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WellCare Health Insurance Review

Item: WellCare Health Insurance
Rating: 4.5

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.

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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.

79 Customer Comments & Reviews

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Lynn R

9/16/2019

Well Care did not update my mailing address and it took me 2 calls at one hour each to get my prescriptions mailed to me. Crossing my fingers that the meds actually arrive.

drhesq

9/4/2019

I had Wellcare back in 2011 through when I dumped them in 2015. I had always had problems with them covering promised covered medical expenses. It was a constant fight with them but the final straw was that my primary back specialist dropped them midstream in my treatment. If you are making a decision of whom to sign with choose a long term reputable insurer but NOT Wellcare

mrspeacock2007

8/12/2019

WellCare needs to have their employees speak the ENGLISH lanquage so it can be understood! The lady I spoke with you could not understand her at all. She never answered the questions I was calling about.

janisb777

7/15/2019

Your company is a nightmare to deal with. Hours, days and months go by with no resolution in sight. Advice to those looking for RX insurance. Stay clear of this company!!!!

Sandra S

4/10/2019

I was told by two different employees of WellCare I had dental coverage. Now I need extractions and they say I am not covered. I will be changing my insurance as soon as possible.

Evy

4/9/2019

Very evasive information. Agents speak poor English making a complicated insurance even more difficult to understand. I believe the agents with heavy accents are part of their plan to be evasive. The information we were given at our Part D meeting is not the same as the company gives you.

Mike

3/1/2019

My doctor is listed in the Wellcare network as a PCP (Primary Care Physician) yet Wellcare would not let me keep him for some unknown reason which they could never explain to me. After a month and a half of arguing with Wellcare they finally added my doctor to the drop down list on their website of doctors to choose from. This was only a month after the corporate office of the medical facility which my doctor is part of contacted Wellcare several times. Just before this was finally settled I switched to another health insurance company. If they gave me a hard time about this I don't know what other trouble they might have had in store for me but I didn't stick around long enough to find out!

susie1261

2/8/2019

WellCare is the worst!!! No one speaks proper English. I wait on the phone for hours. They transfer me fifty million times so I can wait some more. I have spent every business day on the phone for 2 months trying to straighten out my account. They still can't get it right. They originally had a start date of December when I specifically wrote on my paperwork a start date of February 1. They changed it to January after a month of calling. It took another month of calls to change it to the proper start date of February. When they did so, I paid for the rest of the year. Today, I get a letter stating my insurance was cancelled. What? Again, I was on the phone for hours. I... Read More

Clarique L

1/4/2019

Terrible company! They practice bait and switch phone tactics. As a "Prospective Member" you get a very friendly and knowledgeable person base in the US. Very positive experience obviously set up as a Marketing front. Once signed up from Medicare Part D plan, you hear nothing from them. Calling WellCare, they direct you to the "Current Member" phone number answered by a heavy accent based in India who has no idea what you're talking about. Total nightmare dealing with these people. Luckily, my Medicare Part D signup never went through and I still have my previous insurance. I'm so thankful the Medicare system hic-cuped on my application! Never will consider WellCare in the future based on... Read More

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