Wellpoint (Amerigroup) Medicare Advantage 2024 Review

Wellpoint plans — previously known as Amerigroup plans — offer flexible benefits, but they have below-average ratings and a limited service area.
Kate Ashford, CSA®
By Kate Ashford, CSA® 
Updated
Edited by Holly Carey

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Wellpoint Medicare Advantage - ME

Wellpoint

3.12

CMS Star Rating

Wellpoint plans are affordable but not widely available, and they score below-average in terms of Medicare stars and member satisfaction.

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GET A QUOTE

from MedicareEnrollment.com

States available

6 states


Members in high-rated plans

Low (49% or less)


Member experience

2.47 (Below average)


States available

6 states


Members in high-rated plans

Low (49% or less)


Member experience

2.47 (Below average)


Pros

  • Two-thirds of Wellpoint plans are $0 premium.
  • Some plans offer “Essential Extras,” which lets members choose one extra benefit from a list including money toward assistive devices or money toward healthy groceries.

Cons

  • Available in only six states.
  • Below-average overall star ratings from CMS.
  • Below-average member experience scores.

Wellpoint — previously called Amerigroup — is one of the brands of parent company Elevance Health. Wellpoint-branded Medicare Advantage plans are available in six states as part of the Blue Cross Blue Shield collective.

Wellpoint plans offer low- and $0-premium options, but their ratings for both quality and member experience are below average.

Here’s what you should know about Wellpoint Medicare Advantage.

Wellpoint (Amerigroup) Medicare Advantage pros and cons

Wellpoint's offerings have advantages and disadvantages.

Pros

  • Low-cost plans: Two-thirds of Wellpoint Medicare Advantage plans (66%) are $0 premium

    Centers for Medicare & Medicaid Services. CY2024_Landscape_Files_Final_20231005 (ZIP). Accessed Oct 24, 2023.
    .

  • Flexible benefits: Some Wellpoint Medicare Advantage plans offer “Essential Extras,” which lets members choose one extra benefit for their plan from a list including money toward assistive devices, money toward healthy groceries, or money toward dental, vision or hearing care.

  • 24/7 nurse line access: Wellpoint members may have access to a 24/7 nurse line.

Cons

  • Limited availability: Wellpoint offers Medicare Advantage plans in only six states: Arizona, Iowa, New Jersey, Tennessee, Texas and Washington.

  • Low star ratings: Wellpoint plans' average star rating from the Centers for Medicare & Medicaid Services, weighted by enrollment, is 3.12 stars (the national average for all providers is 4.04 stars).

  • Low satisfaction ratings: Member experience ratings in Wellpoint plans, which include metrics like customer service and getting needed care, are well below average for major providers.

  • Limited plan options: In 2024, Wellpoint offers only HMO and HMO-POS plans, which are the most restrictive in terms of medical flexibility.

Wellpoint (Amerigroup) Medicare star ratings

Average star rating, weighted by enrollment: 3.12

The Centers for Medicare & Medicaid Services maintains star ratings for Medicare Advantage and Medicare Part D plans on a 5-point scale, ranking plans from best (5 stars) to worst (1 star). The agency bases these ratings on plans’ quality of care and measurements of customer satisfaction, and ratings may change from year to year.

Based on the most recent year of data and weighted by enrollment, Wellpoint's 2024 Medicare Advantage plans get average ratings of 3.12 stars. There are no Wellpoint Medicare Advantage plans with a higher rating than 3.5 stars

Centers for Medicare & Medicaid Services. 2024 Star Ratings Data Tables (Oct 13 2023) (ZIP). Accessed Oct 24, 2023.
.

The average star rating for plans from all providers is 4.04

Centers for Medicare & Medicaid Services. 10.13.23 Fact Sheet - 2024 Medicare Advantage and Part D Ratings (PDF). Accessed Oct 24, 2023.
.

You can find a plan’s rating with the Medicare plan finding tool.

What does Wellpoint (Amerigroup) Medicare Advantage cost?

Costs for Medicare Advantage plans depend on your plan, your geographic location and your health needs.

Premiums

One of the costs to consider is the plan’s premium. Two-thirds of Wellpoint Medicare Advantage plans have $0 premiums.

Even as a Medicare Advantage user, you’ll still be responsible for paying your Medicare Part B premium, which is $174.70 per month in 2024

Centers for Medicare & Medicaid Services. Costs. Accessed Oct 24, 2023.
, although some plans cover part or all of this cost. (Most people pay this standard amount, but if your income is above a certain threshold, you'll pay more.)

Copays, coinsurance and deductibles

Requirements for copays, coinsurance and deductibles vary depending on your plan, location and the services you use. Other out-of-pocket costs to consider include:

  • Whether the plan covers any part of your monthly Medicare Part B premium.

  • The plan’s yearly deductibles and any other deductibles, such as a drug deductible.

  • Copayments and/or coinsurance for each visit or service. For instance, there may be a $10 copay for seeing your primary doctor and a $45 copay for seeing a specialist.

  • The plan’s in-network and out-of-network out-of-pocket maximums.

  • Whether your medical providers are in-network or out-of-network, or how often you may go out of network for care.

  • Whether you require extra benefits, and if the plan charges for them.

Here are examples of Wellpoint Medicare Advantage costs for three plans in a mid-range city:

Wellpoint Medicare Advantage plans

Pricing

Wellpoint Medicare Advantage (HMO-POS)

Monthly premium: $0.

Out-of-pocket max: $4,900.

Copays:

  • Primary care: $0.

  • Specialist: $30.

  • Tier 1 prescription drugs: $0.

Wellpoint Extra Help (HMO)

Monthly premium: $8.60.

Out-of-pocket max: $4,900.

Copays:

  • Primary care: $0.

  • Specialist: $25.

  • Tier 1 prescription drugs: $10.

Wellpoint Full Dual Advantage Support (HMO D-SNP)

Monthly premium: $0.

Out-of-pocket max: $8,850.

Copays:

  • Primary care: $0.

  • Specialist: $0.

  • Tier 1 prescription drugs: $0.

Selected plans are available in ZIP code 37901.

To get a sense of costs, use Medicare’s plan finding tool to compare information among available plans in your area. You can select by insurance carrier to see only Wellpoint plans or compare across carriers. You can also shop directly from Wellpoint's website by entering your ZIP code.

Wellpoint (Amerigroup) Medicare Advantage plan types

There are three kinds of Wellpoint Medicare Advantage plans, and they vary in terms of structure, costs and benefits. All Wellpoint Medicare Advantage plans include prescription drug coverage.

Plan offerings include the following types:

A health maintenance organization (HMO) generally requires that you use a specific network of doctors and hospitals. You may need a referral from your primary doctor in order to see a specialist, and out-of-network benefits are usually very limited.

HMO point-of-service (POS) plans are HMO plans that allow members to get some out-of-network services, but you’ll pay more for those services.

Special needs plans (SNPs) restrict membership to people with certain diseases or characteristics. Hence, the benefits, network and drug formularies are tailored to the needs of those members. Wellpoint offers three types of SNPs:

  • Chronic Condition SNP: Designed to meet the needs of members living with certain chronic conditions, such as diabetes, congestive heart failure and cardiovascular disease.

  • Dual-Eligible SNP: For people who are entitled to Medicare and who also qualify for assistance from a state Medicaid program.

  • Institutional SNP: For people living in a Wellpoint network nursing home or assisted living community, or another plan-approved location.

Third-party ratings

There are a few companies that weigh in on health plans or on the strength of the company in question, and we’ve included two here:

AM Best Financial Strength Rating: A (Excellent)

AM Best is a credit rating agency that specializes in the insurance industry. In December 2022, AM Best affirmed its Financial Strength Rating of A for the core Blue Cross Blue Shield-branded insurance subsidiaries of Elevance Health, Wellpoint's parent company

. An A rating in this category indicates that AM Best believes the company has an excellent ability to meet its ongoing insurance obligations.

J.D. Power Ranking

In its 2023 U.S. Medicare Advantage Study — the ninth it’s done so far — J.D. Power measured member satisfaction with Medicare Advantage plans based on eight factors ranging from level of trust to how well a provider resolves problems or complaints. The study was fielded in the five biggest Medicare markets, and here’s how Elevance Health, Wellpoint’s parent company, ranked out of all major providers. (Elevance Health sells plans in three of the five markets.)

:

Wellpoint (Amerigroup) Medicare Advantage service area

Wellpoint offers Medicare Advantage plans in six states.

Wellpoint's parent company, Elevance Health, is the fourth-largest for-profit Medicare Advantage provider

. Wellpoint-branded plans cover more than 185,000 Medicare Advantage beneficiaries.

About Wellpoint (Amerigroup)

Wellpoint's parent company, Elevance Health, is headquartered in Indianapolis, Indiana, and was formed in 2004 out of a merger between WellPoint Health Networks and Anthem. In 2022, the company changed its name to Elevance Health, but it still sells Medicare products under a number of brands, including Wellpoint (Amerigroup).

Wellpoint offers Medicare Advantage, Medicare Supplement Insurance and Medicaid plans.

Wellpoint (Amerigroup) customer service

Here’s how Wellpoint (Amerigroup) members can contact customer service:

Compare Medicare Advantage providers

Get more information below about some of the major Medicare Advantage providers. These insurers offer plans in most states. The plans you can choose from will depend on your ZIP code and county.

Find the right Medicare Advantage plan

It’s important to do your research before selecting a Medicare Advantage plan for yourself. Here are some questions to consider asking:

  • What are the plan’s costs? Do you understand what the plan’s premium, deductibles, copays and/or coinsurance will be? Can you afford them?

  • Is your doctor in-network? If you have a preferred medical provider or providers, make sure they participate in the plan’s network.

  • Are your prescriptions covered? If you’re on medication, it’s crucial to understand how the plan covers it. What tier are your prescription drugs on, and are there any coverage rules that apply to them?

  • Is there dental coverage? Does the plan offer routine coverage for vision, dental and hearing needs?

  • Are there extras? Does the plan offer any extra benefits, such as fitness memberships, transportation benefits or meal delivery?

If you have additional questions about Medicare, visit Medicare.gov or call 800-MEDICARE (800-633-4227, TTY 877-486-2048).

Still deciding on the right carrier? Compare Medicare Advantage plans

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