|Medicare rating: 4 stars||A.M. Best financial strength rating: Not Rated||BBB rating: A-||NCQA rating: 2.5 to 3.5 stars||Consumer Affairs rating: 2.9 stars||J.D. Power ranking: 10th out of 10|
Quick WellCare Medicare Prescription Drug Plans review: WellCare offers Medicare Part D prescription drug coverage through standalone Part D plans and Medicare Advantage Plans. Monthly premium prices vary depending on where you live and which type of plan you choose. You can find Centers for Medicare and Medicaid Services (CMS) quality rating information for each plan by searching Medicare.gov.
WellCare Healthplans, Inc. began offering Medicare Part D prescription drug plans (PDPs) in 2006. WellCare was founded in 1985 and acquired by Centene Corporation in January 2020. Since then, WellCare has been Centene’s largest government-sponsored health care programs provider.
If you have Original Medicare Part A and/or B or a Private Fee-for-Service (PFFS) Medicare Advantage Plan, you can purchase one of WellCare’s standalone Part D plans. If you have a WellCare Preferred Provider Organization (PPO) or Health Maintenance Organization (HMO) Medicare Advantage Plan, your plan should include drug coverage.
Compare Wellcare’s Prescription Drug Plans (PDPs) available in your area on Wellcare’s website.
Pros and Cons of WellCare Medicare Part D Plans
|What we like about WellCare Medicare Part D Plans:||The drawbacks of WellCare Medicare Part D Plans:|
What do WellCare Medicare Part D Plans cover?
WellCare Medicare Part D plans are regulated by CMS and must cover a wide range of prescription drugs that people with Medicare take. Plans include a coverage gap that begins when you and your plan have spent a certain amount ($4,660 in 2023) on prescription drugs and ends when you’ve spent $7,400 and enter the catastrophic coverage period. You then will pay a small coinsurance percentage or copay amount for drugs you need until the end of the year. When you are in the coverage gap, you will pay up to 25% of drug costs.
WellCare has a formulary (list of drugs) and separates drugs into tiers that correspond to costs. Lower tiers include generic, lower-cost medications, and higher tiers include higher-cost, brand name, or specialty drugs.
Your share of costs for each prescription drug may change depending on which pharmacy you choose, the tier of the drug, and when you enter each coverage phase. You must meet your annual deductible before your plan pays. Wellcare’s Part D plans include:
- Discounts for preferred retail pharmacies (CVS and Caremark) and three-month prescriptions.
- Options for one-month and three-month mail-order prescriptions
- Permission to use any pharmacy if you get Extra Help to to pay for medications
- Senior Savings Program for select insulins to keep your costs below $35/month
What are WellCare’s Medicare Part D Plan options?
WellCare offers three different Part D Plan options, including a value plan with lower monthly premiums, a medium range plan, and a value plus plan. Initial coverage limits and annual out-of-pocket threshold amounts are the same for all three plans. The difference among the plan options lies in the amount you pay for the monthly premium.
WellCare’s Value Script plan has the lowest monthly premium and no deductible for drugs in tiers one and two. It may be best for you if you don’t need prescription drugs but need prescription drug coverage to avoid paying late penalties. The Value Plus plan has a higher monthly premium but no annual deductible. The WellCare Classic plan includes a moderate monthly premium, but you still pay an annual deductible before your plan starts paying.
Before choosing a plan, make sure your drugs are on WellCare’s formulary, and your pharmacy is in WellCare’s network. Wellcare’s preferred pharmacies are CVS and Caremark. You can keep your costs lower by using preferred pharmacies and asking your doctor for generic versions of drugs if possible.
Understand Wellcare’s rules about how you get your prescription drugs. Prior authorizations may apply. You may have to try drugs on a lower tier first before your plan approves higher-cost drugs. This is called step-wise therapy.
Compare these 2022 WellCare Medicare Part D Plans in Cook County, Illinois:
|Plan name||Monthly premium*||Annual deductible||Initial coverage limit||Annual out-of-pocket threshold amount|
|Wellcare Value Script (PDP)||$11.10||$505 (applies to tiers 3 to 6)||$4,660||$7,400|
|Wellcare Classic (PDP)||$26.20||$505||$4,660||$7,400|
|Wellcare Medicare Rx Value Plus (PDP)||$71.40||$0||$4,600||$7,400|
*Based on pricing in Cook County, Illinois
Wellcare Medicare Part D Plans Reviews and Ratings
The Centers for Medicare and Medicaid Services (CMS) rate Wellcare’s Medicare Part D and Medicare Advantage plans. The Better Business Bureau (BBB) rates Centene, WellCare’s parent company. Consumer Affairs, NCQA, and J.D. Power don’t rank WellCare’s Part D plans separately, but provide insight into Wellcare’s health and Medicare Advantage Plans.
|Medicare rating: 4 stars||Wellcare’s Medicare Part D Plans have an overall average quality rating of 4 stars from the Centers for Medicare & Medicaid Services (CMS).|
|A.M. Best financial strength rating: Not Rated||A.M. Best sets credit ratings for insurers. A.M. Best does not rate Centene or Wellcare.|
|BBB rating: A-||Centene Corp, the parent company of Wellcare, has an A- rating from the Better Business Bureau with nine complaints closed in the last three years. Wellcare health plans in different states across the country received a range of ratings from the BBB. There are no BBB ratings for Wellcare’s standalone prescription drug plans or Wellcare’s Medicare Advantage Plans.|
|NCQA rating: 2.5 to 3.5 stars||Wellcare’s Health Plans, including Medicare Advantage HMO and PPO Advantage Plans, received ratings ranging from 2.5 to 3.5 out of 5 stars from the National Committee for Quality Insurance (NCQA), a leading accreditation agency. Standalone drug plans are not rated separately, but HMO and PPO Medicare Advantage Plans usually include prescription drug coverage.|
|Consumer Affairs rating: 2.9 stars||Consumer Affairs gives WellCare health insurance a 2.9 out of 5-star rating, based on 253 reviews. Customer experience with Wellcare’s Medicare Advantage Plans and standalone prescription drug plans is included. Consumers complain about WellCare’s marketing (aggressive) and poor customer service. Some reviewers note they had difficulty with prior authorization rules.|
|J.D. Power ranking: 10th out of 10||In its 2021 Medicare Advantage Study, J.D. Power measured Medicare Advantage Plan satisfaction based on these important factors: coverage, benefits, provider choice, cost, customer service, information, communication, billing, and payment. Centene scored 769 points out of 1,000, coming in tenth out of the top 10 Medicare Advantage providers.|
Learn More From Our Sources
- Better Business Bureau | Centene Corp | Last accessed June 2023
- Consumer Affairs | Wellcare Reviews | Last accessed June 2023
- JD Power | Medicare Advantage Study 2021 | Last accessed June 2023
- Medicare | What Prescription Drug Plans Cover | Last accessed June 2023
- Medicare | Find a 2023 Medicare Plan | Last accessed June 2023
- NCQA | NCQA Health Insurance Plan Ratings 2019-2020 – Summary Report | Last accessed June 2023
- Wellcare | Find a 2023 Drug Plan | Last accessed June 2023
- Wellcare | Home Page | Last accessed June 2023