Florida-based WellCare focuses its efforts on government-sponsored insurance plans, including Medicare and Medicaid. They have many subsidiaries across the country.
The WellCare Medicare review will examine the coverage and plans. To help you choose the right plan for you, we’ll also review WellCare Medicare quotes.
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What is WellCare?
WellCare was established in Tampa Bay, Florida, in 1985 to provide Medicaid plans for residents. They began offering private Medicare plans in 1987. Originally called Medicare +Choice, but later renamed Medicare Advantage to comply with the legislation. They also started offering Medicare Part D plans in 2006.
WellCare grew mainly in 2012 and 2013 through multiple acquisitions of other states. Their reach now extends almost to every corner of the country. The state determines which WellCare health plan is available.
WellCare has numerous subsidiaries throughout the country, including Ohana and EasyChoice, Harmony and HealthEase. The headquarters of WellCare is still in Tampa Bay. There are seven branch offices in seven other cities.
An FBI investigation into company spending led to WellCare being under fire in 2007. The FBI investigation resulted in the resignation of several senior executives. Restitution payments totaling millions of dollars were made to WellCare, but the company maintained that customers and operations were unaffected.
The provider offers a variety of Medicare plans to customers across the country.
What WellCare Medicare plans are available?
WellCare’s plans for health insurance vary from one state to the next. We chose California as our sample state to review the company’s offerings. All of them are HMO plans. This means that you can only use WellCare Medicare providers who are in-network.
What is WellCare Medicare Advantage and what are its benefits?
Four Medicare Advantage plans were returned by our sample California ZIP code. All healthcare plans offer hearing, vision, or dental.
There are three types of health plans that do not have an additional monthly premium above the Original Medicare premium. These three plans are Freedom, Best, Dividend. These are all HMO plans that have no deductibles and no copays for specialist visits or office visits. Freedom is an HMO/SNP plan. The Dividend plan has the lowest inpatient hospital copay at $125 per day for the first five consecutive days.
Every plan includes prescription drug coverage. Prescription deductibles are not required and Tier 1 generic drugs start at $0, with the exception of Freedom plans which have a $445 deductible. This means that you will be responsible for any prescription drug costs up to the time your deductible is reached, but Tier 1 is excluded.
HMO Plus plans also have no deductibles or copays for office visits. However, the plan has a $800 per day copay for inpatient hospital stays for the first three consecutive days. Prescription coverage copays start at $0. There is no prescription deductible and Tier 1 drugs are not covered.
You can assume that these plans require you use network pharmacies or you may be charged an additional fee.
What is WellCare Medicare Part D and how does it work?
In our sample area, WellCare offers a variety of prescription drug coverage plans through Medicare Rx Part D.
Classic has a plan that covers all tiers, and includes a $405 deductible. After that, Tier 1 is covered by a $0 copay. Tier 2 has a $1 copay and Tier 3 is covered by $32. Tier 4 has a 44% coinsurance, while Tier 5 has a 25% coinsurance.
Tiers 1 through 2 have no copay or minimum deductible. Extra has no extra cost. Tier 3 has a $36 copay, while Tiers 1 and 2 have $36 copays. Tiers 4 and 5, on the other hand, have coinsurance amounts of 40% or 33%.
What are the WellCare Medicare rates?
Three of the three health plans do not charge an additional monthly premium, as Original Medicare does. Plus costs $6.70 per month.
Prices for standalone prescription drug plans start at $15.20 for the lowest premiums and go up to $81 for the highest end.
Although these rates are specific to the area where we sampled them, they are still very affordable compared to other samples from this area. These are HMO plans. This means that access is restricted to network providers only, and includes the use of a retail pharmacy part of their network. This often results in lower rates.
How are WellCare Medicare claims processed?
Although the WellCare website doesn’t offer any information about claims, this is normal for this type insurance provider. Most claims are handled by providers directly, and HMO plans require that all providers be included in the network to handle medical care claims.
You can reach the Right Person to Discuss Your Claim by calling WellCare Medicare’s provider number.
Are WellCare Medicare ratings and reviews positive?
WellCare is rated A+ by the Better Business Bureau (BBB). There have been 51 complaints filed against the company over the last three years. Ten customer reviews have been filed. Most of them complain about poor customer service. Some also mention denials of coverage for certain medications or services.
Consumer Affairs has 54 reviews, with the majority being negative. These complaints are very similar to the ones on BBB. Poor customer service claims were not paid.
Each WellCare company is independently rated by the National Committee for Quality Assurance. Overall ratings range from 2.5 to 3.5 stars. Some companies are in the lower-than-average range, while others are slightly above average. However, none of these companies have a particularly impressive rating.
The Medicare Ratings for Easy Choice plans were both returned as 3.5 stars. These are not terrible ratings, but they are not great either.
Overall, the impression is that the company needs to improve their customer service and customer experience in order to raise their ratings.
What is the bottom line?
Although WellCare’s plans are affordable, it seems that you get what you pay for. Although there are no red flags, the ratings are average and not impressive. It is a good idea to shop around for insurance providers that offer a plan that suits your needs and offers better service. Companies that have a strong reputation can also offer a great value for money.
While you may end up selecting a WellCare Medicare plan that is affordable, make sure it is the best. Compare Medicare quotes using our free tool.