Wellcare Medicare Review: What to Watch Out For – ValuePenguin
wellcare offers low-cost medicare advantage plans and mid-priced medicare part d plans. however, wellcare plans are often poorly rated and not as popular as other providers.
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In some places, a wellcare medicare advantage plan is an especially good deal because it can provide a low limit on your health care expenses. If one of these plans is available in your area, you could save thousands of dollars if you need expensive medical care.
Reading: How much is wellcare insurance
what is wellness?
wellcare is a health insurance brand that is part of centene, a large insurance company with several different subsidiaries.
wellcare’s medicare options go beyond medicare benefits. Wellcare also offers Medicare Part D prescription drug plans, and its parent company, Centene, sells Medigap plans through a subsidiary of Health Net. The company particularly focuses on its Medicare Special Needs Plans (SNPS) and Medicare-Medicaid Plans (MMPS) as part of its larger role as a Medicaid provider.
As of 2021, Centene has been consolidating its Medicare options under the Wellcare brand. that’s why you’ll see medicare plans offered by companies like “wellcare by allwell” and “wellcare by health net,” where the name conflates wellcare with the former brand name. however, not all centene brands use the wellcare name.
With so many brands under a hundred, it’s easy to overlook the company’s huge presence. However, it sells Medicare Advantage plans in 35 states, Medicare Part D plans in all 50 states and Washington, D.C., and SNP or MMP plans in 33 states.
wellcare medicare benefit cost
It costs an average of $14 per month for a wellcare medicare advantage plan with prescription drug coverage. and $0 plans are offered in 98% of the counties where the company operates.
wellcare’s low overall costs mean it’s one of the cheapest medicare advantage companies, and its rates are similar to aetna, which costs an average of $7 per month.
The most expensive brand is Wellcare by Health Net, which operates in California, Oregon, and Washington. Affordable plans are offered here, but the higher average cost is due to the various plan options that cost more than $100 per month.
plans and coverage
While the monthly costs will be low in both cases, the difference between the two is the plan’s out-of-pocket maximum, which is the most you could spend on covered health care services in a year. this benefit is more relevant for those with high medical costs. For example, if you need $50,000 or $100,000 of medical care, you won’t pay more than the plan’s out-of-pocket maximum.
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The most widely available wellcare plans have a modest limit on medical expenses, and plan benefits are comparable to what you can get from other insurance companies.
However, some wellness plans cost less than $25 per month and also limit your medical expenses to $3,500 or less when you see an in-network provider. This means that those who need surgery or who are managing a chronic condition could save thousands of dollars in medical bills compared to a plan with a typical out-of-pocket maximum of $5,000 to $6,000.
Wellcare plans with low out-of-pocket maximums are only available in 35% of counties where plans are offered. however, those who have access to them can get a very good deal on coverage that protects them against costly medical procedures.
health care reimbursement program
wellcare is one of the companies that participates in the medicare reimbursement program, officially called part b premium reduction, and these reimbursement plans can be a very good offer for those who want to keep their expenses monthly to the minimum minimum.
Plans have no monthly costs and will reduce or eliminate the standard cost of $170.10 per month for Medicare Part B, which can save you over $2,000 per year.
However, low monthly costs usually mean there’s a trade-off in medical benefits or plans may not cover extras like dental care. With a reimbursement plan from WellCare or another company, we recommend that you consider how the monthly savings compare to your potential health care costs. For example, you don’t want to save $2,000 in monthly fees only to find out you’ll have to spend $3,000 more on health care or prescriptions than with another plan.
plans to avoid
among wellcare’s medicare advantage affordable plans there are options that don’t include prescription drug coverage. These $0 plans may seem like a good deal, but you won’t have coverage for any drugs. And in almost all cases, you won’t be able to add standalone prescription drug coverage with a Medicare Part D plan.
member resources and unique features
Wellcare member benefits vary between plans, states and brands. however, there is often a long list of benefits, and most plans include:
customer comments and complaints
By comparison, average star ratings typically range from 4.2 stars to 3.9 stars for companies like AARP/UnitedHealthcare, Blue Cross Blue Shield, and Humana. and two-thirds of all medicare advantage plans with prescription drug coverage plans are rated four stars or higher.
One of the most notable issues driving wellcare’s low ratings is how dissatisfied policyholders are with their coverage. satisfaction with the medical portion of their medicare advantage plan is particularly low, and no wellcare subsidiary exceeds a 3-star rating.
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j.d. power reported similar findings, and wellcare’s parent company, centene, ranked last in customer satisfaction with medicare advantage.
Among the many complaints filed with the Better Business Bureau (BBB), customer frustrations span a variety of circumstances, including paperwork issues, coverage issues, poor customer service, and benefit issues such as not receiving your card. flexible.
This low customer satisfaction also indicates that wellcare’s medicare advantage plans are less desirable among buyers, holding only 4% of the medicare advantage market.
Note that Wellcare offers some 5-star plans in California, where it competes with the top-ranked insurer, Kaiser Permanente. If a 5-star Medicare plan is offered in your area, you can switch to it at any time, even if it’s not open enrollment.
wellcare medicare part d plans
These standalone wellcare prescription drug plans are not as highly rated as many of their competitors. wellcare’s medicare parts d plans have an average rating of 3.5 stars, while the industry average is 3.7 stars.
The cheapest wellcare prescription drug plans are $12 or $31, and both have a high prescription drug deductible of $480. That means you’ll have to pay the first $480 of your prescriptions before plan benefits take effect. By comparison, you may be able to get better coverage from Humana, which often offers affordable prescription plans with low deductibles.
after you’ve met your plan deductible, most wellcare part d plans will have $0 tier 1 prescriptions so you can get free preferred generic drugs. the lowest value script plan will have the best coverage if you expect to take generic medications. however, if you expect to need brand-name medications, the classic plan has better coverage while still maintaining a low monthly cost.
the main benefit of the medicare rx value plus plan is that it does not have a deductible, but the plans are generally not the best financial offer. copays are similar to the value script plan, so paying an extra $57 per month on average ($684 per year) would save you $480 in deductible costs.
wellcare provides mail order prescriptions through the cvs caremark mail service pharmacy. this can be a good way to save on prescriptions you fill regularly because copays are often lower. but once again, performance falls short. at jd in power’s customer satisfaction survey for mail order prescriptions, cvs caremark came in last.
frequently asked questions
methodology and sources
medicare advantage cost and star rating data from centers for medicare & Medicaid Services (CMS). our cost analysis only considers medicare advantage plans that include prescription drug coverage, and we exclude rhythm plans, special needs plans, part b-only plans, employer-sponsored plans, medicare-medicaid and sanctioned plans. each instance of a plan is considered individually when it has different monthly costs or coverage. star ratings are averaged based on individual contracts.
in addition, we obtained information from centene and wellcare company. additional rating data is from better business bureau and j.d. power.