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WellCare was founded in 1985 in Tampa Bay, Florida. The company originally provided Medicaid plans, but in 1997 they began offering private plans to residents of the state eligible for Medicare. These plans were originally Medicare+Choice and became known as Medicare Advantage in 2003 with the passing of new legislation. In 2006, WellCare added Part D Prescription Drug plans to their roster.
The company expanded to other states mainly through acquisitions, many of which took place in 2012 and 2013. Today, WellCare offers some form of coverage in every state and the District of Columbia, although what is available differs from state to state. Some have a full complement of plans, while others have only Part D plans.
WellCare was the subject of controversy in 2007 when the company came under investigation by the FBI. The case, which involved false documentation of expenditures, led to a plea bargain, repayment of millions of dollars, and the resignation of WellCare executives. The company stated that its operations were not impacted by the case, which took several years to resolve.
WellCare Health Plans, Inc. is the parent company for a number of other companies including – WellCare itself, Staywell, Healthease, EasyChoice, Ohana, and Harmony. Headquarters for WellCare remain in Tampa Bay, but regional offices are located in seven other cities across the country.
WellCare offers Medicare Advantage and Part D Prescription Drug Plans. They do not write Medicare Supplement. Which plans are available depends on the state in which you live, and plans may be offered through subsidiaries in some states.
In California, where we run our comparisons of Medicare Plans, WellCare’s subsidiary EasyCare offers Medicare Advantage, while Part D plans are purchased directly through WellCare. In order to look at WellCare Medicare Advantage plans directly, we also ran samples in Florida, where the company is headquartered.
In California, there are two Medicare Advantage options available through EasyCare. The first is a basic plan that has no extra premium on top of what is paid for Original Medicare, and the second carries a premium. Both are HMO plans, and both include Part D coverage.
The Easy Choice Best Plan has no deductible and lists $0 co pays for office visits, specialists, or inpatient hospital stays. Prescription drugs are covered, with Tier 1 drugs having no co pay. Tier 2 has a $15 co pay, Tier 3 a $47 co pay, and Tier 4 a $99 copay. Tier 5 carries a 33% coinsurance charge. Dental, hearing, and vision coverage are included with co pays.
The Easy Choice Plus Plan also has $40 co pays for office and specialist visits, although there is a $300 per day co pay for the first three days of inpatient hospital stays. The prescription drug coverage carries a $400 deductible, and also has $0 co pay for Tier 1. Tier 2 has a $20 co pay, while Tiers 3 and 4 are the same as with the previous plan. Tier 5 has a 25% coinsurance. This plan has dental, vision, and hearing benefits with lower costs than the Best plan and no copays for preventative services in most cases.
In order to see what WellCare offers in its home state, we also looked at the available plans in Florida.
The WellCare plans offered in Florida are both $0 premium plans. Both plans include dental, vision, and hearing benefits.
WellCare Essential is an HMO-POS plan with $0 co pays for office visits and $5 co pays for specialist visits. Under this plan, there is no co pay for inpatient hospital stays. The prescription coverage has no deductible, and both Tiers 1 and 2 have a $0 co pay. Tier 3 is $15, Tier 4 is $75, and Tier 5 has a 33% coinsurance charge.
WellCare Dividend is an HMO plan that also offers $0 co pays for office visits. Specialist visits have a $20 co pay, and inpatient hospital stays are charged a $150 co pay for the first five days. The prescription coverage under this plan is the same as the Essential, with the exception of a $25 co pay for Tier 3 drugs.
Prescription Drug Plans
In our first sample area, California, there are two Part D plans available, WellCare Classic and WellCare Extra. The Extra plan has a higher monthly premium in return for lower co pays and no deductible.
The Classic plan has a $400 deductible. Co pays under the plan are $0 for Tier 1, $14 for Tier 2, $46 for Tier 3, and coinsurance of 48% for Tier 4 and 25% for Tier 5. The Extra plan has no deductible. Tier 1 is again $0, and Tier 2 has an $8 co pay. Tier 3 has a $31 co pay and coinsurance for Tiers 4 and 5 are 45% and 33% respectively.
In Florida, the Classic and Extra plans are also offered, but the copays differ slightly. Classic still has the $400 deductible and the $0 co pay for Tier 1, but Tiers 2 through 5 are at $13, $47, 47%, and 25%.
The Extra plan again has no deductible and no Tier 1 co pay. Tier 2 drugs have a $6 co pay, Tier 3 a $32 co pay, and Tiers 4 and 5 coinsurance amounts of 45% and 33% respectively.
California is our sample state used to compare insurance company rates, and overall the rates offered in this state by WellCare stand up well against other companies.
Part D coverage options are priced at $34.90 for Classic and $67.50 for Extra, per month.
Medicare Advantage plans are priced at $0 for the EasyCare Best plan and $33.10 per month for the Plus plan. Considering the low co pays offered by both plans, these rates are among the best value we have seen.
Rates in Florida are very similar, although in that case, both Advantage plans are $0 premiums. The Part D plans are priced within a few dollars of the rates in California.
Based on the available information on the plans, we find the WellCare offerings to be very well priced across the board, and a good value considering the low co pays for most services.
Ratings and Reviews
WellCare has an A+ rating with the Better Business Bureau (BBB) in spite of the previously mentioned government lawsuit against the company, which is noted on their file. There are 41 complaints on file with the BBB in the past three years, 10 of which were closed in the past 12 months.
The company has a 3-star rating on Consumer Affairs. Of the 23 total reviews on the site, 10 are four stars and higher, which is very unusual for an insurance company of any size.
Medicare star ratings for the company’s plans vary, as there are many plans offered in different states. The plans we reviewed averaged a 3-star rating, placing them a little lower than we would like to see in terms of this official rating system.
Considering the fact that this company has been taken to court over violations and false claims, the good reviews are even more surprising. It would appear that the corporate troubles and government sanctions against WellCare have not much impacted the customer experience.
The Bottom Line
WellCare offers a basic selection of Medicare plans at very reasonable prices and appears to enjoy a good reputation among customers. For those who are willing to accept the government action against WellCare as a thing of the past, they are worth consideration for Medicare Advantage or Part D coverage plans.
For a list of companies that we recommend, visit our Best Insurance Companies page.