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WellCare Medicare Advantage Includes HMO and HMO-POS Plans

Senior Couple on BicyclesWellCare includes several Medicare Advantage options

WellCare offers Medicare Advantage plans that are often quite popular with their members.

Both traditional type plans with or without Part D are available.

Wellcare is also a provider of Medicare plans for people who are considered dual-eligible.

This is a natural extension for them given their strong presence in the Medicaid market.

Types of Advantage plans offered by WellCare

WellCare offers coordinated care plans, including both Medicare HMO and HMO-POS plans. The Point-Of-Sale plans give the members greater freedom when choosing providers.

Medicare Advantage plans are not required to include Part D drug coverage and a couple plans offered by WellCare; Advance HMO and Essential HMO-POS, are medical only plans.

Plans branded as: WellCare Choice and WellCare Value, include both medical and Part D coverage. The Choice plan is a HMO-POS and the Value plan is a HMO.

WellCare Medicare Advantage plans are also available for those people that are dual-eligible, that is, enrolled in both Medicare and their State’s Medicaid program. Two popular plans are WellCare Access and WellCare Select. 

Medicare Advantage plans are available on an annual basis and you should not assume that your current plan will look identical to next years plan.

The proof of that is the fact that WellCare PFFS Advantage plans that were once popular are no longer available.

If you are interested in a WellCare Medicare advantage plan you can compare plans online or visit the WellCare website.

 

Visit the Medicare website to review Medicare Star ratings of all WellCare plans.


19 comments

  1. Are you still covering the charleston, SC area?

  2. Cindy, I did a quick search of http://www.medicare.gov and if you are referring to Charleston County, it would seem that WellCare has no Medicare Advantage plans with drug coverage available. There are 19 available plans, many with no monthly premium. Medicare Advantage plans in Charleston NC without a monthly premium include; Any, Any, Any Gold (PFFS), Southesat Community Care Plus (HMO), Ambassador Plus (PPO), AARP Medicare Complete (HMO-POS), Patriot Plus (PFFS) and Care Improvement Plus Gold RX (Regional PPO SNP). Other popular Advantage plans include; Humana Choice (PPO) at $40/mo. and Medicare Blue (PPO) at $25/mo. I hope this helps.
    David Forbes

  3. david, my husband was on celebrex but we had to stop it as it just got to expensive. he has had reactions to all the generic drugs they made him try before celebrex. i know to a lot of people $40-$85 isn’t a lot of money but to us it is the sky. are there any plans out there that the cost is cheaper? at present we are with wellcare. i also received a pharmacy discount card in the mail and wondered if i can really use it? do you know? thanks for any help you can give me.

  4. Cathy, Let me address your last question first. My experience with pharmacy discount cards doesn’t allow for a glowing recommendation. If you had no other option, it may be better than nothing. But you have the option of Part D. Visit http://www.medicare.gov and choose the link to search for plans. You will be prompted to enter your zip code (plans vary across the US and without knowing where you are, I’m little help). Follow the on screen prompts and when asked for your drugs, enter them. This will narrow you list of plans. Then visit the websites of the plans and explore the cost and formulary. Your best bet is to more than likely find Celebrex in Tier 2. Another option is to check with your pharmacist. They have software to compare plans. Also based on your above comments, you should contact Social Security to find out if you qualify for a Low Income Subsidy. Sorry I’m not more help, but this should at least get you in the right direction.
    David

  5. My friends wife who is on Well Care Medicare has a stroke on vacation in St Louis.She wants to know why WellCare only gave 3 Rehab centers to choose from.Can she do anything to obtain a larger choice? Thanks in advance.

  6. Fred, If the plan is a HMO, there are probably only 3 rehab centers in network. Your friend could call Wellcare member services to determine if that is the reason for the limited choice.

  7. I am confused about the dual-eligibility. If a member is eligible and HAS both Medicare and Medicaid and decide for the upcoming year that they want to take out a Wellcare Access HMO. If the member has an active WellCare Access HMO(which I consider to be a Medicare replacement plan) will this WellCare replace both traditional Medicare AND the Medicaid?.. making the WellCare Access the only insurance that would be filed for services or… would it only take the place of Medicare and then Medicaid would be billed as a secondary insurance? Thank you for your help.. this gets to be a little confusing.

  8. Crystal, It is confusing! How the plan will pay and coordinate with Medicaid will depend on whether the plan is a Special Needs Dual Eligible plan. If a member is dual eligible they need to be enrolled in a plan designed for them to maximize their benefits and not be penalized. You should speak with a representative from HealthSpring to learn more.

  9. David I’m comtemplating changing from bsbc[florida blu]to wellcare in 2013 however i’m finding it near imposible to find out the cost of labs.Also even after calling in five times I cant get them to tell me who they use or how I get reimbursed for a gym membership,they also could’nt find cost of labs.Thank you

  10. Hershel, Bad customer service before enrollment may be an indicator of future service. If you still want to pursue Wellcare, you may do better by speaking with a local agent in person.

  11. what’s the difference betwee wellcare extra pdp and wellcare advantage

  12. Kathleen, a PDP is a prescription drug plan aka Part D and a Wellcare Advantage plan is a type of Medicare plan that includes medical with Part D sometimes included. A HMO or HMO-POS Advantage plan will usually include Part D benefits.

  13. I have wellcare (wellcare value,HMO-POS, H1112-027), does it cover dental care, if it does what it covers?
    Thank you for your time and response.

  14. Why am I and everyone I know that has Wellcare Medicare HMO=POS getting notices in the mail that it is no longer available and will be terminated as of 12/31/13. Are they not going to give us an alternative plan or do we need to look for other health plans with other companies?

  15. Bette, The Annual Notice of Change is something that insurance companies offering Medicare Advantage Plans are required to send each year. Usually the just detail changes to a plan’s premium, cost-sharing amounts or a change in benefits offered. Plans are good for one calendar year and companies do have the option of not renewing a plan. Since your Wellcare HMO-POS plan is not renewing for 2014, you should look for a new plan. Here’s a article about what to do if your Medicare Advantage Plans is not renewing that may be helpful.

  16. Hi… I have the same problem as Bette about the Annual Notice. I also was informed that my county in Suffolk, N.Y. will still be on the program. Just the (H3361-106) number is changing and so are my benefits…So I am hoping that I will still be eligible for 2014.. I loved this program and still want to be a part of it.Would love to have a response.

  17. Dolores, You should review the benefits to be sure that that they are still suitable.

  18. I am a cancer survivor. Radiology is a large part of my life now..cat scans, mri’s, etc. I am very pleased with everything offered by Well Care Advantage with the exception of radiology coverage(20% ?). If this is all they pay, I will not be able to have needed tests. Is this all they will pay on my tests?

  19. Patricia, I’m not sure which WellCare Medicare Advantage Plan that you have but 20% is probably your share of expenses, with the plan paying 80%.

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