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Wellcare Medicare Part D 2024 Review
Wellcare Part D plans have low prices, and their quality ratings from the Centers for Medicare & Medicaid Services have improved significantly.
Alex Rosenberg Lead Writer | Medicare, health care, legislation
Alex Rosenberg is a NerdWallet writer focusing on Medicare and information technology. He has more than 10 years of experience researching and writing about health care, insurance, technology, data privacy and public policy. His research has supported lawmakers in the Wisconsin State Legislature as well as health systems and national health authorities in the U.S. and more than 10 other countries. He is based in Stoughton, Wisconsin.
Holly Carey joined NerdWallet in 2021 as an editor on the team responsible for expanding content to additional topics within personal finance. She currently leads the Medicare team. Previously, Holly wrote and edited content and developed digital media strategies as a public affairs officer for the U.S. Navy. She is based in Virginia Beach, Virginia.
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CMS Star RatingAverage Medicare star rating, weighted by enrollment. Star ratings are determined by the Centers for Medicare & Medicaid Services (CMS).
Wellcare’s Part D plans are inexpensive, and their quality ratings have improved significantly since previous years.
Out-of-pocket costsBased on how frequent and how high a company's copays, coinsurance and deductibles are in comparison to other insurance companies.
Varies
Member experienceThe average of CMS' star ratings for quality measures in the domain "Member Experience with the Drug Plan," weighted by contract enrollment.
4.0 (Above average)
Pros
Low prices, and even some $0-premium plans.
Quality ratings are much better than in previous years.
Multiple $0-deductible plan options.
Cons
Underperformed on ratings for online pricing accuracy and member complaints.
Coinsurance for brand-name drugs could be pricey.
Out-of-pocket costsBased on how frequent and how high a company's copays, coinsurance and deductibles are in comparison to other insurance companies.
Varies
Member experienceThe average of CMS' star ratings for quality measures in the domain "Member Experience with the Drug Plan," weighted by contract enrollment.
4.0 (Above average)
Pros
Low prices, and even some $0-premium plans.
Quality ratings are much better than in previous years.
Multiple $0-deductible plan options.
Cons
Underperformed on ratings for online pricing accuracy and member complaints.
Coinsurance for brand-name drugs could be pricey.
Wellcare is part of Centene Corp., which is the second-largest company offering Medicare Part D plans. About 4.6 million Medicare beneficiaries have Wellcare Part D plans as of October 2023
Centers for Medicare & Medicaid Services. PDP Plan Directory. Accessed Oct 18, 2023.
. And while it trails competitors in some areas, Wellcare’s star ratings from the Centers for Medicare & Medicaid Services have improved since previous years
Here’s what you should know about Wellcare Medicare Part D prescription drug plans.
Wellcare Medicare Part D pros and cons
Medicare prescription drug plans from Wellcare have advantages and disadvantages.
Pros
Cons
Low prices. Wellcare has the least expensive Part D plans on the market, on average.
Improved quality. Wellcare plans have much better quality ratings in 2024 than in previous years.
$0-deductible options. Wellcare’s low-cost Value Script plan has no deductible for drugs on formulary Tier 1 and Tier 2, and its Medicare Rx Value Plus plan has no deductible for all covered drugs.
Shopping and service struggles. Wellcare underperformed on quality measures related to online pricing accuracy and member complaints.
Coinsurance requirements. Most Wellcare plans have coinsurance rather than copays for brand-name drugs, which could get expensive.
These ratings use a 5-point scale where 5 is the best and 1 is the worst. The agency bases its ratings on drug plans’ quality of service and customer experiences, and ratings are updated annually.
Based on the most recent year of data, stand-alone Wellcare prescription drug plans get an average rating of 3.5 stars, weighted by enrollment when the ratings were released
Medicare beneficiaries with Original Medicare (Part A and/or Part B) can purchase a Medicare Part D plan for prescription drug coverage. Part D plans are sold by private insurance companies. The costs and coverage can vary significantly, so it’s important to compare options.
Wellcare offers the following stand-alone Medicare Part D prescription drug plans for 2024:
Wellcare Value Script: Wellcare describes this plan as having “a low premium and $0 copays for Tier 1 prescriptions when filled at a preferred cost share pharmacy
Wellcare Medicare Rx Value Plus: Wellcare describes this plan as “best suited to those who take several medications regularly and desire low copays and no deductibles
Wellcare has cut pricing for its low-cost Value Script plan, offering $0 premiums in 16 states in 2024 and premiums of less than $1 per month in all but five states.
The company’s other two Part D plans have gotten more expensive. The mid-range Classic plan costs about $4 more per month, and the higher-coverage Value Plus plan is about $8 more per month, on average.
Deductibles for the two less expensive plans have gone up by $40 to hit the maximum plans are allowed to charge in 2024, with a couple of exceptions. In Arizona and Colorado, the Value Script deductible has dropped to $400, a decrease of $105 from 2023.
The Value Plus plan retains its $0 deductible.
Here are the 2024 premiums and deductibles for Wellcare’s stand-alone Medicare prescription drug plans
A formulary is a list of the prescription drugs covered by an insurance plan. The plans often organize different kinds of drugs into tiers according to the cost of the drugs.
Wellcare prescription drug plans use a six-tier formulary
Preferred generic drugs. May include some brand-name drugs.
Tier 2: Generic drugs
Non-preferred generic drugs. May include some brand-name drugs.
Tier 3: Preferred brand drugs
Preferred brand-name drugs. May include some generic drugs.
Tier 4: Non-preferred drugs
Non-preferred brand-name drugs and certain non-preferred generic drugs.
Tier 5: Specialty tier
Generic and brand-name drugs that meet a government-defined threshold for the cost of ingredients.
Tier 6: Select care drugs
Certain generic or brand-name drugs that treat certain chronic conditions.
Each tier has copay or coinsurance requirements. You’ll generally pay more for drugs listed in higher tiers up to Tier 4, but Tier 5 specialty drugs have a lower coinsurance requirement than Tier 4 drugs. Tier 6 drugs also have relatively low copays.
The drugs included in tiers and what you’ll pay for each tier depend on your choice of prescription drug plan and what kind of pharmacy you use. For example, Wellcare plans generally have the lowest copays for prescriptions you fill through preferred pharmacies, whether in-person or through the mail, while non-preferred pharmacies have higher costs
. It’s the only Wellcare plan for which the deductible depends on the formulary tier. The Wellcare Classic plan applies the deductible to all covered drugs, and the Wellcare Medicare Rx Value Plus plan has no deductible for drugs covered by the plan.
$0-copay options
All of Wellcare’s Part D plans have $0 copays for Tier 1 generic drugs from preferred pharmacies
. The Classic plan also has $0 copays for Tier 6 drugs.
Cost-sharing requirements on higher tiers can quickly get more expensive. As a result, it’s important to check where your medications and pharmacies fall on each plan’s formulary.
Copay vs. coinsurance requirements
You’ll want to check whether you’ll pay a copay or coinsurance for your medications. Copays are set dollar amounts, so it’s easy to see what you’ll pay. Coinsurance is a percentage of the price for your medications, so coinsurance requirements can be more unpredictable and more expensive.
Wellcare starts requiring coinsurance rather than copays at different tiers depending on your plan
Wellcare Value Script: Copays for Tiers 1-2 and Tier 6; coinsurance for Tiers 3-5.
Wellcare Classic: Copays for Tiers 1-2 and Tier 6; coinsurance for Tiers 3-5.
Wellcare Medicare Rx Value Plus: Copays for Tiers 1-3 and Tier 6; coinsurance for Tiers 4-5.
That’s a change since 2023 for the Value Script and Classic plans, which used to have copays rather than coinsurance for drugs on Tier 3.
You can enter your medications and pharmacy information on Wellcare’s website to see which drugs are covered and review your estimated costs with different plan options.
Third-party ratings for Wellcare Medicare Part D plans
American Customer Satisfaction Index: 75 out of 100
The American Customer Satisfaction Index (ACSI) rates consumer satisfaction with products and services based on a scientific model developed at the University of Michigan. Ratings are derived from surveys that measure consumers’ expectations and perceived quality and value of products and services.
In 2023, Wellcare’s parent company, Centene, scored 75 out of 100 on the ACSI health insurance satisfaction benchmark
American Customer Satisfaction Index. Health Insurance. Accessed Oct 18, 2023.
. ACSI measures satisfaction with the health insurance industry as a whole — Centene’s score represents all of its health insurance products, not just Medicare Part D insurance. For comparison, the highest score was 82 and the health insurance industry average was 76.
Wellcare Medicare Part D service area
Stand-alone Medicare prescription drug plans from Wellcare are available in all 50 states and Washington, D.C.
Wellcare offers all three of its Medicare Part D plan options in all of its markets.
About Wellcare
Wellcare was founded in 1985 and became a subsidiary of Centene in 2020. The company's headquarters are in Tampa, Florida. Wellcare offers coverage through Medicaid, Medicare Advantage and Medicare prescription drug plans. Centene covers more than 1.3 million Medicare Advantage members.
Centene posted total revenues of $144.5 billion in 2022.
Find the right Medicare Part D prescription drug plan
The interactive tool on Medicare.gov can help you find a Medicare Part D plan that covers your prescriptions. It also helps you compare costs among Medicare Part D and Medicare Advantage plans available to you.
Here are some things to keep in mind when comparing plans:
Check the formulary: You’ll want to make sure the medicines you currently take and, importantly, any you think you might need in the future, are covered under each of the plans you’re considering. Talk to your health care providers about what brand-name and generic medicines to look for and any alternatives that may also work in case you can’t find your current medicines on the plans available in your area.
Look for plan changes: Formularies change frequently. Your insurer should send you a Notice of Plan Change when the formulary changes. Read that document carefully.
Check the pharmacy network: Most Medicare Part D plans negotiate with a network of pharmacies for the lowest cost. Check to see if your pharmacy or an equally convenient one is in the plan’s network. Also, compare prices for using mail order.
If your plan does change, and the change affects the prescription drugs you need, you can switch plans during Medicare's open enrollment period, Oct. 15 to Dec. 7. Changes go into effect on the following Jan. 1.
If you have additional questions about Medicare, visit Medicare.gov or call 800-MEDICARE (800-633-4227, TTY 877-486-2048).
