Secured with SHA-256 Encryption
Select Page

WellCare Medicare Review

FREE Insurance Comparison

Compare quotes from the top insurance companies and save!

Secured with SHA-256 Encryption

UPDATED: Nov 30, 2018

Advertiser Disclosure

It’s all about you. We want to help you make the right coverage choices.

We strive to help you make confident insurance decisions. Comparison shopping should be easy. We partner with top insurance providers. This doesn't influence our content. Our opinions are our own.

WellCare
Premiums
Claims
Feedback
Financial Strength



Compare Insurance Quotes

Secured with SHA-256 Encryption
Florida-based WellCare focuses on government-sponsored health plans including Medicare and Medicaid. They operate through a variety of subsidiary companies across the country.

About 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.

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.

Medicare Advantage

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,

Rates

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.

Claims

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.

Compare Insurance Quotes

Secured with SHA-256 Encryption

Review Information

Summary
Review Date
Reviewed
WellCare Medicare
Author Rating
31star1star1stargraygray

About Eric Stauffer

Author: Eric StaufferI am a former insurance agent and banker turned consumer advocate. My 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.

18 Comments

  1. My husband sent Wellcare two electronic funds transfer (ACH payment) for both his drug plan and mine.

    The payments covered us both for the entire year, through to the end of 2020– each payment was 158.40.

    The two separate payments were designated for each of us on the memo line of the ACH payment.

    However, only one ACH payment was posted – it was to my husband’s account.

    No ACH payment was posted to my account. In fact, Wellcare insists no payment was made to my account.

    However, my banks have proof that Wellcare deducted two ACH payments from our checking account–One from my husband with his name on it and one from me with my name on it.

    I repeat, Wellcare only posted one of the two ACH payments.

    Two weeks ago, Wellcare sent me a notice saying my account was overdue and if I do not pay it immediately, they will terminate my drug plan.

    We have spent the last two weeks getting the runaround from Wellcare — over the phone – waiting online for hours on end.

    When we finally reach a person, they send us to their accounting department where we wait again to speak with someone.

    And then, the accounting department claims only one ACH payment was received — namely my husband’s.

    They did not post the second ACH payment to my account – which, I emphasize, had my name on it.

    We have proof that Wellcare took the ACH payments out of our account.

    They tell us we must pay them again. I will not.

    Wellcare MUST give us an accounting of my ACH payment they took from our account.

    Buyer beware is all I have to say.

    Reply
  2. My operation was approved by Aetna, but then I switched to Well CARE BECAUSE IT WAS POSTPONED.

    Mind you, IT WAS ALREADY APPROVED AT Aetna.

    I went through all their hoops, breathing tests, because I smoked, then they needed the sign off from the PCP but that was a problem because he was out of network- which I have out of network coverage.

    Then when they get that they wanted a peer to peer calls with the surgeon. They got that.

    Everyone signed off and then they reverted back to – he smokes.

    Really? The plan shouldn’t take smokers then. They suck.

    I am dumping them today and going back to Aetna.

    The only reason I switched was that they forgot to add on vision and dental and I was pissed when I got a bill.

    Reply
  3. I am the same as above…numerous calls to no avail.

    The person on the other end can’t speak English let alone understand what is being asked.

    She finally said I don’t have any benefits information call your provider!

    I can’t get on the website…they can’t figure out how to reset my password after a so-called glitch in their system.

    Now today I go to my rheumatologist and my copay has jumped $10 but I had no idea.

    I’m more than frustrated!!! I even contacted my original agent, who said she would always be available.

    And I sent an email to the complaint area…no response to any.

    Reply
  4. Without a doubt THE ABSOLUTE WORST COMPANY I HAVE EVER HAD THE MISFORTUNE OF DEALING WITH!

    I wish I had seen this before I signed up.

    I switched plans in 2020 and suddenly the computer has dropped me…never told by them…found out when I couldn’t get my heart medicine shipped out to me!

    On hold for HOURS AT A TIME with their top rate Manila “Customer Service” (???) people…

    Medicare needs to drop this company…THEY ARE HORRIBLE!!!!!!!!!!!

    Reply
  5. I think Wellcare is a bad company to do business with.

    Forever on phone.

    3 people could not help at all and if interested.

    The card did not get here in time and I had to pay the full cash price for my Rx.

    They bought Aetna out or took it over.

    Aetna was excellent. Give Wellcare a zero for customer service and cannot get into their website.

    Reply
  6. Premium payments changed without notification to Part D participants.

    Unable to use the website due to website down (still is not usable).

    Sent paperwork twice for authorization to speak with customer service for a spouse…

    finally, WellCare received but sent a letter claiming that spouse did not sign.

    I had made a copy before sending and the signature was clearly on that copy.

    Waited a half hour to answer my call, then had to transfer to another department…another half hour wait.

    Unable to resolve the issue due to the website not working correctly.

    Have received payment booklets twice after setting up recurring payments from credit cards (as had been done the previous year).

    Unable to understand customer service personnel (foreign accent).

    Chat line not working. No satisfactory solutions to any of these issues. I Will not choose WellCare next year.

    Reply
  7. I had Aetna RX select; since Aetna no longer was having drug coverage, they put me into WellCare RX Select.

    Had been a member since 2017. I received my new WellCare RX Select card on 11/12/2019.

    I called Aetna and told them I wanted to stay with the same drug coverage and they said I would have to go online and apply for the coverage I wanted.

    I went online and applied for WellCare Medicare RX Select (PDP) (289).

    Later, I received a WellCare Classic Prescription Drug Card.

    On 12/3/2019 I called WellCare and told them I had 2 prescription drug cards.

    I was told to shred my WellCare RX Select card and use my WellCare Classic card.

    I told the agent that I wanted to keep the drug program I was using.

    In the meantime, Social Security sent me my new benefits and the amount of $18.70 was the premium they were deducting from my Social Security check each month.

    On 11/18/2019 WellCare sent a letter saying the payment needed to be received no later than the 20th of the month in January.

    After talking to another agent about the situation with WellCare; she told me to call WellCare and try to resolve the issue.

    I was on the phone with WellCare for several hours and never got the situation resolved.

    I was told by Jessica to call the next morning at 8:00 am; which was January 1 st.

    They canceled the WellCare Classic and had already canceled the Rx Select plan and told me to file for a new prescription drug plan.

    WellCare Select was filled out on the telephone.

    I explained to her everything I said in this complaint and she finally told me WellCare Select would not accept my application unless I was on Medicaid or had extenuating circumstances for not having a drug plan before January 2020.

    I now have no drug coverage for 2020. Please help me if you can or tell me what I can do now.

    I thought about going to the Social Security Office in Terre Haute, IN.

    Reply
  8. My suggestion to other people is Stay Away from Wellcare!!!!

    I am on Medicare and was set up with Anthem PDP. I was very happy with the way Anthem handled my PDP coverage.

    Then Medicare enrolled me into WellCare PDP. It is now December 18h 2019.

    The paperwork that WellCare sent me says that my coverage starts on January 1st 2020 and that I owe WellCare $34.60.

    I had a few questions about the prescription coverage.

    I called the member service telephone number on the back of my card.

    I was on hold for an hour and a half and No One ever answered the phone.

    I tried calling the following day and was put on hold for an hour.

    I went to the WellCare website and created an account.

    I left 2 messages on their website and still have not received any response.

    WellCare is the worst company that I have ever had to deal with.

    I’m going to find another company with PDP coverage. I WILL NEVER, EVER USE WELLCARE IN THE FUTURE!!!!

    My suggestion to other people is Stay Away from this company!!!!

    Reply
    • I could not agree more with Robert. Worst company I’ve ever tried to get an HONEST answer from.

      My last two conversations with their INCOMPETENT staff assured me that an e-mail would be sent immediately confirming our conversation………….

      NEVER HAPPENED!!!!!! They lie just to get you off the phone, and they barely speak English!!!!!!!!!!!!!!!

      Reply
    • UPDATE; I searched online and found the Good Rx website.

      I printed a free medication discount coupon from the Good Rx website.

      I took the coupon to my pharmacy.

      My pharmacy accepted the coupon and gave me the medication for $21.00 for a 3 months supply.

      WellCare was charging me $34.60 a month + $1.25 copay at the pharmacy.

      The last time I talked to Well Care on the phone I told them to CLOSE my account !!!

      Now for the last 2 weeks, someone from Well Care has been leaving me messages on my voicemail asking me to call them back.

      I am NOT going to return the call. Screw this company !!!

      P.S. I have found a few Free Drug Discount Programs on the internet; Drugs.com, Good Rx, Easydrugcard.com and many many more.

      Reply
  9. I have enrolled and after two weeks decided to back check their application process as I had not received a confirmation.

    App was apparently in limbo because the primary doctor did not exist …..

    Of course, the primary they apparently recorded was not the primary I provided them with.

    Not off and running well.

    Reply
  10. WORST CUSTOMER SERVICE EVER! STAY AWAY FROM THIS COMPANY!

    Reply
  11. My major complaint is that when I call Well Care for assistance, the person I am speaking to can hardly speak English, never mind understand it.

    I have to continually repeat myself.

    If the person cannot understand English, how can they properly take care of your issue?

    Reply
    • WellCare is a really bad choice to make.

      They do not issue membership cards but once.

      Lose your card and you just have to go without one!

      They just do not care about people!

      Reply
  12. You are right; you get what you pay for.

    Their customer service and website member service is the absolutely worse I have ever experienced.

    Information, specifically account payments, are not shared.

    And one has to wait for the approval chain to take place.

    The person on the phone has absolutely no authority.

    Expect to be on the phone for +30 minutes to get a simple question answered.

    You would think that one could accomplish simple bill payment and record keeping online.

    Their website is used for their announcements versus a member-focused utility platform.

    I regret starting with WellCare; they are killing me and I have not gotten a prescription filled by them yet! Stay away.

    Reply
  13. I am looking for information to lodge a complaint and perhaps get some help. I enrolled and received a confirmation #. however, when I called regarding a life-saving medication script, nobody had my ID #. I was calling for the #. they wouldn’t/couldn’t find the ID number and told me to call back when I found it!!!???????

    Reply
    • This has been a nightmare dealing with this company.

      I am kept on the phone for half a day with no resolution to issues relating to my parents accounts.

      I have been trying to get them to stop billing my deceased mother’s account for about six months, with no resolution in sight.

      Helpppppp

      Reply
  14. Written by Ayla Ellison May 23, 2014
    Tampa, Fla.-based WellCare operates HMOs in several states, providing health and prescription drug plans to 3.5 million members through Medicare and Medicaid. On May 19, three top executives from the company were sentenced for their involvement in a scheme to defraud Florida’s Medicaid program.

    Here are five things to know about the alleged WellCare Medicaid fraud scheme:

    1. StayWell and Healthease, two of WellCare’s HMOs operating in Florida, have contracts with the Agency of Health Care Administration, the agency that administers Florida’s Medicaid program, to provide Medicaid recipients with many healthcare services. According to a Florida statute, all Florida managed-care plans, such as WellCare, that spend less than 80 percent of premiums on patient care are required to return the difference to the Agency of Health Care Administration.

    2. In May 2009, federal charges were brought against WellCare alleging the company had submitted annual reports containing inflated expenditure information to the Florida Medicaid program to reduce its payback obligation. As part of a deferred prosecution agreement, WellCare was required to pay $40 million in restitution, forfeit another $40 million to the government and cooperate with the government’s criminal investigation concerning the fraud scheme. For complying with all terms of the agreement, all charges were dropped against the company.

    3. After the charges were dismissed against WellCare, HHS’ OIG, the Federal Bureau of Investigation and the Florida Medicaid Fraud Control Unit continued their criminal investigation of three WellCare executives. The investigation revealed the executives had kept $40 million that should have been spent on patient care or otherwise returned to the Florida Medicaid program.

    4. In June 2013, a federal jury convicted the three executives for their involvement in the Medicaid fraud scheme. WellCare’s former CEO, Todd Farha was convicted of two counts of healthcare fraud. On May 19, he was sentenced to three years in prison. Mr. Farha also received a $50,000 fine that was ordered by the court to be paid immediately.
    5. WellCare’s former CFO, Paul Behrens, was convicted of two counts of healthcare fraud and two counts of making false statements related to healthcare matters. Mr. Behrens received a two year prison term for his involvement. William Kale, WellCare’s former vice president, was also convicted of two counts of healthcare fraud, and he was sentenced to one year in prison for his participation in the fraud scheme.

    By personal experience, it has been a death sentence dealing with WellCare. I know have a Chicago Law team hired to fight them.

    Reply

Leave a Rating

Your email address will not be published. Required fields are marked *