What is WellCare?
WellCare is a healthcare company that provides government-sponsored managed care services, primarily through Medicaid, Medicare Advantage, and Medicare Prescription Drug plans. The company is based in Tampa, Florida, and serves more than 5 million members in the United States. Its services include medical, behavioral health, and pharmacy benefits management, as well as disease management and health improvement programs.
WellCare Medicare is a division of WellCare Health Plans, Inc. that offers a variety of Medicare Advantage plans and Medicare Prescription Drug plans to individuals who are eligible for Medicare. Medicare Advantage plans are offered as an alternative to Original Medicare and typically provide additional benefits such as vision, hearing, and dental coverage. Medicare Prescription Drug plans, also known as Part D plans, provide coverage for prescription drugs.
WellCare Medicare Advantage plans include Health Maintenance Organizations (HMOs), Preferred Provider Organizations (PPOs), and Private Fee-for-Service (PFFS) plans. Each plan type has different rules and networks, which can affect the cost and availability of services.
WellCare Medicare Prescription Drug plans are available in different formularies, which is a list of covered drugs and their cost-sharing requirements.
What is WellCare Medicare Advantage?
WellCare Medicare Advantage is a division of WellCare Health Plans, Inc. that offers a variety of Medicare Advantage plans to individuals who are eligible for Medicare. Medicare Advantage plans, also known as Medicare Part C, are offered as an alternative to Original Medicare (Part A and Part B) and typically provide additional benefits such as vision, hearing, and dental coverage.
WellCare Medicare Advantage plans include:
- Health Maintenance Organizations (HMOs)
- Preferred Provider Organizations (PPOs)
- Private Fee-for-Service (PFFS) plans
Each plan type has different rules and networks, which can affect the cost and availability of services.
Health Maintenance Organizations (HMOs) typically have a network of providers that members must use to get covered benefits, and referrals may be needed for certain specialists. Preferred Provider Organizations (PPOs) also have a network of providers, but members have more flexibility in choosing providers, and usually don't need referrals. Private Fee-for-Service (PFFS) plans have more flexibility in choosing providers, but may have higher out-of-pocket costs.
WellCare Medicare Advantage plans may also include coverage for prescription drugs, which is typically provided through a Medicare Prescription Drug plan (Part D).
What Does WellCare Medicare Cover?
WellCare Medicare covers a variety of health care services for individuals who are eligible for Medicare. The specific coverage depends on the type of plan an individual enrolls in, but generally, WellCare Medicare Advantage plans cover all of the services that Original Medicare (Part A and Part B) covers, and may also include additional benefits such as vision, hearing, and dental coverage.
WellCare Medicare Prescription Drug plans, also known as Part D plans, provide coverage for prescription drugs. The specific coverage and cost-sharing requirements depend on the plan an individual enrolls in.
It's important to note that WellCare Medicare plans have network providers and may have different rules, network providers and cost sharing than Original Medicare. Also, the coverage and benefits may change from year to year, so it is important to review the plan's benefits, coverage and cost before enrolling or renewing the plan.
Is WellCare Medicare Free?
WellCare Medicare plans are not free. Individuals who are eligible for Medicare are required to pay a monthly premium for their coverage. The cost of the premium varies depending on the type of plan an individual enrolls in, and whether they qualify for any financial assistance such as extra help with Medicare prescription drug costs.
Medicare Advantage plans, such as those offered by WellCare, may have lower or higher monthly premiums than Original Medicare (Part A and Part B) depending on the plan and the area. Additionally, these plans may have other out-of-pocket costs such as copays and coinsurance for certain services.
Medicare Prescription Drug plans, also known as Part D plans, also have monthly premiums that vary depending on the plan and the area. Additionally, these plans may have other out-of-pocket costs, such as deductibles and coinsurance.
It is important to review the cost and coverage of any plan before enrolling, and to check if an individual qualify for any financial assistance that can help with the cost of their coverage.
Does WellCare Offer Dual Eligible Medicare-Medicaid Plans?
Yes, WellCare offers Medicare-Medicaid plans, also known as Dual Eligible Special Needs Plans (D-SNP), for individuals who are eligible for both Medicare and Medicaid. These plans are designed to coordinate the benefits and services provided by both programs for individuals who are eligible for both Medicare and Medicaid.
WellCare's D-SNP plans provide coverage for all the services that are covered by both Medicare and Medicaid.
WellCare D-SNP plans also offer additional benefits such as case management, transportation, and personal care services. These plans also have a network of providers that members must use to get covered benefits.
It's important to note that the availability of WellCare D-SNP plans and the specific benefits offered can vary depending on the state and the area. And also that the benefit and coverage may change from year to year, so it is important to review the plan's benefits, coverage and cost before enrolling or renewing the plan.
Additional Resources
Learn More About WellCare
https://www.wellcare.com/en/Kentucky/Corporate/About-Us
Last updated: January 24, 2023
