TABLE OF CONTENTS

Is WellCare good health insurance?

WellCare health insurance may be a good choice for Medicare beneficiaries seeking low monthly premiums.

Overall rating: 4

Tampa-based WellCare Health Plans Inc. has provided competitively priced health insurance and prescription drug coverage to Americans since 1985. Today, it serves customers nationwide and offers Medicare plans in at least 27 states. In 2020, WellCare merged with Centene Corporation, a multinational health care enterprise and Fortune 100 member. To date, it’s written more than 589,352,177 premiums, which makes it one of the nation’s top 50 insurers. Learn more about some of the WellCare health insurance plans that may suit your needs.

WellCare Logo

WellCare Health Insurance Overview
Company founded 1985
Coverage area All 50 states
A.M. Best rating B
BBB rating A+
NCQA accreditation Yes
NCQA rating 3.0
Plans available
  • Family health insurance
  • Individual health insurance
  • Medicaid
  • Medicare
Provider network
  • A large national network of hospitals and physicians

Is WellCare a Good Health Insurance Provider?

What we like about WellCare health insurance plans: The drawbacks of WellCare health insurance plans:
  • Competitive premiums
  • Many coverage options for Medicaid and Medicare enrollees
  • Nationwide carrier
  • Coverage options vary by state
  • People who don’t qualify for Medicare may have limited options

What Do WellCare Health Insurance Plans Cover?

WellCare health insurance includes commercial plans available to individuals and families and Advantage Plans, and Part D prescription drug policies for Medicare enrollees. Coverage options vary depending on your state of residence and may include:

  • Children’s Health Insurance Program (CHIP)
  • Individual and family plans
  • Medicaid managed care coverage
  • Medicare Advantage and prescription drug plans

WellCare Affordable Health Insurance Plan Options

While WellCare offers commercial marketplace insurance plans and children’s health insurance in some states, such as New York, it primarily focuses on Medicare Advantage Plans and Part D prescription benefits.

You can choose from health maintenance organizations (HMOs) and preferred provider organizations (PPOs), including options for individuals who qualify for special needs plans due to a specific medical condition. In addition, private fee-for-service options may be available in particular communities.

WellCare offers competitive rates and many policies with $0 premiums and no annual deductible. Medicare Advantage Plans typically include dental, vision, and hearing.

Learn about some of the options that may be available in your area:

#
Compare your options for WellCare health insurance plans:
Plan name Plan type Monthly premium Annual deductible Office visits Annual maximum out-of-pocket cost
WellCare Absolute PPO $0 $0 for medical/$90 for prescription drugs $0 primary/$40 specialist $6,700 in-network/$10,000 combined
WellCare Compass HMO $16.40 $0 for medical/$445 for prescription drugs $0 primary/$25 specialist $4,900
WellCare Premier PPO $0 $0 for medical/$75for prescription drugs $0 primary/$30 specialist $5,500 in-network/$10,000 combined
WellCare Classic PDP $27.20 $445 $0-$30 for Tier 1-3 medications/25-34% coinsurance for Tier 4 and 5 medications $6,550

*Based on pricing for a Medicare enrollee in Nashville, Tennessee

How Is WellCare Rated?

Customer satisfaction ratings can give you a good idea of how WellCare stacks up against competitors. We considered coverage quality, financial strength, and overall value when determining these ratings.

Overall rating: 4
Financial strength rating: 3.5
 Customer satisfaction rating: 4
 Value rating: 4.2
 Coverage rating: 4.5

Financial strength: 3.5/5

WellCare has a fair ability to meet its ongoing financial obligations. According to A.M. Best, a credit agency that provides Financial Strength Ratings, the company has a B rating.

Customer satisfaction: 4/5

Customer satisfaction ratings for WellCare are based on Better Business Bureau, Consumer Affairs, and the National Committee for Quality Assurance data sets. Here’s how the insurer performed.

WellCare has maintained an A+ rating from the BBB with more than 35 years in business. The company has had 72 complaints closed in the past year, with most issues related to its Part D prescription drug plans.

The National Committee for Quality Assurance gives WellCare of New York an average rating of 3.0 for its commercial insurance plans. Ratings range from 2.5 for preventive care to 3.0 for treatment and customer satisfaction. Performance varies for Medicare and Medicaid plans.

WellCare has a 3.3 rating from Consumer Affairs based on more than 240 reviews. Some consumers have reported issues with denials, delayed reimbursement, and poor customer service. However, customers report that the coverage is good with competitive premiums and plenty of plan choices.

Value: 4.2/5

Competitive premiums are one of WellCare’s selling points. Its Medicare Advantage plans offer $0 copays for primary care and competitive copays for specialists. As a result, premiums and deductibles are low, but out-of-pocket maximums vary.

Coverage: 4.5

This rating is based on the size and scope of WellCare’s provider network and its coverage terms, and the selection of policies. Consumers in most areas can choose from several plans depending on needs and budget.

author-img
Tammy Burns
Insurance and health care consultant

Tammy Burns is an experienced health insurance advisor. She earned her nursing degree in 1990 from Jacksonville State University, obtained her insurance billing and coding certification in 1995, and holds a health and life insurance license in Alabama, Georgia, Iowa, Mississippi, and Tennessee. Burns is Affordable Care Act (ACA)-certified for health insurance and other ancillary, life, and annuity products. She maintains an active nursing license and practices private-duty nursing.

Burns’ background as a nurse, insurance biller and coder, and insurance consultant includes infectious disease, oncology, gynecology, phlebotomy, post operative, family medicine, geriatrics, home health, hospice, human resources, management, billing, coding, claims, fixed annuities, group and individual health and life products, and Medicare. She’s always been driven by a desire to help people, spending more than 25 years as a practicing nurse in hospitals, private doctors’ offices, home health, and hospice. As a nurse, Burns supported patients filing insurance claims with Medicare, Medicaid, and private insurance companies as well as responding to billing questions from confused patients.

Seeing firsthand how unsuspecting patients are frequently confused by an overly complex system they don’t understand led Burns to become an insurance agent and health care consultant, now helping people understand the medical system. Since becoming an insurance agent in 2013, she has worked with some of the largest and most reputable insurance carriers and agencies in the nation, and she has built a large and loyal clientele by way of her commitment to transparency and personalized service.

author-img
Tammy Burns
Insurance and health care consultant

Tammy Burns is an experienced health insurance advisor. She earned her nursing degree in 1990 from Jacksonville State University, obtained her insurance billing and coding certification in 1995, and holds a health and life insurance license in Alabama, Georgia, Iowa, Mississippi, and Tennessee. Burns is Affordable Care Act (ACA)-certified for health insurance and other ancillary, life, and annuity products. She maintains an active nursing license and practices private-duty nursing.

Burns’ background as a nurse, insurance biller and coder, and insurance consultant includes infectious disease, oncology, gynecology, phlebotomy, post operative, family medicine, geriatrics, home health, hospice, human resources, management, billing, coding, claims, fixed annuities, group and individual health and life products, and Medicare. She’s always been driven by a desire to help people, spending more than 25 years as a practicing nurse in hospitals, private doctors’ offices, home health, and hospice. As a nurse, Burns supported patients filing insurance claims with Medicare, Medicaid, and private insurance companies as well as responding to billing questions from confused patients.

Seeing firsthand how unsuspecting patients are frequently confused by an overly complex system they don’t understand led Burns to become an insurance agent and health care consultant, now helping people understand the medical system. Since becoming an insurance agent in 2013, she has worked with some of the largest and most reputable insurance carriers and agencies in the nation, and she has built a large and loyal clientele by way of her commitment to transparency and personalized service.

Sources