Wellcare Medicare Part D 2022 Review

Wellcare Part D plans have low prices, but they fall behind on most quality measures from the Centers for Medicare & Medicaid Services.
Jun 10, 2022

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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 May 27, 2022.
. 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.

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 ratings. Wellcare has below-average ratings on two-thirds of CMS’ Medicare Part D quality measures.

  • Classic plan’s coinsurance requirements. The Wellcare Classic plan requires coinsurance rather than copays for some Tier 3 (preferred brand-name) drugs, which could get expensive.

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. 2022 Medicare Plans. Accessed May 27, 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. 2022 PDP Landscape Source Files (v 10 26 21): State; Organization Name; Plan Name. Accessed May 27, 2022.
.

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

Cost

Wellcare Medicare Part D premiums and deductibles

Here are the 2022 premiums and deductibles for Wellcare’s stand-alone Medicare prescription drug plans

Centers for Medicare & Medicaid Services. 2022 PDP Landscape Source Files (v 10 26 21): Monthly Drug Premium. Accessed May 27, 2022.
:

Plan

Pricing

Wellcare Value Script

Monthly premiums:

  • Lowest: $5.50.

  • Average: $11.85.

  • Highest: $13.00.

Annual deductible: $480.

Wellcare Classic

Monthly premiums: 

  • Lowest: $21.70.

  • Average: $30.82.

  • Highest: $36.30.

Annual deductible: $480.

Wellcare Medicare Rx Value Plus

Monthly premiums:

  • Lowest: $59.

  • Average: $68.70.

  • Highest: $69.

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 formulary

Wellcare. Comprehensive Formulary. Accessed May 27, 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 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

Centers for Medicare & Medicaid Services. Fact Sheet - 2022 Part C and D Star Ratings. Accessed May 27, 2022.
.

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

Centers for Medicare & Medicaid Services. 2022 Star Ratings Data Table — Measure Stars (Oct 06 2021). Accessed May 27, 2022.
. 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

:

Measure

Wellcare's rating

National average

Rating of drug plan

4 stars.

3.8 stars.

Medication adherence for diabetes medications

4 stars.

3.9 stars.

Medication Therapy Management program completion rate for comprehensive medication review

5 stars.

3.7 stars.

Measure

Wellcare's rating

National average

Call center – foreign language interpreter and TTY availability

4 stars.

4.2 stars.

Complaints about the drug plan (a higher star rating means fewer complaints)

4 stars.

4.8 stars.

Members choosing to leave the plan (a higher star rating means fewer members choose to leave)

3 stars.

4.2 stars.

Getting needed prescription drugs

3 stars.

3.9 stars.

Medicare plan finder price accuracy

3 stars.

3.3 stars.

Medication adherence for hypertension

3 stars.

3.5 stars.

Medication adherence for cholesterol

3 stars.

3.6 stars.

Statin use in persons with diabetes

3 stars.

3.3 stars.

Third-party ratings

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 May 27, 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 Medicare Part D star rating (2022)

3.9 stars.

3.5 stars.

3.75 stars.

3.67 stars.

3.5 stars.

3.5 stars.

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).

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