WellCare Prescription Drug Plan Review
WellCare is a nationwide Medicare and Medicaid health insurer with over 4.5 million Medicare beneficiaries—most of whom have a standalone Part D plan with WellCare.1 This insurer also recently bought all Aetna’s Part D business. In short, WellCare covers a lot of Medicare beneficiaries across all 50 states and in Washington, DC.
If you can find one of their higher-rated plans in your area, WellCare could be a good option for Part D coverage.2,3,4
Who might want a WellCare Part D prescription drug plan?
- People who shop at CVS: This preferred pharmacy has 9,900 locations nationwide (and Puerto Rico), so those who already shop here will find it convenient.5
- People who find high-rated plans: While WellCare’s average Part D ratings are average, you might find one of their higher quality plans near you.
- People who take mostly Tier 1 drugs: Many plans come with a $0 copayment for Tier 1 prescriptions filled by a preferred pharmacy.
WellCare Part D prescription drug plans
WellCare operates under several regional brand names, such as Easy Choice in California and TexanPlus in Texas. If you look up WellCare Part D plans in your area, you may find yourself redirected to one of these brand’s websites.
Plan options in each area vary widely, but in the plans we sampled, copayments for drugs in Tiers 1 and 2 are consistently just a few dollars for a 30-day supply. To get the $0 copayment, you’ll need to fill them through CVS or Caremark—WellCare’s preferred pharmacies.
The WellCare Medicare Part D plan that works best for you may be determined by which medications you take.
Check your medications against WellCare’s drug formulary to find out which tiers they fall into.
WellCare Value Script (PDP)
This is WellCare’s basic plan. To receive coverage, you’ll first need to cover the deductible out of pocket—except for Tier 1 and 2, which offers first-dollar (immediate) coverage.
A 30-day supply of Tier 1 drugs will cost less if you use a preferred provider. This seems standard for WellCare plans. When it comes to Tiers 2 through 4, however, this plan is one of WellCare’s most expensive. The plan then levels back out at Tier 5, with some of WellCare’s most affordable cost-sharing.
To summarize, people who take mostly Tier 1 or Tier 5 drugs will likely see the best savings with this plan.
WellCare Classic (PDP)
This plan’s monthly premium offers the lowest copays and coinsurance of the three plans we sampled, and as such, it could lower your out-of-pocket costs the most. With this plan, your share of costs is WellCare’s lowest in every Tier except Tier 1.
The downside? You’ll have to meet the entire deductible first—no exceptions for Tier 1 or 2 like the other plans. But if you expect your annual costs to exceed that, your copayment and coinsurance savings could outweigh that initial cost.
This plan might be the right fit for Medicare recipients who take mostly Tiers 4 and 5 drugs. These drugs typically cost more than lower Tier medications, so your savings could add up quickly.
WellCare Wellness Rx (PDP)
Among the plans we sampled, this one generally had WellCare’s least expensive premium—but it comes with a deductible for Tiers 3 through 5, so you'll have to meet that before any prescriptions in those tiers are covered. If you rely on prescriptions on Tier 1 or 2, however, your coverage will kick in right away.
Costs for medications in Tiers 1 through 4 are all smack dab in the middle of the three plans we sampled. Tier 5 drugs cost the exact same as WellCare’s other plans.
If you take mostly Tier 1 or 2 drugs, this may be the best plan for you. If you take mostly Tier 3 through 5 drugs, keep in mind you'll need to meet the deductible before this plan covers any of your medications.
Bottom line: WellCare offers a variety of plans nationwide
If you can find one of WellCare’s higher rated plans in your area, this Part D insurer could be worth considering.
This company offers solid benefits, partnerships with CVS and Caremark, and availability nationwide. It’s quality ratings sit right at the national average, but individual plans may vary.
Whether you think WellCare is right for you or not, call the number below. A licensed sales agent can help you narrow your options and choose a plan that fits your needs.
To prevent a pharmaceutical monopoly during the 2018 CVS acquisition of Aetna, the US Justice Department required Aetna to sell all Part D business—which it did—to WellCare. WellCare made no changes to Aetna plans in 2019 but certainly has for 2020.
Due to policies enacted as part of the Affordable Care Act, the Part D coverage gap (also known as the Donut Hole) has completely "closed" in 2020. Now that it's closed, your Medicare Part D costs will be 25% for both brand name and generic drugs, regardless of which company’s health plan you choose.
1. Centers for Medicare and Medicaid Services, “Enrollment by Contract”
2. Centers for Medicare and Medicaid Services, “2019 Star Ratings and Display Measures”
3. Centers for Medicare and Medicaid Services, "Fact Sheet - 2020 Part C and D Star Ratings"
3. Centers for Medicare and Medicaid Services, “2020 Part C and D Medicare Star Ratings Data”
4. CVS, “CVS Health at a Glance”
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