Wellcare Medicare Part D Coverage Reviews

checkmark Fact checked Reviewed by: Leron Moore, Medicare consultant - Updated: Jan 13, 2022

 

Is Wellcare Medicare Part D a good fit for you?

Quick Wellcare Medicare Part D Coverage review:
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Wellcare offers Medicare Part D prescription drug coverage through standalone plans for people with Original Medicare Part A and/or B. Prescription drug coverage is also included in many of Wellcare’s Medicare Advantage Plans.

 
Medicare rating: 3.7 stars A.M. Best financial strength rating: Not Rated BBB rating: A- NCQA rating: 2.5 to 3.5 stars Consumer Affairs rating: 3 stars J.D. Power ranking: 9th out of 10

Wellcare Healthplans Inc. was initially founded in 1985 and began offering Medicare Part D prescription drug plans in 2006. Wellcare was acquired by Centene Corporation in January 2020 and is Centene’s largest provider of government-sponsored health care programs.  

Based on Medicare ratings, plans vary in quality across the nation, but you can find Centers for Medicare and Medicaid Services (CMS) rating information for each plan by searching on Medicare.gov

Wellcare’s preferred pharmacies are CVS and Caremark, so your costs are lowest if you use one of these pharmacies and choose generic drugs. Compare Wellcare’s Prescription Drug Plans (PDPs) available in your area on Wellcare’s website.

What do Wellcare Medicare Part D Plans cover?

All Medicare Part D plans are regulated by CMS and must cover a wide range of prescription drugs that people with Medicare take. Each plan has its own formulary (list of drugs) and separates drugs into tiers that correspond to costs. Lower tiers include generic, lower-cost medications, and higher tiers include higher-cost, brand name, or specialty drugs. 

As with most Medicare Part D plans, Wellcare’s plans include a coverage gap that begins when you and your plan have spent a certain amount ($4,430 in 2022) on prescription drugs and ends when you’ve spent $7,050 and enter the catastrophic coverage period. You then will pay a small coinsurance percentage or copay amount for drugs you need until the end of the year. 

When you are in the coverage gap, you will pay up to 25% of drug costs. 

Your share of costs for each prescription drug may change depending on which pharmacy you choose, the tier of the drug, and when you enter each coverage phase. You must meet your annual deductible before your plan pays. Wellcare’s Part D plans include:

  • Discounts for preferred retail pharmacies and three-month prescriptions.
  • Options for one-month and three-month mail-order prescriptions
  • Allowance for those who get Extra Help to use any pharmacy
  • Senior Savings Program for select insulins to keep your costs below $35/month

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What are Wellcare’s Medicare Part D Plan options? 

Wellcare offers three primary levels of PDPs, which include low, medium, and high monthly premiums. Their Value Script plan is the least expensive in terms of monthly premiums and no deductible requirement for tiers one and two. This plan may be best for you if you don’t need prescription drugs but need drug coverage to avoid paying late penalties. It may also be a good option if you only take generic drugs which are on Wellcare’s formulary and use their preferred pharmacies. The Value Plus plan has a higher monthly premium but no annual deductible.

Before choosing a plan, make sure your drugs are on the formulary and your pharmacy is in Wellcare’s network. Understand Wellcare’s rules about how you get your prescription drugs. Prior authorizations may apply. You may have to try drugs on a lower tier first before your plan approves higher-cost drugs. 

Compare these 2022 Wellcare Medicare Part D Plans with drug coverage in Denver County, Colorado:

Wellcare Medicare Part D Plans
Plan name Monthly premium* Annual deductible Initial Coverage Limit** Annual out-of-pocket threshold amount**
Wellcare Value Script (PDP)  $5.50 $480 (applies to tiers 3, 4, 5) $4,430 $7,050
Wellcare Classic (PDP) $33.90 $480 $4,430 $7,050
Wellcare Medicare Rx Value Plus (PDP) $68.90 $0 $4,430 $7,050

*Based on pricing in Denver County, Colorado

Pros and cons of Wellcare Medicare Part D plans

 

What we like about Wellcare Medicare Part D Plans: 

The drawbacks of Wellcare Medicare Part D Plans: 

  • Three standalone plans available with an option for a zero deductible plan
  • Low monthly premium plan available
  • Nationwide options
  • Average ratings compared to other providers
  • Prior authorization and step-wise therapy requirements

Wellcare Medicare Part D Plans reviews and ratings 

Wellcare’s Medicare Part D and Medicare Advantage plans are rated by the Centers for Medicare and Medicaid Services (CMS). Other ratings and ranking entities provide insight into Wellcare’s parent company, Centene, or Wellcare’s health plans as a whole. See how Wellcare stacks up against other health insurance providers.  

 
Medicare rating: 3.7 stars Wellcare’s Medicare Part D Plans have an overall average quality rating of 3.7 stars from the Centers for Medicare & Medicaid Services.
A.M. Best financial strength rating: Not Rated A.M. Best sets credit ratings for insurers. Wellcare is not rated by A.M. Best.
BBB rating: A- Centene Corp, the parent company of Wellcare, has an A- rating from the Better Business Bureau with nine complaints closed in the last three years. Wellcare health plans in different states across the country received a range of ratings from the BBB. There are no BBB ratings for Wellcare’s standalone prescription drug plans or Wellcare’s Medicare Advantage Plans.
NCQA rating: 2.5 to 3.5 stars Wellcare’s Health Plans, which include Medicare Advantage HMO and PPO plans Advantage Plans, received ratings that range from 2.5 to 3.5 out of 5 stars from the National Committee for Quality Insurance (NCQA), a leading accreditation agency. Standalone drug plans are not rated separately, but the company’s Medicare Advantage Plans usually include prescription drug coverage.
Consumer Affairs rating: 3 stars  Wellcare health insurance received a 3 out of 5 star rating from Consumer Affairs based on 256 reviews. Reviews include customer experience with Wellcare’s Medicare Advantage Plans and standalone prescription drug plans. Complaints include frustration with Wellcare’s aggressive marketing, poor customer service, and difficulties with prior authorization requirements.
J.D. Power ranking: 9 out of 10 In its 2021 Medicare Advantage Study, J.D. Power measured Medicare Advantage Plan satisfaction based on these important factors: coverage, benefits, provider choice, cost, customer service, information, communication, billing, and payment. Centene scored 769 points out of 1,000, coming in ninth out of the top 10 Medicare Advantage providers.

How Wellcare Medicare Part D Plans compare

Is Wellcare the best Medicare Part D provider? See how this insurer compares on major ratings.

 
Insurance company Medicare rating A.M. Best rating BBB rating NCQA rating J.D. Power ranking
Aetna 4 stars A A+ 2.5 to 4.5 stars Fifth out of 10
Anthem Blue Cross Blue Shield 4 to 4.5 stars A+ A+ Not rated Sixth out of 10
Cigna 4 stars A- Not rated 2.5 to 4.5 stars Seventh out of 10
Highmark 4.5 stars A A- 2.5 to 4.5 stars Second out of 10
Humana 4 stars A- A+ 1.5 to 4.5 stars Third out of 10
Kaiser 5 A A- 4.5 to 5 stars First out of 10
Premera 3.5 to 4.5 stars A B- 3 stars Not ranked
Providence 5 stars Not rated F 4 stars Not ranked
UnitedHealthcare 3.5 stars A- A- 4 stars Fourth out of 10
Wellcare 3.7 stars Not rated A- 2.5 to 3.5 stars Ninth out of 10

How to choose a Medicare Part D plan

Ask these questions as you consider whether a Wellcare Medicare Part D plan is right for you:

  • Are your prescriptions covered?
  • Is your pharmacy in network?
  • What’s your monthly premium?
  • What’s your annual deductible?
  • What is your initial coverage limit and annual out-of-pocket threshold amount?

When can you enroll in a Wellcare Medicare Part D plan?

You can enroll in a Medicare Part D plan if you’re enrolled in Original Medicare. Enrollment is available during these periods:

  • Your Initial Enrollment Period: Seven months around and at your 65th birthday when you’re newly eligible for Medicare.
  • Open Enrollment Period: Annually between October 15 and December 7.
  • Medicare Part D Open Enrollment: Annually between January 1 and March 31.
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Reviewed by:

Leron Moore, Medicare consultant

Leron Moore has guided Medicare beneficiaries and their families as a Medicare professional for nearly 15 years. First as a Medicare provider enrollment specialist, and now a Medicare account executive, Moore works directly with Medicare beneficiaries to ensure they understand Medicare and Medicare Advantage Plans.