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Wellcare is part of Centene Corp., which is the second-largest company offering Medicare Part D plans. About 4.2 million Medicare beneficiaries have Wellcare Part D plans as of April 2022.
Wellcare’s Part D plans are relatively inexpensive, but their ratings aren’t great. They have a below-average overall star rating from the Centers for Medicare & Medicaid Services, or CMS, and they’re rated below average on eight out of 12 Medicare Part D quality measures.
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.
Available Medicare Part D prescription drug plans
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.
While Wellcare previously offered six plans, it has consolidated its stand-alone Medicare prescription drug plan offerings to three for 2022:
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 Classic: Wellcare describes this plan as “best suited to those who take only a few medications and seek a low monthly premium.”
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 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.
Wellcare Medicare Part D premiums and deductibles
Here are the 2022 premiums and deductibles for Wellcare’s stand-alone Medicare prescription drug plans:
Wellcare Value Script
Annual deductible: $480.
Annual deductible: $480.
Wellcare Medicare Rx Value Plus
Annual deductible: $0.
Wellcare Medicare Part D drug formulary tiers
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 five-tier formulary:
Tier 1: Preferred generic drugs
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 non-preferred generic drugs.
Tier 5: Specialty tier
Generic and brand-name drugs that meet a government-defined threshold for the cost of ingredients.
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.
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 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.
The Wellcare Value Script plan has no deductible for Tier 1 and Tier 2 drugs — 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.
All of Wellcare’s Part D plans have $0 copays for Tier 1 generic drugs from preferred pharmacies, but 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.
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.
Wellcare Medicare Part D star ratings
Average Part D star rating: 3.5
The Centers for Medicare & Medicaid Services rates Medicare Part D plans on 12 quality measures. (You can find definitions for each of these factors in the CMS Star Ratings Technical Notes.)
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 overall rating of 3.5 stars. The 2022 average for all stand-alone Medicare Part D plans from all providers, weighted by enrollment, was 3.7 stars.
Compare Wellcare Part D star ratings
Stand-alone Medicare Part D plans from Wellcare outperformed the national average on three Part D measures, but fell behind the national average on eight measures. For one measure, drug plan quality improvement, there wasn’t enough data available for Wellcare to be rated in 2022.
Here’s how stand-alone Wellcare plans compared with national averages for each of the remaining 11 Part D measures:
American Customer Satisfaction Index: 72 out of 100
The American Customer Satisfaction Index, or 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 2021, Wellcare’s parent company, Centene, scored 72 out of 100 on the ACSI health insurance satisfaction benchmark. 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 75 and the health insurance industry average was 73.
Centene Corp. started as Family Hospital Physician Associates, a Medicaid plan created in 1984. It became Centene Corp. and established its headquarters in St. Louis, Missouri, in 1997. Centene’s business includes Medicare, Medicaid, health insurance marketplace plans, federal health insurance programs and health care programs for correctional institutions. The company also offers whole health services, including specialty pharmacy, dental, vision and call-in nurse support. It acquired Wellcare in 2020 and has since consolidated its Medicare offerings under the Wellcare brand name. In 2021, Centene posted $126 billion in total revenue.
Compare Medicare Part D prescription drug plan companies
Average Medicare Part D star rating (2022)
Find the right Medicare Part D prescription drug plan
The interactive tool on Medicare.gov can help 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 this 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).