WellCare Health Plan Options for Medicare Beneficiaries

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 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.

Copyright 2018 TZ Insurance Solutions LLC. All rights reserved.

MedicareAdvantage.com is a website owned and operated by TZ Insurance Solutions LLC. TZ Insurance Solutions LLC and TruBridge, Inc. represent Medicare Advantage Organizations and Prescription Drug Plans having Medicare contracts; enrollment in any plan depends upon contract renewal.

Plan availability varies by region and state. For a complete list of available plans, please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov.

Medicare has neither reviewed nor endorsed this information.