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WellCare Health Insurance Review

79 Customer Comments & Reviews - see all comments
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WellCare Health Plans is a health insurance provider that specializes in delivering Medicare and Medicaid services nationwide. The company offers government-sponsored care services to families, individuals, and seniors.

What’s Included with WellCare?

  • Diagnostic tests and imaging
  • Preventive care services
  • Primary care
  • Outpatient surgery
  • Immediate medical attention
  • Prescription drugs
  • Hospitalization
  • Pregnancy care
  • Habilitation and rehabilitation services
  • Mental health, behavioural health, and substance abuse needs
  • Pediatric dental or eye care

Types of Health Insurance Plans

 

Businesses and Organizations

No

Individuals and Families

Yes

Short-Term Health Insurance

Not Stated

Other Plans Offered:

  • Medicare Advantage and PDP Plans

Plans Reviewed

Bronze Plan

  • Out-of-pocket limit: $6,350 per individual and $12,700 per family
  • No overall annual limit on specific services
  • Overall deductibles: $3,000 per person and $6,000 per family
  • A written referral is required to visit a specialist
  • Other covered services: infertility treatment, Chiropractic care, Hearing aid

Silver Plan

  • Out-of-pocket limit: $5,000 per individual and $10,000 per family
  • Overall deductibles: $2,500 per person and $5,000 per family which do not apply to prenatal, postnatal, PCP visits, Tier 1 generic drugs, and Preventive care
  • No annual maximum limit on selected covered services
  • A written referral is required to see a specialist
  • Other covered services: Infertility treatment, Hearing aid, Acupuncture, Dental care for adults, Chiropractic care

Gold Plan

  • Out-of-pocket limit: $4,000 per individual and $8,000 per family
  • Overall deductibles: $600 per person and $1,200per family which excludes prescription drugs
  • No overall annual limit on specific covered services
  • A written referral is required to visit a specialist
  • Other covered services: Hearing aid, Chiropractic care, Infertility treatment

Platinum Plan

  • No overall deductibles for both individuals and families
  • No annual maximum limit for specific covered services
  • Out-of-pocket limit: $2,000 per individual and $4,000 per family
  • A written referral is required to see a specialist
  • Other covered services: Hearing aid, Infertility treatment, Chiropractic care

*Details shown above are for the state of New York

How Much Does It Save You?

 

Bronze

Silver

Gold

Platinum

Services Offered

In-Network

(Your Cost)

Out-of-Network

(Your Cost)

In-Network

(Your Cost)

Out-of-Network

(Your Cost)

In-Network

(Your Cost)

Out-of-Network

(Your Cost)

In-Network

(Your Cost)

Out-of-Network

(Your Cost)

Diagnostic Test

50% after deductible

Not covered

30% after deductible

Not covered

PCP office: $25 co-pay after deductible

Specialist office: $40 co-pay after deductible

 

 

Not covered

PCP office: $15 co-pay after deductible

Specialist office: $35 co-pay after deductible

Not covered

Imaging

50% after deductible

Not covered

30% after deductible

Not covered

$40 co-pay after deductible

Not covered

$35 co-pay

Not covered

Preventive Care Services

Covered in full

Not covered

Covered in full

Not covered

Covered in full

Not covered

Covered in full

Not covered

Primary Care

50% after deductible

Not covered

Visits 1-3: $0 co-pay Visits 4+: 30% deductible

Not covered

$25 co-pay after deductible

Not covered

$15 co-pay

Not covered

Generic Drugs

Retail: $10 co-pay

Mail Order: $25 co-pay after deductible

Not covered

Retail: 30%

Mail Order: 30% after deductible

Not covered

Retail: $10 co-pay

Mail order: $25 co-pay

Not covered

Retail: $10 co-pay

Mail order: $25 co-pay

Not covered

Specialty Drugs

Mail order: $70 co-pay after deductible

Not covered

Mail order: 30% after deductible

Not covered

Mail order: $70 co-pay

Not covered

Mail order: $60 co-pay after deductible

Not covered

Hospital Stay

50% after deductible

Not covered

30% after deductible

Not covered

$100 co-pay after deductible

Not covered

Physician/Surgeon fee: $100 co-pay

Facility fee: $500 co-pay per admit

Not covered

Outpatient Surgery

50% after deductible

Not covered

30% after deductible

Not covered

$100 co-pay after deductible

Not covered

$100 co-pay

Not covered

Urgent Care

50% after deductible

50% after deductible

30% after deductible

30% after deductible

$60 co-pay after deductible

$60 co-pay after deductible

$55 co-pay

$55 co-pay

Emergency Room Services

50% after deductible

50% after deductible

30% after deductible

30% after deductible

$150 co-pay after deductible

Not covered

$100 co-pay

$100 co-pay

Emergency Medical Transportation

50% after deductible

Not covered

30% after deductible

Not covered

$150 co-pay after deductible

Not covered

$100 co-pay

Not covered

Mental/ Behavioral Inpatient Services

50% after deductible

Not covered

30% after deductible

Not covered

$1,000 co-pay per admit after deductible

Not covered

$500 co-pay per admit

Not covered

Mental/ Behavioral Outpatient Services

50% after deductible

Not covered

30% after deductible

Not covered

$25 co-pay after deductible

Not covered

$15 co-pay

Not covered

Substance Use Disorder Inpatient Services

50% after deductible

Not covered

30% after deductible

Not covered

$1,000 co-pay per admin after deductible

Not covered

$500 co-pay per admit

Not covered

Substance Use Disorder Outpatient Services

50% after deductible

Not covered

30% after deductible

Not covered

$25 co-pay after deductible

Not covered

$15 co-pay

Not covered

Prenatal and Postnatal care

Covered in full

Not covered

Covered in full

Not covered

Covered in full

Not covered

Covered in full

Not covered

Pregnancy Delivery and Inpatient Services

50% after deductible

Not covered

30% after deductible

Not covered

$1,000 co-pay per admit after deductible

Not covered

$500 co-pay per admit

Not covered

Rehabilitation and

50% after deductible

Not covered

30% after deductible

50% after deductible

$30 co-pay after deductible

Not covered

$25 co-pay

Not covered

 
Annual Maximum Limit

Bronze

None

Silver

None

Gold

None

Platinum

None

*Only on specific covered services

Summary

WellCare health insurance offers excellent medical services coverage and benefit programs that makes them a good choice for seniors, families, and individuals.

 

 

 

 

 

 

 


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79 Customer Comments & Reviews

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Susan M
2/23/2024
one of twelve 2 years and they have blocked me in every way to find health in this Tallahassee Town, you had ONE DOC in this town and her go to sentence is (we cant work together)Dr. Rashida A Reid is an Internal Medicine Specialist in Tallahassee, Florida.= the worst bedside or failed compassionate human on your pay roll I am not okay i am not Happy with the serves you fake to offer , i am not happy the denials Stopped my possible assessment. I will be looking into ANYTHING but your services.


Denise B
11/10/2023
Don't do it. Don't chose them. All is well and good until something goes wrong. My wheelchair was in an accident towards the end of June. I called the wheelchair store where I got it and they came and picked it up. I WENT THROUGH HELL all summer long until October trying to get my repairs approved, meanwhile, not really being able to go anywhere or do anything. I have very limited mobility and can barely get around my very small apartment without any help. So, they FINALLY approved the repair after MONTHS of appeals, etc. I got the chair back and after about 4 hours, I was getting a fault code again. The store picked it up and put in the part that they didn't know the chair needed... Read More


C
Carol
10/24/2023
I have WellCare Part D prescription coverage. The Pro is it is much less expensive for me with the meds I take. Also I live in a community with no CVS pharmacies and WellCare has two preferred providers to choose from. The cons are this company is impossible to reach, to figure out information you badly need to find, and they care absolutely nothing for the clients they serve. The one time I did finally reach a human being to talk to she kept arguing with me that my community had no non CVS pharmacies as preferred providers. She also had no idea how much my copays were going to be. She could give me no way to seek online where I was at on my personal meds. I could find no way on their site... Read More


C
Carol
10/24/2023
I have WellCare Part D prescription coverage. The Pro is it is much less expensive for me with the meds I take. Also I live in a community with no CVS pharmacies and WellCare has two preferred providers to choose from. The cons are this company is impossible to reach, to figure out information you badly need to find, and they care absolutely nothing for the clients they serve. The one time I did finally reach a human being to talk to she kept arguing with me that my community had non CVS pharmacies as preferred providers. She also had no idea how much my copays were going to be. She could give me no way to seek online where I was at on my personal meds. I could find no way on their... Read More


gradyguy4
10/19/2023
This is now open season for 2024 Medicare. I did NOT appreciate receiving an automated telephone call from the marketing department of WellCare at 5:22 a.m. PST. Automated calls should have restricted calling times depending upon the time zones. Note: Our area code is 702, which is within the PST time zone.


J
jonestexas3
2/21/2023
Transportation: was told and appeared on website it needed 72 hrs advance notice- not true! It’s 3 business days. Trips can ONLY be to approved providers- no grocery store trips. Drs say not getting paid, dropping many. Told no premium but have. Chgd back to UHC. Tired of lies. Had to research DMEs myself, takes3 wks and 3 days to get. ‘Specialists” took 4 days to get back to me wo answer. Hire me- did it in an hr, found DME takes Medicare allotment. Terrible insurance.


schwartz.mariejose
1/25/2023
Unbelievable horrendous customer “service,”. Agents or supervisors not any better. Seems as if I’m bothering them with one question. Trying to call corporate office, no number can be found. If issue is not resolved I will write corporate a letter with my concerns. Or maybe to Biard of WellCare is a better option Frustoin Georgia.


Osvaldo M
1/13/2023
I have gone through different health providers, some very good like "Leon Medical Center", others regular to bad like "Humana" or "UnitedHealthCare" but where "Wellcare" arrives there can be no one who can surpass it in indolence, lack of attention, entangled Telephone mechanisms that make you stay more than an hour for any health management. When I need to do something with this provider, I have to take extra blood pressure pills, so I don't get infected. I do not understand how the government does not demand a minimum level from companies that serve the health of the people. There is no negative rating that I can give them, they only deserve contempt.


Shari R
1/3/2023
In november I requested information booklet advertised on tv to be sent to me. Not received in a reasonable amount of time so first of december I called again and made the same request. Person who responded suggested my address may have been the problem but she would send another. Nothing received. Called again and requested to speak to a supervisor. Thirty five minutes later I finished the call after all the information was recorded as a "grievience". If given a choice = choose another company!


J
Jane
12/27/2022
I changed to Humana and tried to stop my automatic payments out of bank account. I was put through hell trying to accomplish this. After going through all the questions, I was told I could not terminate. I finally asked for a supervisor, Ivy, and she assured me that I would not be charged. I told her that I would write a complaint. Horrible customer service.



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