Jane Dotson
WellCare is a US health insurance provider that offers Medicare Advantage plans with more benefits and flexibility than Original Medicare. WellCare's plans include additional dental, vision, hearing, and prescription drug coverage, with $0 or low monthly premiums, copays, and deductibles. WellCare also offers Dual Special Needs Plans (D-SNP) and Health Maintenance Organization (HMO) plans, which provide coordinated care through a network of providers, including primary care providers (PCPs) and specialists. WellCare's insurance is accepted at various hospitals, post-acute/long-term care facilities, and community care services in New York City.
What You'll Learn
WellCare's Medicare Advantage plans
WellCare is a private insurance company that offers Medicare Advantage plans with a range of benefits and options to suit individual needs. These plans are designed to provide more comprehensive coverage than Original Medicare, including additional benefits such as dental, vision, hearing, and prescription drug coverage.
WellCare's Medicare Advantage PPO plans, for example, offer a wide network of doctors, providers, specialists, and hospitals. Members are not required to select a Primary Care Provider (PCP) and can freely choose the providers that work best for them. This plan type also eliminates the need for referrals to see specialists. However, choosing an out-of-network provider may result in higher costs for care.
In contrast, WellCare's HMO plans may require members to choose a PCP and obtain referrals for specialist care. While this plan type may offer a more limited provider network, it still ensures comprehensive coverage and coordination of care through the selected PCP.
WellCare also offers Special Needs Plans (SNPs), which are tailored to individuals with specific health care needs. The Dual-Special Needs Plans (D-SNP) are designed for individuals who are enrolled in both Medicare and Medicaid, providing coordinated coverage for their unique needs. Chronic Condition Special Needs Plans (C-SNP) are also available for individuals with certain chronic conditions, offering additional support and resources.
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WellCare's Prescription Drug Plans
WellCare Health Plans, Inc. is a private American health insurance company that provides managed care services through Medicaid, Medicare Advantage, and Medicare Prescription Drug plans. WellCare has been operating since 1985 and is headquartered in Tampa, Florida.
WellCare offers Medicare Part D Prescription Drug Plans (PDPs) that help cover the cost of prescription drugs. These plans offer affordable coverage for thousands of prescription drugs, with low monthly payments and $0 copays on Tier 1 generic drugs at preferred pharmacies. WellCare's PDPs are available in your area and can be accessed by contacting a Member Service team to understand your coverage and benefits.
WellCare's Medicare Prescription Drug Plans provide convenience and savings by offering medication home delivery. This service, provided through Express® Scripts Pharmacy, ensures that members receive a 90-day supply of their medications without any extra cost for mail-order prescriptions.
WellCare's network of pharmacies includes national chains such as CVS, Walgreens, regional grocery stores, and independent pharmacies. They also partner with preferred pharmacies to help members save money. These preferred pharmacies include well-known national and regional retailers, which can be found using the “Find a Provider” tool on their website.
WellCare offers plans designed to assist those eligible for Extra Help (Low-Income Subsidy), where members may pay no or low premiums and copays. They also provide plans with no deductibles, meaning prescription drug costs are covered from day one.
Medicare Part D prescription drug plans are a government program offering prescription drug insurance to those entitled to Medicare Part A or enrolled in Medicare Part B. It's important to review the formulary, or the list of covered drugs, to ensure a plan meets your specific prescription needs.
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WellCare's Dual Special Needs Plans
WellCare is a health insurance company that offers a range of plans, including Medicare Advantage plans and Dual Special Needs Plans (D-SNPs). WellCare's Dual Special Needs Plans are a type of Medicare Advantage plan that provides additional benefits and support for individuals who qualify for both Medicaid and Medicare coverage.
D-SNPs from WellCare offer enhanced coverage and personal support for those who are dually eligible for Medicare and Medicaid. These plans combine the benefits of both programs to provide a comprehensive range of services at no additional cost. This means that individuals enrolled in a WellCare D-SNP can access additional benefits, such as prescription drug cost support through the EXTRA HELP program, and more personalised assistance to manage their health needs.
Enrollees in a WellCare D-SNP are required to select a Primary Care Provider (PCP) who will coordinate their care across different providers. This ensures that all the benefits and services received are tailored to the individual's specific health needs and work together effectively. While enrollees can choose to see an out-of-network doctor, it may result in higher costs for their care.
WellCare's D-SNP plans are designed to provide a seamless and integrated approach to healthcare for those with special needs, ensuring they receive the necessary support and benefits from both Medicare and Medicaid programs. These plans offer a comprehensive solution for individuals who require additional assistance and want to streamline their healthcare experience.
To learn more about WellCare's Dual Special Needs Plans, individuals can contact the company directly or visit their website to explore the specific plans and benefits available in their area.
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WellCare's Health Maintenance Organization plans
WellCare is a private insurance company that offers a range of health insurance plans, including Health Maintenance Organization (HMO) plans. These plans focus on providing coordinated care through a network of providers, including doctors and hospitals.
With a WellCare HMO plan, members are required to select a Primary Care Provider (PCP) who will coordinate their care and refer them to specialists as needed. This referral is also necessary if members wish to see an out-of-network provider. WellCare's HMO plans offer access to a wide network of healthcare providers and hospitals, with the added benefit of potential cost savings by staying in-network for medical care.
WellCare offers a variety of HMO plan options, all of which include personal daily support for members. The specific benefits of each plan may vary depending on the location and the chosen plan. To find out more about the local plan options, members can contact WellCare's support services.
WellCare's HMO plans are designed to provide coordinated and affordable healthcare. By offering a wide range of benefits and a large network of providers, these plans aim to give members greater flexibility and control over their healthcare choices while potentially reducing their overall healthcare costs.
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WellCare's insurance accepted hospitals
WellCare is a private insurance company that offers Medicare Advantage plans, including HMO, PPO, and Special Needs Plans. They also offer prescription drug plans (PDP) and Dual Special Needs Plans (D-SNP).
WellCare insurance is accepted at many hospitals and healthcare facilities across the United States, with some variation by state and plan type. For example, in New York City, WellCare insurance is accepted at all NYC Health + Hospitals, including:
- NYC Health + Hospitals/Bellevue
- NYC Health + Hospitals/Elmhurst
- NYC Health + Hospitals/Harlem
- NYC Health + Hospitals/Jacobi
- NYC Health + Hospitals/Kings County
- NYC Health + Hospitals/Lincoln
- NYC Health + Hospitals/Metropolitan
- NYC Health + Hospitals/North Central Bronx
- NYC Health + Hospitals/Queens
- NYC Health + Hospitals/South Brooklyn Health (formerly known as NYC Health + Hospitals/Coney Island)
- NYC Health + Hospitals/Woodhull
WellCare insurance is also accepted at the following post-acute/long-term care facilities in New York City:
- NYC Health + Hospitals/Carter
- NYC Health + Hospitals/Carter LTACH
- NYC Health + Hospitals/Coler
- NYC Health + Hospitals/Gouverneur
- NYC Health + Hospitals/McKinney
- NYC Health + Hospitals/Sea View
Additionally, WellCare insurance is accepted at various Gotham Health Centers/Clinics in New York City, as well as ExpressCare facilities, including ExpressCare - Lincoln and ExpressCare - Virtual.
To find a provider or pharmacy that accepts WellCare insurance in your specific state or location, it is recommended to use the "Find a Provider Tool" available on the WellCare website. This tool allows you to search for providers by name or specialty and will provide you with a list of accepted hospitals and healthcare facilities in your area.
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Frequently asked questions
WellCare is a health insurance company that offers Medicare Advantage plans, including Health Maintenance Organization (HMO) plans and Prescription Drug Plans (PDP).
HMO plans provide coordinated care through a network of providers, including a Primary Care Provider (PCP) who can refer you to specialists as needed.
The WellCare Medicare Advantage plan includes additional dental, vision, and hearing coverage, as well as resources and support for everyday use. Depending on your area, WellCare offers plan types like D-SNP, HMO, PPO, and C-SNP, so you can choose the coverage option that best suits your needs.
