Wellcare Medicare Part D 2023 Review

Wellcare Part D plans have low prices, but they fall behind on most quality measures from the Centers for Medicare & Medicaid Services.
Alex Rosenberg
By Alex Rosenberg 
Edited by Holly Carey

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Wellcare is part of Centene Corp., which is the second-largest company offering Medicare Part D plans

Centers for Medicare & Medicaid Services. PDP Plan Directory. Accessed Oct 14, 2022.
. About 4.2 million Medicare beneficiaries have Wellcare Part D plans as of October 2022.

Wellcare’s Part D plans are relatively inexpensive, but their ratings aren’t great. They have a below-average 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.

Pros

Cons

  • Low prices. Wellcare plans are priced lower than plans from most major competitors, on average.

  • $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.

  • Low quality rating. Among the top five largest Medicare Plan D insurance companies, Wellcare has the lowest average summary star rating, weighted by enrollment.

  • Shopping and service struggles. Wellcare underperformed on quality measures related to online pricing accuracy, the call center and member complaints.

Wellcare 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.

Wellcare offers the following stand-alone Medicare Part D prescription drug plans for 2023

Wellcare. 2023 Medicare Plans. Accessed Oct 14, 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.

Centers for Medicare & Medicaid Services. 2023 PDP Landscape Source File (v 09 06 2022): State; Organization Name; Plan Name. Accessed Oct 14, 2022.
.

Wellcare offers all three of its Medicare Part D plan options in all of its markets.

Wellcare Medicare Part D cost

Wellcare Medicare Part D premiums and deductibles

The average premium for Wellcare Value Script, Wellcare’s least expensive Medicare Part D plan, is a little lower in 2023. Premiums for the Wellcare Classic and Wellcare Medicare Rx Value Plus plans have both risen by a couple of dollars per month, on average. For the plans with deductibles, the deductible is $25 higher for 2023 than it was in 2022.

Here are the 2023 premiums and deductibles for Wellcare’s stand-alone Medicare prescription drug plans

Centers for Medicare & Medicaid Services. 2023 PDP Landscape Source File (v 09 06 2022): Monthly Drug Premium. Accessed Oct 14, 2022.
:

Plan

Pricing

Wellcare Value Script

Monthly premiums:

  • Lowest: $3.50.

  • Average: $9.73.

  • Highest: $11.20.

Annual deductible: $505.

Wellcare Classic

Monthly premiums:

  • Lowest: $24.30.

  • Average: $32.91.

  • Highest: $37.60.

Annual deductible: $505.

Wellcare Medicare Rx Value Plus

Monthly premiums:

  • Lowest: $65.

  • Average: $71.22.

  • Highest: $71.40.

Annual deductible: $0.

» If you have concerns about affording Medicare Part D, look into Medicare Extra Help

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 or six-tier formulary

Wellcare. Comprehensive Formulary. Accessed Oct 14, 2022.
:

Drug tier

Description

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 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 diabetic drugs*

Certain brand-name diabetic drugs.

* Wellcare Value Script and Wellcare Medicare Rx Value Plus plans only. The Wellcare Classic plan uses only the first five tiers.

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.

$0-deductible options

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.

$0-copay options

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.

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.

All of Wellcare’s Medicare Part D plans have copays for Tier 1-3 drugs and coinsurance for Tier 4-5 drugs. The Wellcare Value Script and Medicare Rx Value Plus plans both have copays for Tier 6 diabetic drugs.

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, weighted by enrollment: 3 stars

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 average rating of 3 stars, weighted by enrollment. The 2023 average for all stand-alone Medicare Part D plans from all providers, weighted by enrollment, was 3.25 stars

Centers for Medicare & Medicaid Services. 2023 Medicare Star Ratings Fact Sheet. Accessed Oct 14, 2022.
.

Compare Wellcare Part D star ratings

Stand-alone Medicare Part D plans from Wellcare outperformed the national average on three Part D measures, tied the average for one measure and fell behind the national average on eight measures

Centers for Medicare & Medicaid Services. 2023 Star Ratings Data Table - Measure Stars (Oct 04 2022). Accessed Oct 14, 2022.
.

Here’s how stand-alone Wellcare plans compared with national averages for each of the 12 Part D measures

:

Measure

Wellcare's rating

National average

Getting needed prescription drugs

4 stars.

3.5 stars.

Medication adherence for diabetes medications

3 stars.

2.9 stars.

Statin use in persons with diabetes

3 stars.

2.9 stars.

Members choosing to leave the plan

(a higher star rating means fewer members choose to leave)

4 stars.

4 stars.

Measure

Wellcare's rating

National average

Call center – foreign language interpreter and TTY availability

3 stars.

4.1 stars.

Complaints about the drug plan

(a higher star rating means fewer complaints)

4 stars.

4.4 stars.

Drug plan quality improvement

2 stars.

2.2 stars.

Rating of drug plan

3 stars.

3.3 stars.

Medicare plan finder price accuracy

3 stars.

3.5 stars.

Medication adherence for hypertension

2 stars.

2.7 stars.

Medication adherence for cholesterol

3 stars.

3.1 stars.

Medication Therapy Management program completion rate for comprehensive medication review

2 stars.

3.1 stars.

Third-party ratings for Wellcare Medicare Part D plans

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

American Customer Satisfaction Index. Health Insurance. Accessed Oct 14, 2022.
. 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.

About Centene

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 alternatives

Compare Medicare Part D prescription drug plan companies

Company

Average stand-alone Medicare Part D star rating, weighted by enrollment (2023)

3.21 stars.

3.5 stars.

3.52 stars.

3.02 stars.

2 stars.

3 stars.

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).
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