WellCare is a private insurance company that contracts with health care providers to bring health coverage to individuals and families through Medicare Advantage plans, Medicare Part D prescription drug plans and Medicaid services.
Certain types of Medicare Advantage plans and Medicare Part D plans (also called Medicare PDPs) have networks of providers that beneficiaries must visit for most of their covered health care services.
Locating a WellCare provider is all the more important if you have a WellCare plan that is an HMO (Health Maintenance Organization) plan. HMO plan members might not be able to receive coverage for health care sought outside of their WellCare plan’s network.
If you receive health care outside of the plan network or visit a pharmacy that is not within your plan network, you may pay higher out-of-pocket costs than if you chose an in-network provider. HMO members may also need to select a primary care physician (PCP) within the WellCare network.
If your WellCare Medicare plan is an SNP (Special Needs Plan), you may have some network provider restrictions. Any provider networks associated with your plan may vary based on the plan you have.
WellCare providers may include general practice doctors, specialists, pharmacies, hospitals, laboratories, health clinics, medical device retailers and more. Contact your WellCare plan directly if you have questions about WellCare providers in your plan network.
If you have a Medicare Advantage or Medicare Part D plan through WellCare, you should check to see a list of WellCare providers near you. Visiting a provider that contracts with your WellCare Medicare plan may offer the most coverage under your plan’s terms.
To find out if a provider or pharmacy is a WellCare provider, you can use the “Find a Provider/Pharmacy” tool on the WellCare company website.
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