage Plans offer members an inexpensive path to medical services. Not all plan types and coverage are available in every service area, and certain restrictions may apply to specific plans.

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