Wellcare Health Plan Options for Medicare Beneficiaries

At a glance

  • $0 premium plans available in some areas
  • Many plans offer prescription drug coverage, vision or dental benefits
  • Over 26 million people are enrolled in a Medicare Advantage plan1

Wellcare offers health plans such as Medicare Advantage plans (Medicare Part C) and Medicare Part D prescription drug plans.

This guide gives you an overview of the types of Wellcare Medicare health plans that may be available where you live.

Wellcare Medicare Advantage plans

Wellcare Medicare Advantage plans offer all the same benefits that are covered by Original Medicare (Part A hospital insurance and Part B medical insurance). Some Medicare Advantage plans may offer some additional benefits not covered by Original Medicare.

These additional benefits can include coverage for prescription drugs, dental, vision, hearing and more.

Wellcare Medicare Advantage plans can typically come in two popular health plan forms: HMO plans and PPO plans.

With a Medicare HMO (Health Maintenance Organization) plan, a beneficiary is typically required to choose a primary care physician (PCP) to coordinate their care. The beneficiary sees their primary care physician for most health care, and that physician typically administers treatment or refers the patient to a specialist within the plan’s network of health care providers.

HMO health plan beneficiaries generally do not receive any coverage for visits made outside of the network, except for in cases of emergency or out-of-network kidney dialysis. If you seek medical care outside of your HMO plan network, you may be responsible for 100% of the costs of your care (except in the case of emergency).

With a Medicare PPO (Preferred Provider Organization) plan, a beneficiary typically is not required to designate a primary care physician or to obtain a referral for seeing specialists.

Members of PPO plans are typically free to visit providers within their plan network or outside of their plan network. If a beneficiary receives care outside of their PPO plan network of providers, they will likely face higher out-of-pocket costs.

Wellcare Medicare Part D plans

Wellcare Medicare Part D plans provide coverage for certain prescription medications. Each Part D plan will include a drug formulary, which is the list that details the drugs covered by the plan and how much they cost under the plan.

Medicare Part D plans may also include a list of participating pharmacies within the plan network that contract with the plan to offer discounts and other coverage benefits to members of the health plan.

Enrolling in a Medicare health plan

The availability of Wellcare Medicare health plans will vary within each state, as will the cost and coverage of each plan.

You can speak with a licensed insurance agent to find out what Wellcare Medicare Advantage plans are offered in your area and to learn more about plan coverage and costs. Speak with a licensed insurance agent by calling  TTY Users: 711 24 hours a day, 7 days a week. 

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