WellCare Medicare Advantage Review
WellCare serves more than 4.6 million Medicare beneficiaries, but only 556,519 of those enrollees have Medicare Advantage plans—the rest chose a standalone Part D plan.1 However, WellCare has Medicare Advantage plans in only 18 states, and many of its plans are available in only a handful of those states.
If you do live in a state WellCare serves and discover a high-rated plan that fits your situation, WellCare could be a good health insurance option.
States WellCare serves
- New Jersey
- North Carolina
- South Carolina
Is a WellCare Medicare Advantage plan right for you?
WellCare plans aren’t for everyone, but some groups may find this insurer’s coverage a good fit:
- People who want an HMO: Most of WellCare’s Advantage plans are Health Maintenance Organizations (HMOs).
- People who want drug coverage: Most WellCare insurance also includes Medicare prescription drug coverage.
- People who find a high-rated plan: While Wellcare’s average Medicare Star Rating is low compared to plans most people are enrolled in4, a few plan options have 4 or more stars.
WellCare Medicare Advantage plans
Generally, WellCare offers a variety of HMOs, as well as some PFFS plans. WellCare also offers PPO plans, but we didn’t come across many among the plans we sampled. Depending on where you live, the WellCare plans available to you may have different names—like Easy Choice in California or Ohana in Hawaii—and different benefits.
WellCare offers a variety of plans nationwide, but the five we sample below give a range of possibilities.
WellCare TexanPlus Classic (HMO)
This plan is available in—you guessed it—Texas.
HMO Advantage plans like this one require enrollees to stay in WellCare’s network of providers to receive coverage for all services except emergency and urgent care situations. If you’re a Texan, don’t mind staying in a network, and want a quality plan, this one could be a good option.
WellCare Today’s Options Advantage Plus 550B (PPO)
Like other PPO Advantage plans, this plan has a network of preferred providers but allows beneficiaries to receive care outside that network at a higher cost. As a result, enrollees may see separate deductibles, copayments, and coinsurance for in-network and out-of-network services.
Like many other WellCare plans, this one includes prescription drug, vision, dental, and hearing benefits.
If you want the savings of WellCare’s provider network as well as the freedom to choose providers outside that network, this plan might be a good choice for you.
WellCare Access (HMO-SNP)
This plan is a Special Needs Plan designed for dual eligibles—people who have both Medicare and Medicaid. It’s also a managed care plan, meaning a plan representative will help you coordinate doctor visits, prescriptions, and more.
If you have both Medicare and Medicaid and think your annual health care costs will be higher than $6,700, this could be a good fit for you.
WellCare Today’s Options Premier 200 (PFFS)
WellCare’s Private-Fee-for-Service (PFFS) plans are like Original Medicare in that you can seek care from any provider that accepts Medicare, provided they agree to accept your plan before delivering care. Unlike other PFFS plans, however, this one also offers an optional network of providers. Enrollees who stay in this network may have lower health care costs than those who don’t.
In addition to everything Medicare Parts A and B cover, this plan also offers hearing, dental, and vision benefits. It does not, however, cover prescription drugs.
PFFS plans aren't for everyone for one compelling reason: doctors aren't required to accept this health insurance. That means you'll need to have written confirmation from each provider you use, before every service—or risk having to foot the bill yourself. But if you feel the freedom to receive care out of network is worth the effort to obtain this confirmation, this plan could work for you.
Bottom line: A few high-quality gems among low average Star Ratings.
While WellCare offers a variety of plan Medicare Advantage plans in 18 states, this insurer doesn’t come highly rated overall.
WellCare does some things better than others, but when it comes to delivering care, WellCare falls short in many areas.
Still, if this company offers a hard-to-find plan type you’re looking for (like a PFFS or HMO-POS), or you find a gem with high Star Ratings, WellCare could be right for you.
Either way, call a licensed sales agent to help you find and compare plans in your area to find the right fit.
Want to learn more about WellCare or Medicare? Check out these other pages to fill in the gaps.
Is Medicare Advantage better than Original Medicare?
Which form of Medicare coverage is best depends on your unique situation, but by law, Medicare Advantage must cover all the benefits Original Medicare does. And many Advantage plans come with additional benefits such as vision and dental coverage.
Read our guide if you’re considering Original Medicare vs. Medicare Advantage.
When can I enroll in Medicare Advantage?
If you know you want Medicare Advantage as soon as you have Medicare eligibility, you can enroll in Medicare Advantage during your Initial Enrollment Period (IEP). This period begins three months before you’re eligible for Medicare and runs for seven months.
If you’re switching to a Medicare Advantage plan from Original Medicare after your IEP, you can use the annual Medicare Open Enrollment period from October 15 through December 7 each year.
1. Center for Medicare and Medicaid Services, “Part C and D Performance Data”
2. Kaiser Family Foundation, “A Dozen Facts About Medicare Advantage”
3. Kaiser Family Foundation, “A Dozen Facts About Medicare Advantage”
4. National Council on Aging, “A Guide to Medicare Advantage/Part C Costs”
5. Center for Medicare and Medicaid Services, “Part C and D Performance Data”
6. Center for Medicare and Medicaid Services, “Part C and D Performance Data”