Wellcare Medicare Review: What to Watch Out For
Wellcare Medicare Review: What to Watch Out For
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Wellcare offers low-cost Medicare Advantage plans and average-priced Medicare Part D plans. However, Wellcare's plans are usually poorly rated, and they are not as popular as those from other providers.
In some locations, a Medicare Advantage plan from Wellcare is an especially good deal because it can provide a low cap 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.
Our thoughts
Medicare Advantage plans from Wellcare are generally cheap, costing an average of $14 per month. Plus, $0 plans are widely available so many people won't pay anything on top of the cost of Medicare Part B, and some "giveback plans" can reduce or eliminate this cost.
However, Wellcare's customer satisfaction is low. Wellcare's overall performance rating is 3.6 stars while most other major insurers rate above four stars. That means there's a clear tradeoff between cost and quality, and many policyholders are unhappy with their cheap Wellcare plans.
Keep in mind that a lower star rating tells you about a plan's overall experience, not just the level of health coverage it provides. And in some locations, those who need expensive health procedures can get very good coverage from Wellcare. If you have access to a Wellcare plan that caps your spending at $3,500, the potential for lowering your medical bills may make Wellcare worth it, despite the company's frustrating service.
For those who would rather have a Medicare Advantage plan with higher customer satisfaction, we recommend AARP/UnitedHealthcare, which has a 4.2 overall star rating, offers many $0 plans and is widely available.
What is Wellcare?
Wellcare is a health insurance brand that's a part of Centene, a large insurance company with several different subsidiaries.
Wellcare's Medicare options go beyond Medicare Advantage. Wellcare also offers Medicare Part D prescription drug plans, and its parent company, Centene, sells Medigap plans through the Health Net subsidiary. The company is particularly focused on its Medicare Special Needs Plans (SNPs) and Medicare-Medicaid plans (MMPs) as a part of its large role as a Medicaid provider.
As of 2021, Centene has been consolidating its Medicare options under the Wellcare brand. This is why you'll see Medicare plans offered by companies such as "Wellcare by Allwell" and "Wellcare by Health Net," where the name joins Wellcare with the previous brand. However, not all brands under Centene use the Wellcare name.
Centene subsidiary | Medicare Advantage | Medigap | Medicare Part D | SNPs or MMPs |
|---|---|---|---|---|
| Wellcare | ||||
| Wellcare by Allwell | ||||
| Wellcare by Fidelis Care | ||||
| Wellcare by Health Net |
With so many brands under Centene, it's easy to overlook the company's large footprint. 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.
What we considered in this Wellcare Medicare review
We considered Medicare Advantage plans that include prescription drug coverage, which are sold by Wellcare and its partner brands: Wellcare by Allwell, Wellcare by Fidelis Care and Wellcare by Health Net. We didn't review the Medigap plans, which have limited availability, SNPs or Medicare-Medicaid plans. However, we did review Wellcare's Medicare Part D plans and had similar findings as its Medicare Advantage options.
Cost of Wellcare Medicare Advantage
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 overall low costs means that it's one of the cheapest Medicare Advantage companies, and its rates are similar to Aetna, which costs an average of $7 per month.
Brand | Average monthly cost |
|---|---|
| Wellcare | $15 |
| Wellcare By Allwell | $11 |
| Wellcare by Fidelis Care | $9 |
| Wellcare by Health Net | $33 |
Medicare Advantage plan with prescription drug coverage
The most expensive brand is Wellcare by Health Net, which operates in California, Oregon and Washington. Here, cheap plans are offered, but the higher average cost is driven by the several plan options costing more than $100 per month.
Plans and coverage
Most Wellcare Medicare Advantage plans have OK coverage, but in about one third of the counties, Wellcare's plans are a particularly good value for those who need expensive medical care.
While the monthly costs will be low in both instances, the difference between the two is the plan's out-of-pocket maximum, which is the cap on the most you could spend on covered health care services in a year. This benefit is most relevant to 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 plans out-of-pocket maximum.
Wellcare's most widely available plans have a moderate limit on medical expenses, and the plan benefits are comparable to what you can get from other insurance companies.
However, some Wellcare plans cost less than $25 per month while also limiting your medical spending to $3,500 or less when you go to an in-network provider. This means those who need surgery or who are managing a chronic illness could save thousands of dollars in medical bills as compared to a plan with a typical out-of-pocket maximum of $5,000 to $6,000.
Examples of plans that are a good value for those who have high health care costs
Plan | Avg. monthly cost | Avg. drug deductible | Avg. limit on your health expenses (in-network) |
|---|---|---|---|
| Wellcare No Premium Essential (HMO) | $0 | $0 | $3,450 |
| Wellcare TexanPlus Classic No Premium (HMO) | $0 | $0 | $3,400 |
| Wellcare Complement Assist (HMO) | $15 | $480 | $3,450 |
The Wellcare plans that have low-out of pocket maximums are only available in 35% of the counties where plans are offered. However, those who have access to them can get a very good deal on coverage that protects against costly medical procedures.
Wellcare giveback program
Wellcare is one of the companies that participates in the Medicare giveback program, officially called the Part B premium reduction, and these giveback plans can be a very good deal for those who want to keep their monthly expenses to a bare minimum.
The plans have no monthly costs, and they will reduce or eliminate the standard $170.10-per-month cost for Medicare Part B, which can save you more than $2,000 per year.
However, the low monthly costs usually mean there's a tradeoff in medical benefits or that plans may not cover extras such as dental care. With a giveback plan from Wellcare or another company, we recommend that you consider how the monthly savings compares to your potential health care costs. For example, you don't want to save $2,000 in monthly fees only to discover that you'll have to spend $3,000 more for medical care or prescriptions than with another plan.
Plans to avoid
Among Wellcare's cheap Medicare Advantage plans 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 medications. And in nearly all cases, you won't be able to add on stand-alone prescription coverage with a Medicare Part D plan.
Member resources and unique features
Wellcare's member benefits vary between plans, states and brands. However, there is usually a large list of benefits, and most plans include:
- Dental care
- Hearing care
- Vision care
- Gym membership or Silver Sneakers
- Discounts for the LifeStation medical alert system
- Telehealth
- Transportation
- Over-the-counter (OTC) benefit: A set an allowance which can be used to purchase items at CVS pharmacies
- Flex card: A prepaid debit card to pay for nearly anything, including gas and groceries
Customer reviews and complaints
Wellcare has one of the lowest ratings among major Medicare Advantage providers, averaging 3.6 stars overall.
In comparison, average star ratings usually 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 have a rating of four stars or higher.
One of the most notable issues driving Wellcare's poor ratings is how dissatisfied policyholders are with their coverage. Satisfaction with the medical portion of their Medicare Advantage plan is particularly poor with no Wellcare subsidiary surpassing a 3-star rating.
Brand | Overall | Health plan | Drug plan |
|---|---|---|---|
| Wellcare | 3.7 | 2.4 | 3.7 |
| Wellcare By Allwell | 3.4 | 2.8 | 2.8 |
| Wellcare by Fidelis Care | 4.0 | 2.0 | 4.0 |
| Wellcare by Health Net | 3.8 | 2.4 | 2.0 |
The overall performance rating from CMS is a comprehensive analysis, while the health and drug plan ratings are feedback from policyholders about their satisfaction.
J.D. Power reported similar findings, and Wellcare's parent company Centene ranked in last place for Medicare Advantage customer satisfaction.
Among the many complaints logged with the Better Business Bureau (BBB), customer frustrations span a range of circumstances such as paperwork issues, coverage problems, poor customer service and benefits issues such as not receiving their flex card.
This low customer satisfaction also points to Wellcare's Medicare Advantage plans being less desirable among shoppers, and it only has 4% of the Medicare Advantage market.
Note that Wellcare does offer some 5-star plans in California, where it's competing 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's Medicare Part D plans
A Medicare Part D plan from Wellcare costs an average of $37 per month, which is slightly cheaper than the average cost of $48.
These stand-alone prescription drug plans from Wellcare are not as well-rated as those from many other 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 cost $12 or $31, and both have a high prescription drug deductible of $480. That means you'll have to pay for the first $480 of your prescriptions before the plans' benefits kick in. In comparison, you may be able to get better coverage from Humana, which frequently offers cheap prescription plans with low deductibles.
Medicare Part D prescription plan | Average monthly cost | Average deductible |
|---|---|---|
| Wellcare Value Script | $12 | $480 |
| Wellcare Classic | $31 | $480 |
| Wellcare Medicare Rx Value Plus | $69 | $0 |
After you've met the plan's deductible, most Wellcare Part D plans will have $0 Tier 1 prescriptions so you can get preferred generic medications for free. The cheaper 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 having a low monthly cost.
The primary benefit of the Medicare Rx Value Plus plan is its no deductible, but plans are typically not the best financial deal. The copayments are similar to the Value Script plan, so paying an extra $57 per month on average ($684 per year) would save you $480 for the costs toward the deductible.
Wellcare does provide mail-order prescriptions through CVS Caremark Mail Service Pharmacy. This can be a good way to save on prescriptions that you regularly take because the copayments are usually lower. But yet again, performance falls short. In J.D. Power's customer satisfaction survey for mail order prescriptions, CVS Caremark was in last place.
Frequently asked questions
Is Wellcare the same as Medicare?
Wellcare is a private insurance company that sells Medicare plans. However, Wellcare is just one of the companies you can get Medicare benefits from, and the best Medicare Advantage companies include Kaiser Permanente, AARP/UnitedHealthcare and Aetna.
Is Wellcare a good plan?
Wellcare Medicare Advantage plans can sometimes have good coverage, helping those who need expensive medical care to save thousands of dollars. However, Wellcare's overall customer satisfaction is lower than other major providers like AARP/UnitedHealthcare.
Is Wellcare better than Humana?
No, in most cases, Humana is better for Medicare than Wellcare. Wellcare's Medicare Advantage plans and Medicare Part D plans have lower overall ratings, and the number of complaints about Wellcare on the Better Business Bureau reveal how frustrated Wellcare policyholders are.
Is Wellcare a Chinese company?
The health insurance company, Wellcare, is based in the U.S. and is a subsidiary of Centene Corporation, a large, St. Louis-based health insurer. "Wellcare Global" is a separate company based in Taiwan that makes electric blankets and other products.
Methodology and sources
Medicare Advantage data on cost and star ratings is from Centers for Medicare & Medicaid Services (CMS). Our cost analysis only considers Medicare Advantage plans that include prescription drug coverage, and we excluded PACE plans, special needs plans, Part B-only plans, employer-sponsored plans, Medicare-Medicaid plans and sanctioned plans. Each instance of a plan is considered individually when it has different monthly costs or coverages. Star ratings are averaged based on individual contracts.
Further, we sourced company information from Centene and Wellcare. Additional rating data is from the Better Business Bureau and J.D. Power.
Editorial Note: The content of this article is based on the author’s opinions and recommendations alone. It has not been previewed, commissioned or otherwise endorsed by any of our network partners.