WellCare is a reputed managed health insurance services provider based at Tampa, Fla. The company has been providing government-sponsored managed care services to families, children, seniors and individuals.
The major healthcare plans that company offer includes Medicaid, Medicare Advantage and Medicare Prescription Drug Plans. As of now, the company serves approximately 6.3 million members nationwide.
As stated, WellCare health plans cover three major government-sponsored health plans Medicaid, Medicare Advantage and Medicare Prescription Drug Plans. Since its inception to the health care marketplace, the company is continually improving the quality of health care and managed services offered to all its stake holders and members.
Wellcare Health Plans, Inc. holds a several subsidiaries under its umbrella. These subsidiaries include WellCare, Staywell, HealthEase, Harmony, and ‘Ohana. Company operates from its multiple regional offices located in Miami, New York City, New Haven, Baton Rouge, Marietta, Houston, and Chicago.
WellCare based in Tampa, Florida is recognized by Fortune magazine as the world’s most admired company. The company began its journey as a Medicaid provider for the state of Florida in 1985. However, after the implementation of the Balanced Budget Act of 1997, the company also started offering Medicare Advantage plans, and in 2003 the company started offering Medicare Advantage plans with prescription drug coverage. The company went public in the year 2004 and started offering Medicare Part D plans in 2006. WellCare appointed Kenneth Burdick as the new CEO and a board member in 2014. With a complete emphasis on holistic health, the company rebranded itself with the tagline “Beyond Healthcare: A Better You.” in September 2017. WellCare included UNC Health Alliance primary care physicians and specialists into its Medicare Advantage network in October 2017.
Centene Corporation acquired WellCare in January 2020, so now it is a subsidiary of Centene Corporation. WellCare is the holding company for several subsidiaries such as Staywell Health Plan, Meridian Health Plan, WellCare, Ohana Health Plan, Missouri Care, and Care1st Health Plan Arizona. The company holds extensive experience in government plans like Medicare and Medicaid and the Medicare Advantage plans offered by the company have earned four out of five stars for the government’s quality ranking. WellCare offers Medicare, Medicaid, and Medicare Prescription Drug plans to more than 15 million customers across the country and has employed more than 14,000 associates. The company is currently serving in 32 states and it’s committed to offer top-notch service to help people stay healthy.
Wellcare started operations in 1985 in Tampa, Florida as a verified Medicaid provider for the Florida State. As the Balanced Budget Act of 1997 came into the effect, WellCare started offering Medicare health insurance plans. At the time, these programs were offered with Medicare+Choice or Part C plans.
Company added Medicare Advantage plans in its product portfolio in 2003 to offer prescription drug benefits to the insurance seekers. It happened after the company was approved for offering services under the Medicare Prescription Drug, Improvement, and Modernization Act.
Thereafter in 2006, Wellcare included Medicare Part D plans in its product portfolio. Now, the company has shot to fame for one of the top 10 Part D insurance providers by membership volume for these types of plans.
Since its arrival in the healthcare marketplace, WellCare got through several acquisitions where the company taken over many smaller Medicare & Medicaid supplement providers. These acquisitions helped company to expand its product portfolio significantly. Following are some of the major acquisitions by the WellCare:
November, 2012: Easy Choice Health Plan in California
February, 2013: UnitedHealthcare’s Medicaid business in South Carolina
April, 2013: Missouri Care, Incorporated
September, 2013: Purchase of Windsor Health Group in Mississippi
November, 2016: Universal American
January, 2017: Care1st Health Plan Arizona
Medicare Plans Offered by WellCare:
WellCare, along with other health insurance carriers provide Medicare Advantage plans in the state. Following are the major Medicare plans provided by WellCare:
1: WellCare Health Maintenance Organization (HMO) Plans:
In case you go for a WellCare HMO plan, you’re required to name a primary care physician (PCP). He will take care of all of your medical needs including referring you to another healthcare provider in the network if he finds it necessary as per your medical conditions. The USP of the plan is its affordability since it comes with low premiums, copays, and coinsurance.
2: WellCare Point of Service (POS) Plans:
A POS plan is an HMO subtype that’s operated provided by a network of healthcare providers. However, it differs in a way as it allows beneficiaries to look for medical professionals outside the network if needs arise.
WellCare’s PPO Medicare plans are a perfect fit for the beneficiaries living in certain counties in New York, Georgi, Florida, and South Carolina. The plan enables beneficiaries to choose a medic professional of his/ her choice as long as he or she is in the plan’s network. The only downside of the plan is that you have to pay higher premiums, copay, and coinsurance.
4. WellCare Special Needs Plans (SNP)
An SNP is typically offered to those with chronic health issues or those who qualify for insurance coverage through both Medicare and Medicaid. Availability varies by location.
5. WellCare Special Needs Plans (SNP)
WellCare’s SNP plan is ideal for those who are taking medication for chronic health issues. The plan is also applicable for those patients who qualify for insurance coverage through both Medicare and Medicaid. To note, the availability of the plan may vary from one location to the other.
In addition to the above, WellCare Medicare Advantage plans also offer beneficiaries prescription drug coverage. However, one can purchase a stand-alone drug plan if he or she has already has the original Medicare plan.
Another WellCare plan called Medication Therapy Management is designed to help mitigate drug-related risks, increase prescription awareness, and support healthy prescription drug habits. With the plan, beneficiaries receive a comprehensive medication review to discuss your prescription medications, and over-the-counter medicines.
Fortune magazine has recognized WellCare as the World’s most admired company and the company has also received 3.57 out of 5 stars by Medicare’s rating system. The company has an A+ rating with the Better Business Bureau (BBB) and is also considered best for customer service.
If you once get enrolled in a health plan, then you cannot be dropped or disqualified due to any medical condition. The company reserves the right to dis-enroll you only in the case if you commit fraud or move out of the company’s service area. The Medicare Advantage plan offered by the company is offered for a complete one year and every year the company decides whether to continue the plan for another year. If a Medicare Advantage Plan gets discontinued at the end of a benefit year, then also you will not lose your Medicare coverage. If a health plan is discontinued due to any reason then the company will notify in writing at least 60 days in advance before the end of the coverage. you will also be explained about your other Medicare options available in your area.
The doctor with whom you received healthcare will submit a claim on your behalf to the company and you would be covered for the care received except for the copay. You will receive an explanation of benefits from your carrier and a bill from your doctor if you owe anything. If you have availed healthcare from an out-of-network provider, then you will not receive coverage unless it was an emergency.
All the individuals who are eligible for Medicare and Medicaid can avail of health insurance from WellCare, as this company only offer government health plans like Medicaid, Medicare Advantage, and Medicare Prescription Drug plans.