UPDATED: Nov 30, 2018
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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.
WellCare Medicare Plans
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.
Our sample California zip code returned only two Medicare Advantage plans. Both are sold by Easy Choice, a WellCare subsidiary.
The Easy Choice Best Plan has no additional premium beyond the Original Medicare premium. It is an HMO plan with no deductible and $0 copays across the board for office visits and for hospital stays. There is no prescription deductible and drugs start at $0 for Tier 1 generics.
The Easy Choice Plus plan is also an HMO, and again has no deductible and no copays for office visits, although there is a $300 a day copay for the first three days of an inpatient hospital stay. There is a prescription deductible of $405 and copays after that start at $0.
Medicare Part D
There are also two Part D prescription drug plans available from WellCare in our sample area.
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,
As noted above, the Best Plan does not have a premium beyond what you pay for Original Medicare. The other plan, Plus, costs $28.30 a month.
The prescription drug plans are priced at $32.90 for the Classic plan and $69.90 a month for the Extra plan.
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.
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.
Ratings and Consumer Reviews
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.
The Bottom Line
WellCare’s plans can be inepensive, 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 benficial to shop around for 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.
For a list of companies that we recommend, visit our Best Insurance Companies page.