WellCare Medicare Insurance Review & Complaints: Health Insurance

WellCare Medicare rates are less than $7 per month for WellCare Medicare Advantage plans. WellCare Medicare Part D rates average between $15-$81 per month. WellCare Medicare insurance options differ from state to state, and the company has multiple subsidiaries and partners.

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Eric Stauffer is a former insurance agent and banker turned consumer advocate. His priority is to help educate individuals and families about the different types of insurance they need, and assist them in finding the best place to get it.

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Leslie Kasperowicz holds a BA in Social Sciences from the University of Winnipeg. She spent several years as a Farmers Insurance CSR, gaining a solid understanding of insurance products including home, life, auto, and commercial and working directly with insurance customers to understand their needs. She has since used that knowledge in her more than ten years as a writer, largely in the insuranc...

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Reviewed by Leslie Kasperowicz
Farmers CSR for 4 Years

UPDATED: Dec 2, 2020

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Florida-based WellCare focuses on government-sponsored health insurance plans including Medicare and Medicaid. They operate through a variety of subsidiary companies across the country.

Our WellCare Medicare review will look at the plans and the coverage that’s included. We’ll also look at WellCare Medicare quotes to help you decide if one of these plans is right for you.

Before you decide if you want to buy WellCare Medicare insurance, take a look at some comparison quotes. Just enter your ZIP code now for free quotes from top companies.

What is WellCare?

WellCare was founded in Tampa Bay, Florida in 1985 for the purpose of writing Medicaid plans for local residents. In 1987 they began offering private Medicare plans as well, initially called Medicare +Choice and later renamed to Medicare Advantage in keeping with legislation. In 2006, they also began offering Medicare Part D plans.

Mainly in 2012 and 2013, WellCare expanded through multiple acquisitions into other states, and their reach now extends to nearly every part of the country. Plan availability varies depending on the state.

WellCare has many subsidiaries across the country, including Ohana, EasyChoice, Harmony, HealthEase, and Staywell. Their headquarters remain in Tampa Bay, with branch offices found in seven other cities.

WellCare came under fire in 2007 due to an FBI investigation of company expenditures. The case resulted in the departure of several top executives and restitution payments to the tune of millions of dollars, but the company insisted that operations and customers were not affected.

The company continues to offer a range of Medicare plans to customers nationwide.

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What WellCare Medicare Plans are Offered?

WellCare’s plans differ from state to state, and for the purpose of this review, we selected California, our usual sample state, to look at the company’s offerings. They are all HMO plans, which means you can use only WellCare Medicare providers that are in-network.

What is WellCare Medicare Advantage?

Our sample California ZIP code returned four Medicare Advantage plans. All of the plans include hearing, vision, and dental.

There are three health plans that have no additional premium beyond the Original Medicare premium. These are Dividend, Best, and Freedom. All are HMO plans with no deductible and $0 copays across the board for office visits and specialists. Freedom is an HMO-SNP plan. The Dividend plan is the only one of the three that has an inpatient hospital copay of $125 a day for the first five days. There is no prescription deductible and drugs start at $0 for Tier 1 generics, except for the Freedom plan which has a $445 deductible excluding Tier 1.

The Plus plan is also an HMO, and again has no deductible and no copays for office visits, although there is a $800 a day copay for the first three days of an inpatient hospital stay. There is a prescription deductible of $445 excluding Tier 1 and copays after that start at $0.

What is WellCare Medicare Part D?

There are a number of WellCare Medicare Rx Part D prescription drug plans available from WellCare in our sample area.

As a sample of the health plan coverage, Another example, Classic, has a $405 deductible that applies to all tiers of coverage. After that, Tier 1 has a $0 copay, Tier 2 $1, and Tier 3 $32. Tier 4 has a coinsurance amount of 44%, and Tier 5 a coinsurance of 25%.

Extra has no deductible and no copay for either Tier 1 or 2. Tier 3 has a copay of $36 and Tiers 4 and 5 have coinsurance amounts of 40% and 33% respectively.

What are the WellCare Medicare Rates?

As noted above, three of the health plans do not have a premium beyond what you pay for Original Medicare. The other plan, Plus, costs only $6.70 a month.

The prescription drug plans range in price from $15.20 to $81 a month.

These rates are specific to the area we sampled them from but compared to other samples in this area they are very affordable. It is important to note that these are both HMO plans, which means access is limited to only those providers that are part of the plan. That often means lower rates.

How are WellCare Medicare Claims Handled?

The WellCare website does not offer information regarding claims, which is normal for this type of insurance company. Health insurance companies generally handle claims directly with providers, and since these are HMO plans all of those providers should be in-network and deal with claims smoothly.

The WellCare Medicare provider phone number found on any bills you receive will connect you with the right person to discuss your claim.

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Are the WellCare Medicare Reviews and Ratings Positive?

WellCare has an A+ rating with the Better Business Bureau (BBB) and has 51 complaints on file in the past three years. There are ten customer reviews, most of which complain of poor customer service, with some citing denial of coverage for medications and services.

There are 54 reviews on Consumer Affairs, the majority of which are negative. The complaints are similar to those found on the BBB site – poor customer service claims not being paid.

The National Committee for Quality Assurance ranks each of the WellCare companies independently, and the ratings range from 2.5 stars to 3.5 stars overall. That puts some of them in the below-average range and others a little above average, but none of the companies has a particularly impressive rating.

Finally, the Medicare Ratings for the Easy Choice plans returned on our search were both 3.5 stars. Again, not poor ratings, but not stellar either.

Overall the impression is of a company that has some work to do on customer service and on improving the customer experience to bring up their ratings.

WellCare Medicare: What’s the Bottom Line?

WellCare’s plans can be inexpensive, but it appears to be a case of getting what you pay for. There are no red flags here, but ratings are mediocre and unimpressive. It would likely be beneficial to shop around for an insurance company with a plan that fits your budget and provides a higher level of service. There are companies that offer both a great reputation and also a good value for the dollar.

You may wind up choosing an affordable WellCare Medicare plan, but make sure it’s the best choice first. Compare Medicare quotes right now with our free tool below.

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