Wellcare Medicare Advantage Plans Review
Wellcare offers Medicare Advantage plans in all 50 states, including HMO, PPO, and SNP plans.
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Wellcare Medicare Advantage plans were crafted to help members get the affordable and quality care they need to feel their best. The company provides coverage not offered by Original Medicare, such as dental, hearing, and vision care, although benefits may vary by plan. Some plans may include prescription drug coverage, fitness memberships, massages, and alternative medicine coverage. In this article, we’ll help you understand Wellcare Medicare Advantage plans to find out if this carrier’s plans are right for you.
Pros About What We Like
- Wellcare is owned by Centene, which has provided Medicare Advantage plans for over 20 years and is one of the largest Medicare-managed care organizations in the U.S.
- Many plans include the Visa flex card benefit, which can provide additional coverage for vision, dental, and hearing visits.
- Some of WellCare’s plans offer dual coverage for members who are eligible for both Medicare and Medicaid through the S-SNP program.
- Wellcare offers low monthly premiums and even $0 monthly premiums for some plans.
- Out-of-pocket maximums are low for most plans.
- Wellcare plans may also include benefits such as fitness memberships and alternative medicine.
Cons About What We Don't Like
- If you choose Wellcare, it may be more expensive to use out-of-network providers. For example, your plan may cost more if you want to use a primary care physician who isn’t in your network, or you may have higher copays.
- If you live in a rural area, it may be harder to find doctors who are in your network.
- Some of WellCare’s plans received only three stars from Medicare.gov1
Available Wellcare Medicare Advantage Plans
Wellcare offers plans such as HMOs, PPOs, and D-SNPs. Wellcare’s Medicare Advantage plans include benefits such as dental, hearing services, and vision with varying levels of copays and out-of-pocket maximums for in-network and out-of-network service providers. In addition, some plans include prescription medication plans with structured tiers of payments. Plans and payments can change from year to year, so you’ll want to review your coverage regularly.
Health Maintenance Organization (HMO) Plans
The HMO plan includes Original Medicare benefits, along with additional coverage for things like dental, hearing, vision, and prescriptions. Your care will be coordinated through a primary care doctor and a network of providers. Out-of-network providers may cost more, and referrals are usually needed to see a specialist.
These plans are best for seniors and other Medicare beneficiaries who don’t often travel out of their network area or who are looking for low-cost options. With these plans, it’s harder and more expensive to receive care from practitioners who are not in-network.
Preferred Provider Organization (PPO) Plans
PPO plans have reduced rates for in-network providers but also still receive reimbursements for out-of-network providers. This makes it easier to visit out-of-network providers when necessary. Often, you don’t need a referral for specialists with these types of plans.
A PPO may be right for you if you have a doctor or team of doctors that might not be in your HMO network or if you live in a more rural area where in-network practitioners are harder to find.
Did You Know? Some Wellcare plans cover benefits such as fitness memberships and alternative medicine, like chiropractic care and acupuncture.
Special-Needs Plans (SNPs)
SNPs are for people who meet specific criteria. To qualify for an SNP, you must be:
- Eligible for Medicare
- Living on a limited income
- Eligible for Medicaid
Your plan may include hospital, doctor, and prescription drug coverage; care management services; routine vision and dental coverage; transportation assistance for appointments; and coverage for certain over-the-counter items. This plan may be right for you if you have limitations due to income or specific health needs.
Extra Perks and Benefits
There are a variety of extra benefits included with Wellcare Medicare Advantage plans, such as over-the-counter medications, telehealth services, and varying levels of dental services. You may also find diabetes resources, fitness benefits, and short-term meals. All plans include a 24-hour nurse helpline and compassionate customer service. Wellcare also offers a unique benefit on some plans called the Visa flex card, which extends dental, vision, or hearing coverage when needed.
FYI: Wellcare is one of SeniorLiving.org’s top picks for Medicare Advantage plans thanks to its extra health and wellness benefits.
Wondering how these plans compare to other Medicare Advantage carriers? Cigna Preferred offers many of the same benefits but has better ratings and potentially lower monthly premiums than Wellcare. On the other hand, companies such as Highmark have high copays for hearing aids, while Wellcare includes hearing aids in some of its plans. Knowing what services you need can help you pick the plan that’s right for you.
How Much Do Wellcare Medicare Advantage Plans Cost?
Plan prices can vary widely for Wellcare’s Medicare Advantage plans. Although some of Wellcare’s plans have no monthly cost, this doesn’t include the standard monthly Medicare Part B premium of $174.70 per month.2
Other costs will vary depending on the type and amount of coverage, whether the plan offers out-of-network coverage, how much the maximum out-of-pocket expense will be, and more.
For example, plans that have low or zero-cost monthly premiums usually come with higher deductibles or more expensive copays. But on the other hand, plans that have higher monthly premiums are more likely to have lower copays and deductibles.
Did You Know? There are over 63 million people already enrolled in Medicare. Here’s everything you need to know about Medicare enrollment.
Wellcare plans may range in cost from $0 to $69 per month for a standard Medicare Advantage Plan, according to our research. These costs fall in the middle of the price range for popular Part C plans. Just keep in mind that this does not include the standard Medicare Part B premium of $174.70 that most beneficiaries pay.
Where Are Wellcare Medicare Advantage Plans Available?
Wellcare Medicare Advantage plans are available in all 50 states, with over 1.2 million people enrolled. You’ll still need to check if Wellcare’s Medicare Part C plans are available in your area. Unfortunately, in-network provider participation is sparse in more rural areas, where the population is less dense. You’ll have more options if you live in a more populated area.
So how does Wellcare’s coverage compare to other Medicare Advantage carriers? More than 540,000 people are enrolled in Cigna Preferred in over 12 states, which is about half the size of Wellcare’s enrollment and offers far less nationwide availability. UnitedHealthcare is the largest Medicare Advantage company, serving people in 49 states and Washington, D.C., and boasting more than 1 million network providers.
Reviews and Ratings
It can be helpful to look at reviews and ratings from credible third parties to see how Wellcare ranks in the industry. Wellcare Medicare Advantage plans receive anywhere from 2.5 to 3 stars from Medicare.gov. Other agencies have also weighed in with their ratings.
| Agency | Rating |
|---|---|
| Medicare.gov | 2.5 to 3 stars |
| A.M. Best | C+, B-, and B |
| BBB | 1.13 out of 5 stars |
A.M. Best has given several of Wellcare’s subsidiaries ratings of C+, B-, and B, which reflects their underwriting, operating results, and consistency in operation.3
The BBB gives a low rating of 1.13 stars out of 5 to Wellcare plans, with over 350 complaints in the last three years.4
While these ratings are pretty low, it’s important to note that these agencies often receive negative feedback and might not be receiving equally important positive feedback from satisfied beneficiaries. The reviews might not reflect the whole picture, but they are still important to consider.
Customer Service
You can reach the customer service line at 1-800-275-4737 (TTY: 711) from 8 a.m. to 8 p.m., seven days a week from October 1 through March 31, and weekdays from April 1 through September 30. There is also a messaging service for after-hours, weekends, and holidays. If you aren’t a member, call 1-877-846-0774 (TTY: 711).
Wellcare also offers a mobile app and website portal that you can use to review your benefits. You can also use your app in place of your ID card at an appointment.
Did You Know? Your Wellcare Medicare Advantage plan may offer telehealth services so you can talk to your care provider without leaving home.
Final Thoughts on Wellcare Medicare Advantage Plans
Many people across the United States are enrolled in a Wellcare Medicare Advantage plan. The company has a long history of offering plans that help Medicare beneficiaries live their healthiest life, with a large network of providers and services available.
Sadly, Wellcare Medicare Advantage plans don’t have the greatest reviews. However, this is a large provider that has been offering Medicare Advantage plans for years and has a variety of solid options for you to choose from.
Wellcare may be a solid option if you live in an area with good network coverage. But if you live in a rural area where the availability of medical care is a little more sparse, you may want to find a different company to access Medicare Advantage plans.
Overall, Wellcare Medicare Advantage plans are comprehensive, offering a variety of options to suit your individual health needs with plenty of extra benefits to help you live your healthiest life.
Centers for Medicare and Medicaid Services. (2023). IMPORTANT INFORMATION: 2023 Medicare Star Ratings.
Medicare.gov. (2023). 2023 Medicare Costs.
A.M. Best. (2023). A.M. Best Takes Various Rating Actions on WellCare Health Plans, Inc.’s HMO Subsidiaries.
Better Business Bureau. (2023). WellCare Health Plans, Inc..