At a glance
- WellCare offers Medicare Advantage plans in 36 states and Part D plans in 50 states.
- WellCare offers PPO, HMO, and PFFF Medicare Advantage plans.
- The specific plans available to you will depend on where you live.
- WellCare has been acquired by Centene Corporation, which services more than 26 million members in all 50 states.
WellCare Health Plans is a Tampa, Florida-based insurance supplier that offers Medicare Advantage ( Part C ) and Medicare Part D ( prescription drug ) plans to Medicare beneficiaries in several states. This article will explore the different Medicare Advantage design types that WellCare offers, a well as provide some examples of costs under different WellCare plans across the area.
WellCare Medicare Advantage plan options
The comply are examples of types of Medicare Advantage plans that may be available in a person ’ sulfur coverage area. Plans are normally very region-specific, and WellCare may not offer all design types in a particular area .
WellCare HMO plans
WellCare offers Health Maintenance Organization ( HMO ) plans as depart of their Medicare Advantage offerings. typically, a WellCare HMO plan will involve selecting a primary care provider ( PCP ) who manages a person ’ second care. This means the PCP will make referrals to healthcare specialists who are in-network for WellCare. When a person is a member of an HMO, they may pay higher or wax costs if they see a doctor who is out-of-network .
WellCare PPO plans
WellCare offers Preferred Provider Organization ( PPO ) plans in most states. These organizations offer reduced rates for choosing in-network providers, so far a person may still receive reimbursement if they see out-of-network providers. typically, a person will not have to obtain a referral to see a specialist. however, there may be instances where getting a referral or obtaining pre-authorization for a routine may be encouraged, particularly if the supplier is an out-of-network matchless .
WellCare Medicare Advantage Special Needs Plans
special Needs Plans ( SNPs ) are Medicare Advantage plans geared toward those who have a detail medical condition or fiscal want. here are the unlike types of SNPS available for those who meet the criteria :
- Chronic Condition Special Needs plans (C-SNPs): for people with chronic health conditions
- Institutional Special Needs plans (I-SNPs): for people who live in nursing homes or long-term care facilities
- Dual Eligible SNPs (D-SNPs): for patients who are eligible for both Medicare and Medicaid coverage
These plans each offer comprehensive hospitalization, medical service, and prescription coverage but have been separated based on the patients they serve .
WellCare Private Fee-for-Service plans
WellCare offers Private Fee-for-Service ( PFFS ) plans in choice areas of the nation. This is a plan that normally offers a set pace for what it will pay hospitals and doctors for services, with a set copay, or coinsurance, the policyholder will pay vitamin a well. A PFFS design may have a supplier network or a person may be able to see any provider they choose. The provider must normally accept appointment from Medicare or accept the PFFS plan ’ mho terms for what it will pay.
What do WellCare Medicare Advantage plans cover?
WellCare Medicare Advantage plans can vary by state and area. however, many plans offer the adopt benefits in addition to Medicare parts A and B. These include :
- annual fitness membership
- dental services, including preventive and treatment coverage
- prescription drug coverage
- transportation to doctor’s visits and pharmacies
- vision services and help paying for glasses and contact lenses
When you are evaluating a particular plan, cautiously read the plan ’ second explanation of benefits so you can see the types of extra services WellCare offers .
How much do WellCare Medicare Advantage plans cost?
WellCare offers some Medicare Advantage plans at a $ 0 premium. You must still pay your Medicare Part B premium each month to Medicare but can receive extra services with no monthly premium from WellCare. No count what premium you pay, you will have deductibles, copayments, or coinsurance for services, as set by your plan and Medicare. The follow are some examples of WellCare Medicare Advantage plans available across the country and what you might pay in 2022 .
| City/ plan |
Star rating |
Monthly premium | Health deductible/drug deductible | Out-of-pocket max | Primary doctor copay/coinsurance per visit | Specialist copay/coinsurance per visit |
|---|---|---|---|---|---|---|
| Cleveland, OH: WellCare Dividend Giveback (HMO) | 3.5 | $0 | $0; $480 | $4,350 in network |
20% | 20% |
| Little Rock, AK: Wellcare No Premium Preferred (HMO) |
3.5 | $0 | $0; $0 | $6,000 in network |
$0 | $35 |
| Portland, ME: Wellcare No Premium Open (PPO) | 4 | $0 | $0; $0 | $5,000 in network |
$0 in network; $25 out of network |
$30 in network; $50 out of network |
| Springfield, MO: Wellcare No Premium (HMO) | 4 | $0 | $0; $0 | $6,700 | $0 | $35 |
| Trenton, NJ: Wellcare Assist (HMO) | 3.5 | $18.20 | $0; $480 | $7,550 | $0 | $35 |
available plans and costs can vary from year to year. If you have a particular WellCare Medicare Advantage plan, the design will notify you in the fall of any changes to costs .
What is Medicare Advantage (Medicare Part C)?
Medicare Advantage ( Part C ) is a “ bundled ” health plan where a private insurance company is creditworthy for providing a person ’ randomness Medicare coverage. Medicare Part C normally includes Part A ( hospital coverage ), Part B ( medical coverage ), and Part D ( prescription drug coverage ). however, some WellCare plans preceptor ’ metric ton cover Part D. When you purchase a Medicare Advantage design, Medicare pays your insurance company of choice to provide you with health benefits. To stay competitive, your indemnity plan may offer you extra benefits not available in original Medicare. These include services such as dental, vision, or hearing coverage. Companies that offer Medicare Advantage frequently contract with doctors and hospitals to negotiate costs for medical services. If a doctor or hospital agrees to provide services at a certain rate with the insurance company, the company will normally designate them as an “ in-network ” supplier. Medicare Advantage plans are very state- and region-specific because of the manner a plan negotiates with hospitals and doctors in each area. As a consequence, not all design types WellCare offers are available in all states.
The takeaway
WellCare offers Medicare Advantage in 36 states and Medicare Part D plans in all 50 states, with plans varying by region. These plans may include PPOs, HMOs, and PFFFs, and could help you manage healthcare and prescription drug drug costs not covered under standard Medicare programs. You can find out if WellCare offers a design in your sphere by searching Medicare ’ s find a plan tool .
