Haris Ashley
WellCare is a health insurance company that offers Medicare Advantage, Medicare Part D and D-SNP plans. The company has received mixed reviews from customers, with some praising the low costs of its plans and others complaining about issues with customer service, billing, and prescription coverage. WellCare's plans are rated on a 5-point scale by the National Committee for Quality Assurance and the Centers for Medicare and Medicaid Services (CMS), with ratings based on clinical quality, member satisfaction, and survey results. While WellCare's plans are generally cheaper than those of its competitors, they often receive lower ratings.
| Characteristics | Values |
|---|---|
| Number of members in California | 108K (as of April 2023) |
| Number of members nationwide | 1.2M (as of April 2023) |
| Types of plans offered | HMO, PPO, and Special Needs Plans |
| Number of plans with a star rating of 4 | 4 (all PFFS plans) |
| Highest-rated HMO plan | 3.5 stars |
| Highest-rated PPO plan | 3 stars |
| NCQA ranking (as of September 2024) | 2.5-3.5 stars |
| Number of rated plans in NCQA ranking | 9 |
| Number of plans with a rating of 2.5 stars | 5 |
| Number of states offering Medicare Advantage plans | 32 |
| Number of states offering $0-premium Wellcare Value Script plans | 42, plus Washington, D.C. |
| Average monthly cost of Medicare Advantage plans | $8 |
| Average monthly cost of Medicare Part B | $174.70 |
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What You'll Learn
- Wellcare's Medicare Advantage plans are rated lower than competitors
- Wellcare's customer service has received negative reviews
- Wellcare's parent company Centene ranked last for Medicare Advantage customer satisfaction
- Wellcare's Medicare Part D plans have high star ratings
- Wellcare offers affordable Medicare Advantage plans
Wellcare's Medicare Advantage plans are rated lower than competitors
WellCare is a health insurance company that offers Medicare Advantage plans in 32 states. These plans are typically cheaper than the national average, with some plans even having a $0 monthly premium. However, WellCare's Medicare Advantage plans are rated lower than those of its competitors.
The National Committee for Quality Assurance (NCQA) rates health insurance plans on a 5-point scale (with 5 being the best) based on clinical quality, member satisfaction, and results from the NCQA Accreditation Survey. In September 2024, the NCQA ranked WellCare plans between 2.5 and 3.5 stars, with five of the nine rated plans scoring 2.5 stars.
WellCare's low ratings could be due to various factors, including poor customer service and long wait times. Some customers have reported issues with language barriers, rude representatives, and problems with prescription coverage. Additionally, WellCare's parent company, Centene, ranked in last place for Medicare Advantage customer satisfaction in a J.D. Power survey across four states.
However, it is worth noting that WellCare's Medicare Advantage plans are not consistently rated poorly. In California, WellCare's plans have received a 3-star rating, which is the average rating on the market. Additionally, WellCare's Medicare Part D plans, such as the Value Script plan, have received high ratings, outperforming major competitors in terms of both price and quality.
When considering WellCare's Medicare Advantage plans, it is essential to research the specific plans available in your area, as ratings can differ by location and plan type. While WellCare offers low-cost options, prospective customers should carefully evaluate their priorities, such as cost, quality of care, and customer satisfaction, before making a decision.
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Wellcare's customer service has received negative reviews
WellCare Insurance has received negative reviews for its customer service. Customers have complained about long wait times, rude representatives, and language barriers. One customer complained about being transferred from one customer service representative to another, only to be provided with incorrect information. Another customer reported that their issue was not resolved despite calling multiple times, and that the representative refused to answer their questions.
WellCare's Medicare Advantage plans have consistently been rated lower than those of its competitors. In September 2024, the National Committee for Quality Assurance (NCQA) ranked WellCare plans between 2.5 and 3.5 stars, with five out of nine rated plans scoring 2.5 stars. WellCare's parent company, Centene, ranked in last place for Medicare Advantage customer satisfaction in a J.D. Power survey across four states.
WellCare's low-cost Medicare Advantage plans are available in 32 states, but the company has lost 87,000 members for the 2025 plan year. While WellCare offers affordable plans, customers have complained about issues with prescription coverage and billing. One customer reported that WellCare only approved half of a prescription approved by their doctor, despite it being in the formulary. Another customer experienced issues with removing their sister's credit card from their file for payments, resulting in billing errors and notices of non-payment.
While WellCare's Medicare Part D plans have received positive reviews for their $0-premium options and quality, with star ratings beating those of major competitors, their overall customer satisfaction remains lower than that of other major companies. WellCare's plans have been described as confusing, with customers reporting issues with coverage and understanding the benefits included in their plans.
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Wellcare's parent company Centene ranked last for Medicare Advantage customer satisfaction
WellCare is a health insurance company that offers Medicare Advantage, Medicare Part D, and D-SNP plans. The company was founded in 1985 and became a subsidiary of Centene in 2020. Centene is also the parent company of Ambetter. WellCare offers Medicare Advantage plans in 32 states, while its parent company Centene is the fifth-largest Medicare Advantage provider among for-profit health plans.
In a recent J.D. Power survey, Centene ranked last for Medicare Advantage customer satisfaction in four states. WellCare's overall customer satisfaction is also worse than that of other major companies like AARP/UnitedHealthcare. The J.D. Power survey measured member satisfaction with Medicare Advantage plans based on eight factors, including the level of trust and how well a provider resolves problems or complaints.
WellCare's Medicare Advantage plans are consistently rated lower than competitors, despite their low cost. The National Committee for Quality Assurance (NCQA) rated WellCare's plans between 2.5 and 3.5 stars in September 2024, with five out of nine plans scoring 2.5 stars. The NCQA rates health insurance plans on a 5-point scale based on clinical quality, member satisfaction, and results from the NCQA Accreditation Survey.
WellCare offers HMO, PPO, and Special Needs Plans, with varying member benefits depending on the plan, state, and brand. Some plans include the Spendables card, which is preloaded with funds that members can use on various items, and the Giveback benefit, which refunds some or all of the Medicare Part B premium.
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Wellcare's Medicare Part D plans have high star ratings
WellCare is a subsidiary of Centene, the fifth-largest Medicare Advantage provider among for-profit health plans. WellCare offers Medicare Part D prescription drug coverage through standalone Part D plans and Medicare Advantage Plans.
WellCare's Medicare Advantage plans have been rated lower than their competitors. However, their standalone Medicare Part D plans have received higher ratings. In 2025, WellCare's standalone Medicare Part D plans received an average star rating of 3.5 out of 5 stars from CMS, while the weighted average star rating for all standalone Part D plans was 3.11 stars. WellCare's Value Script plan offers $0 premiums in 42 states and Washington, D.C. The Classic plan includes a moderate monthly premium and an annual deductible. The Rx Value Plus plan offers a $0 deductible for Tier 1, Tier 2, and Tier 3 drugs, while the Classic plan applies the deductible to all covered drugs. All of WellCare's Part D plans offer $0 copays for Tier 1 generic drugs from preferred pharmacies.
The Centers for Medicare and Medicaid Services (CMS) rates Medicare Part D plans on 12 quality measures. The Better Business Bureau (BBB) rates Centene, WellCare's parent company, while Consumer Affairs, NCQA, and J.D. Power provide insights into WellCare's health and Medicare Advantage Plans.
WellCare offers HMO, PPO, and Special Needs Plans, allowing customers to choose the plan that best suits their needs. It is important for customers to research the plans available in their area and understand the associated costs, such as premiums, deductibles, copays, and coinsurance, to make an informed decision.
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Wellcare offers affordable Medicare Advantage plans
Medicare Advantage plans from Wellcare offer additional benefits beyond Original Medicare, such as dental, vision, and hearing coverage. These plans also feature low or no deductibles and limited out-of-pocket spending. Furthermore, some Wellcare plans include the Spendables card, which is preloaded with funds that can be used for various purposes, including over-the-counter items, groceries, and utility assistance.
While Wellcare offers low-cost options, their plans consistently receive lower ratings compared to competitors. In September 2024, the National Committee for Quality Assurance (NCQA) rated Wellcare plans between 2.5 and 3.5 stars, with five out of nine plans scoring 2.5 stars.
Despite some positive experiences, Wellcare has received mixed reviews from customers. While some praise the helpfulness of their personnel, others have expressed frustration with issues such as language barriers, long wait times, and billing problems. It is always important to research and carefully consider the costs, benefits, and customer feedback before selecting a Medicare Advantage plan.
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Frequently asked questions
In September 2024, the National Committee for Quality Assurance ranked Wellcare plans between 2.5 and 3.5 stars, with five of the nine rated plans scoring 2.5 stars.
WellCare's Medicare Advantage plans are rated lower than competitors. In California, WellCare's Medicare Advantage plans have a 3-star rating.
WellCare's Medicare Part D plans beat major competitors' star ratings.
WellCare gets significantly more customer complaints compared to an average insurance company of the same size. WellCare's overall customer satisfaction is worse than other major companies.
