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Wellcare Health Insurance Company

Overall Rating11111
Customer Service11111
Network11111
Plans1.11.11.11.11.1

Wellcare Health Insurance of Arizona, Inc., better known simply as Wellcare Health Plans, Inc.,  is a Florida based company specializing in managed care programs for consumers covered by the government based Medicare and Medicaid programs.

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Wellcare Health Plans is a public company traded on the New York Stock Exchange under the symbol WCG. It is currently valued at just over $40 per share. As a publicly traded company, Wellcare has an extensive investor’s information web page.

Corporate offices for Wellcare are located at:

Wellcare Health Plans, Inc
8735 Henderson Rd
Tampa, Florida 33624

813-865-1568
866-238-9898

Wellcare Products and Services

Wellcare serves the needs of almost two and one half million-member subscribers. They provide plans for families, children, the elderly and even disabled and blind members of our community.

Main benefits of Wellcare Plans include, low or no co-payments, prescription coverage, free wellness care and preventive medical visits and a broad selection of participating practitioners. Open enrollment begins on October 15, 2011 and plans are available in all 50 United States. A current Wellcare promotion offers customers a free $10.00 Walgreens wellness card with a Wellcare appointment.

Wellcare Medicare managed care programs are designed to provide Medicare recipients with additional coverage without the cost of a supplemental insurance program, manageable co-payments, a large network of high quality care providers and prescription benefits. Other benefits, depending on location, may include:

  • Vision and hearing
  • Dental
  • Non-prescription medications and other health related items
  • Transportation
  • Fitness or gym member discounts
  • Meals for seniors
  • Emergency alert systems
  • Other discounts

All of these benefits and more are available in Wellcare Medicare Advantage Plans. Enrollment is fast and simple and may be accomplished on line, by phone or by regular mail. Forms and customer assistance is available for Spanish speakers.

Medicaid programs through Wellcare are currently available in seven states including:

  • Florida
  • New York
  • Missouri
  • Georgia
  • Hawaii
  • Illinois
  • Ohio

Clicking on each state will provide the visitor with details on programs available in his or her state. Wellcare Medicaid programs provide basic and supplementary services to qualified families and children.

It is important to note here that health and wellness program benefits may vary from state to state so it is important to check available programs for your area. A pull down menu at the Wellcare home page lists all states for easy access.

Wellcare Customer Service

Most member services are available on line and may be accessed from the Wellcare home page. Members may check eligibility, plan information, or file a claim on line. Provider information is also available for:

  • Medical doctors
  • Behavioral professionals
  • Hospitals and other emergency care facilities
  • Vision, hearing and dental care facilities
  • Pharmacies

In Florida, community service groups are also listed. For questions or general information, call Wellcare toll free, 866-765-4385.

Visitors to the Wellcare website may also compare plans in their area by filling in a brief survey form. The Wellcare response will give a visitor an estimate of anticipated out-of-pocket medical expenses for each program based on the visitor’s age, location, and general health. Coverage can be selected and riders added for prescription drugs or other services and a final cost can be calculated. Once a plan is selected, new enrollees may apply on line. After enrollment, monthly billing may also be handled through the Wellcare website.

Medical providers may also register on the Wellcare website. Providers also have a wide selection of available resources including mandated training for Medicare and Medicaid fraud, abuse and waste. Other available provider resources include:

  • Manuals and reference guides
  • Medicare and Medicaid forms and documents
  • Coverage and practice guidelines
  • Educational and training materials
  • Updates for claims submissions
  • Resource guides and aids
  • Newsletters

As a member or a provider, claims may be filed, eligibility determined and authorizations obtained on line and both subscribers and practitioners have access to a wealth of program information and services.

Wellcare Careers

Wellcare Plans, Inc is a Fortune 500 company employing about 3,500 health care professionals and administrative staff. An applicant from outside the Wellcare network may search for job openings on their website.

At present, there are seven pages of job listings posted on the Well.care website. Most are in the Tampa, Florida area but many others are outside of the Wellcare home base and range from New York and the New England states to Hawaii. Applicants may apply on line for all postings.

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10 reviews

  • Angry Daughter-in-Law /
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    Wellcare Insurance company is a HUGE waste of money.

    The sales rep came into my mother-in-law’s home, assured her that all her current doctors and medications would be covered and she wouldn’t have to pay anything more than she was already. Huge lie.

    She is in her 70’s and he sold her a plan that covered nothing. None of her current doctors accepted the insurance and it did not cover any of her current meds. She had to switch all her doctors and be put on different medications which ended up putting her in the hospital twice. Oh, and the copay for those two hospital visits were $900 and $600 respectively.

    It’s pretty sad when the hospital staff pull you aside and tell you to switch insurance companies as soon as possible because no respectable physician or hospital accepts or participates with your current insurance company, which is exactly what happened when she was in there. Thankfully, she switched back to a reputable insurance company as of January 1.

    I work for a cancer center and worked with the patient access staff to make her appointments when we suspected she had cancer. The first thing I told them was to make sure that Wellcare would cover her appointments. Wellcare told the patient access rep that she was approved for 5 visits.

    She just received a letter today from Wellcare stating that they would not pay for those visits because she did not get prior approval. Now I know that they are lying because I was right there when they gave approval! Shame on them for taking advantage of people like they are.

  • Rebecca /
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    The BNSF switched to this plan January 1, 2013, and I have had trouble costing many hours of my time, my Target pharmacist’s time, my doctor’s time, staff of Extend Health’s time AND the Railroad Retirement Board’s time.

    The Well Care website is worthless when trying to research the COST of drugs they make my doctor prescribe over his professional opinion and the call center (located in Hawaii) is even worse. Call center employees follow a script and when there is a question deviating from that script, one can expect a wide range of varying answers…….in my case, the answers have been inaccurate!

    THEN the Well Care pharmacy is TOTALLY unreliable for faxed prescriptions. My doctor’s office had to fax a prescription THREE times for it to finally get filled! I sent an original prescription for a controlled substance (as required) by CERTIFIED MAIL on Feb 13, 2013…..it was received by Well Care on Feb 19th and they cannot find it!!!!!!!

    My Extend Health representative made a call with me to get results and “CJ”, a senior manager at the Well Care Pharmacy PROMISED to call us back on Friday, March 1, 2013, after he had a chance to locate it. I am still waiting for his call!

    My next move will be to contact the Railroad Retirement Board to solicit their clout. WELL CARE IS A MESS. MY ADVISE: RUN, DO NOT WALK, AWAY FROM THEM!!!!!!!

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    Agree with the other reviewers. I just went on Medicare and chose Wellcare because I am on a very tight budget and no premium/no copay for a primary care visit sounded good. Well, it is true you get what you pay for.

    Spent almost a half hour this morning on the phone with a customer service rep trying to get a question answered. I could barely understand her. I didn’t feel she was listening to me but reading from a script. Asked to be transferred to a US-based rep – held for about another 10 minutes and finally hung up because my phone’s minutes were running out.

    Can hardly wait til the end of the year when I can change my plan!

  • Rebecca too. /
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    I’m finding the same difficulties as the authors above. It is January 10th, I signed up for Wellcare RX coverage, before December 7th. -To date I have been unable to sign on to their website due to their admitted technical difficulties, now it will not accept my password or their temporary passwords which take up to 3 days to receive. On the one occasion, I did log on I was not able to view MY ACCOUNT or get any of my questions answered.
    – They write clearly in red ink on the prescription order form that you have your MD fill in and fax to them “Our Promise. We will never auto-ship medications and will verify all prescriptions with member before shipping.” After receiving a recorded phone call from “Eliza” their automated system,(oh yeah, when talking to them you have to know their in-house technical jargon as they use it as freely as a foreign language.)to let me know that medications had been shipped and should be expected to arrive in 3 days.

    I called to see just what had been filled and shipped without my consent. Thankfully only one of my prescriptions had been shipped and it was an inexpensive one. The other was my insulin. They had contacted my endocrinologist and changed to their preferred drug. Their brand is actually slightly different and I was not aware we were about to change my RX. Fortunately, my phone call was in time to avoid the auto-shipping of a very expensive medication.

    When I queried the agent regarding why these meds were being shipped without my placing an order, she responded that they, “auto-ship every 93 days”. I was cut off rudely when I attempted to ask about the “we will never auto-ship” memo on the paper RX form. Later in the phone call she returned to that question telling me that “Eliza” (there’s that term again) calls and informs you have a shipment ready. Apparently at that time you have the option of declining any medications you do not want to receive. The recorded “Eliza will call 3X after which they will mail the medications if they have not gotten ahold of you”, according to the agent.

    -This company relies heavily on automated phone answering systems taking many minutes to get to a live person who is, when asked, in the Philippines. After three phone calls and not being able to understand the live person on the other end of the phone, each time I eventually broke down and asked if I could speak to an agent within the USA and was told yes. They would not give me an alternative phone number, but they promised to transfer my call. Each of the 3 times the call was dropped after several minutes of waiting on hold.

    I then called the pharmacy line in hopes of getting anyone I could understand and who perhaps could transfer me to the appropriate department, after answering my actual pharmacy questions. That was when I reached the beyond rude agent.

    -Here’s are my concerns. It seems to me that this is a very important relationship in our lives. It’s at the core of our health. This company is handling and filling my prescription medications some of which sustain life. (I am diabetic on insulin), it is of utmost importance to be able to communicate with them.

    -These medications are expensive. I do not want them auto-shipped or anything else done without my permission.
    -The good part. They have not provided me with any method of paying my premiums nor do they have any method of receiving payment for the medications that I have received, or the antibiotic that I had filled at my local “preferred pharmacy”; though I have repeated asked how do I pay you?

    – I’ve asked repeated for directions to make premium payments, the only reply I’ve received was that they were not due until the 28th of the month, not where to send it or what method of payment they required.

    Of the 3 prescriptions I’ve submitted, I have had issues with each. The antibiotic they did not cover because they required a trial of their “formulary” antibiotic or a written explanation from my MD as to why the other was prescribed…the reason is I have anaphylactic reactions to their alternative. The second medication I had filled locally, is a very common pain medication that I do use monthly. I received written notice that they only filled it because they were required by law during the 31-day new patient period and now were demanding a letter from my MD for a prior authorization, step therapy, quantity limits.

    The only notations in their formulary were MS (mail service available) and QL (quantity limited each 31 days- a number that I was well under.) Or the doctor could submit a letter requesting an exception. This is a common medication they imply is not used in “outpatient setting” which is very much not true.

    The received letter encourages over and over to “Please contact Wellcare to discuss this…”. Which as stated in the beginning of my rant, is all but impossible.
    -I have been lied to by agents(yes, multiple) on the phone even after reading to them their own printed documents.
    -I have been disconnected when requesting to speak to someone within the USA and refused when I requested an in-country phone number.
    -I have spent hours and hours attempting to gain information as to what medications they have filled and sent, as was told to me by a recorded phone call. Medications I did not request.

    -After more than a month of trying I’ve been unable to gain access to “MY ACCOUNT” on-line or reliably access their website which they appear to rely upon heavily for member/company communication. And I have spent literally hours and hours on the phone attempting to receive answers to very basic questions and then been treated rudely…however very consistently rudely.

    -This being a new policy and early in the year, I am extremely fearful that I will be unable to make changes to my insurance carrier until open enrollment for next year. To do business with this company is by far one of the worst decisions, that I have ever made and yet one of the most important ones. No matter what the price is was not worth it and I will be spending the next few days attempting to correct it anyway that I can.

    Be afraid. Be very afraid. Do your research on this one with outside informants before signing up to do business with them.

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    I was referred to a Urologist by my PCP (Wellcare PCP). I called to make an appointment with him. The Urologist secretary (receptionist), told me that they do not accept Wellcare insurance. So I called my PCP’s office and asked for a Urologist in Network. They told me that they do not refer in network.

    So I called Wellcare. They told me that if the Urologist will accept a P.O.S.(point of Service) that they will cover the appointment. I just have to pay 30% of his fee. They called for me and the Urologist agreed to accept the POS. Now I asked, What needs to be done? Wellcare told me that I will need an Authorization form filled out by my PCP. They said they would send it to him. They told me that they had his fax number and would send it on that day. It was a Monday. I called my PCP’s office two days later because they were not open on Tuesday, and they said that they did not receive the fax.

    So, I called Wellcare and told them. They said they would send the Authorization form again that day. On Friday I called the PCP’s office again. They still had not received the fax. So, I tried to call Wellcare and they were closed for the weekend. I called again on Monday. I told them what the Doctor’s office said. Then I said. “Would you fax the Authorization form to me and I will hand deliver it to the PCP.” They did that and I had it in 15 minutes. I took it to the PCP’s office that day and had them fill it out. I faxed it back when I got home. I figured it would take a couple of days to get it into the system.

    So, I called Wellcare on Thursday. They said they did not receive it yet. That it takes 72 hours to get put into the system. I told them it had been over 72 hours. They did some searching and found it. They said it wasn’t into the system yet. I asked when it might be in the system? They said it takes 72 hours. I said I know that and that they have had it for more than 72 hours already. Then they said, well, sometimes it takes a little longer. I said” do you think it will be in the system by Monday. He said yes.”I said I would call back on Monday to check.”

    So, I did. The next excuse they gave me is that it takes 14 business days to “OK” the Authorization. Mind you, it has already been two weeks since I got the referral. I called back on Friday to see what progress had been made. They said they needed more information from the doctor. I asked, Why didn’t you call him for that information? They said they were not responsible for that. I asked than Why isn’t the one responsible calling my doctor. They said, “I don’t know.”

    It has been over a month and I still have not been able to make the appointment with the Urologist. Now my PCP wants me to get a stress test, and I need an authorization for that.

    This Medical plan is a waste of time and energy. Someone could die before they get the medical exams they need.

  • Melinda /
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    I TOTALLY agree with ALL posted ABOVE!

    In addition, I did find through WellCare’s Escalated agent when complaining about Customer Service Reps speaking little English and NOT understanding or giving me the runaround for over a month, NOT getting my meds and doc having to fax scripts 3X to them – you can ASK for a Customer Service Rep who lives in the United States!

    I just can’t believe Medicare would use a company, “WellCare” who pays and gives jobs to people outside the United States instead of hiring United States people, especially Veterans – these are medications we’re talking about, NOT ordering something trivial online!

  • Denise M. Hudson /
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    I would give them less than one star if possible.

    I enrolled in June and one day later notified them I wanted to cancel. It is now August 5, 2014, and I have not been able to accomplish this simple task. I have spent in excess of two hours trying to accomplish this with no result.

    A review of their financial status as reported in the Wallstreet Journal and other reviews confirms for me that this is not the company to handle my enrollment. Very poor customer service with a very passive/aggressive approach to customer relations.

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    Canceled part D coverage without notice. Customer service non-existent. Reps are very difficult to understand, can offer no help. Transfer to a supervisor takes 5 – 10 minutes.

    Supervisors don’t help and transfer you to another department that places you on hold for another 5 -10 minutes. One supervisor agreed that plan should to have been terminated but could do nothing about it – told me I have to apply again and coverage won’t start until 2015 plan year.

  • Fontaine Ellison /
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    This company is the worst medical insurance company I’ve ever come in contact with. They do not pay for anything. To get an approval from them is like pulling teeth.

    My uncle has stage 4 lung cancer and has been back and forth to the hospital.The last time he was there he Fx his femur in order to live at home he needed certain items, Sliding board,shower chair, walker, and wheelchair. All the items except for the wheelchair were not covered.

    My uncle who only receives 975$ in SS had to pay for it all. We have been waiting since Friday, April 3, 2015, for an approval on the wheelchair. All we keep getting is the runaround. There is no reason for WellCare to exist. They make it harder to deal with the death sentence my Uncle has already been given.

    It is traumatizing speaking to these people.Something drastic needs to be done and immediately. I have been so stressed speaking with these people from well care that I’ve had asthma attacks.There has to be a way to shut them down.

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    This insurance company is super BAD. Don’t use it. I had their POS advantage plan and they won’t pay the out of network bc the visit was not pre-authorized. I called, they said you need to get pre-authorize before the visit. Referral is not as preauthorization. They gave different instructions every time.

    The first time, they said they could do retroactive authorization. The second time they said you need to have the pre-authorize which is not automatic even when you called ahead. Your doctor you visit won’t know and you won’t know either.

    First, they said they will “forgive” and paid 80% of the bill and after I dropped their plan starting next year Jan 2017 and they declined payment retroactively in Dec. The saga continued. The medical coverage is even worse. It can be different every time, always come up with no pre-authorization even with the network doctor.

    The customer service can only speak Indian English and hard to understand. The letters of notification had random messages. One test with the visit is approved and paid and another not..Medicare should take them out.

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