The bottom line: Wellpoint Medicare Advantage offers low-cost plans in six states, but star ratings and member experience are subpar for the field. Jump to: Full Review
Wellpoint Medicare Advantage pros and cons
Pros
- $0 premiums: Three-quarters of Wellpoint Medicare Advantage plans (74%) are $0 premium.
- Low-cost plans: The average premium for a standard Wellpoint Medicare Advantage prescription drug plan is $12.30, which is lower than the average from all major providers.
- Flexible benefits: Some Wellpoint Medicare Advantage plans offer “Essential Extras,” a feature where members choose an extra benefit for their plan, including money toward assistive devices, healthy groceries, or dental, vision or hearing care.
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 (CMS), weighted by enrollment, is 3.34 stars, which is below the average for all providers.
- Low satisfaction: Member experience ratings, which include metrics like customer service and getting needed care, are well below average for major providers.
- Limited plan options: Wellpoint offers only HMO and HMO-POS plans, which are the most restrictive in terms of medical flexibility.
Compare against other providers
🔍 UnitedHealthcare Medicare Advantage
» More options in our roundup of the best Medicare Advantage plans
Compare against other providers
🔍 UnitedHealthcare Medicare Advantage
» More options in our roundup of the best Medicare Advantage plans
Our full review
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Wellpoint Medicare star ratings
Average star rating, weighted by enrollment: 3.34
Wellpoint Medicare Advantage plans are rated below the industry average, receiving an average rating of 3.34 stars out of 5 from CMS for 2025, weighted by enrollment. For comparison, the average weighted star rating for plans from all providers is 3.96.
There are no Wellpoint Medicare Advantage plans with a rating higher than 3.5 stars.
CMS 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.
You can find a plan’s rating with the Medicare plan finding tool.
What does Wellpoint Medicare Advantage cost?
Three-quarters of Wellpoint standard Medicare Advantage prescription drug plans have $0 premiums. For plans with a monthly cost, the average premium is $12.30, which is lower than the average from big providers. You'll also still be responsible for paying your Medicare Part B premium, which is $185 per month in 2025.
(Most people pay this standard Part B amount, but if your income is above a certain threshold, you'll pay the income-related monthly adjustment amount (IRMAA). Some Medicare Advantage plans cover part or all of your Part B premium.)
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. Deductible: None. Out-of-pocket max: $6,750 in-network. Copays:
Dental allowance: $2,000. |
Wellpoint Extra Help (HMO-POS) | Monthly premium: $9.10. Deductible: None. Out-of-pocket max: $4,900 in-network. Copays:
Dental allowance: $3,250. |
Wellpoint Medicare Advantage 2 (HMO-POS) | Monthly premium: $0. Deductible: None. Out-of-pocket max: $4,150 in-network. Copays:
Dental allowance: $2,500. |
Selected plans are available in ZIP code 37901. *Inpatient hospital copay is per day for days 1-6. | |
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.
Wellpoint Medicare Advantage plan types
There are three kinds of Wellpoint Medicare Advantage plans, and all Wellpoint Medicare Advantage plans include prescription drug coverage.
Plan offerings include the following types:
- HMO plans
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-POS plans
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.
- SNPs
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.
Wellpoint 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 125,000 Medicare Advantage beneficiaries.
About Wellpoint
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.
Wellpoint offers individual and family plans, dental and vision coverage, Medicare Advantage, Medicare Supplement Insurance and Medicaid plans.
Wellpoint customer service
Here’s how Wellpoint members can contact customer service:
Call the number on the back of your ID card, available Monday to Friday from 8 a.m. to 8 p.m. Eastern time.
Chat live with a member services representative once you’ve logged into your account online.
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).
- Three-quarters of plans are $0 premium.
- For plans with a monthly premium, the average cost for a standard Medicare Advantage plan is lower than that of bigger providers.
- Available in only six states.
- Below-average star ratings and member experience scores.
- Offers only HMO and HMO-POS plans.
Article sources
NerdWallet writers are subject matter authorities who use primary, trustworthy sources to inform their work, including peer-reviewed studies, government websites, academic research and interviews with industry experts. All content is fact-checked for accuracy, timeliness and relevance. You can learn more about NerdWallet's high standards for journalism by reading our editorial guidelines.
- 1.Centers for Medicare & Medicaid Services. 2025 Star Ratings Data Tables (ZIP). Accessed Apr 22, 2025.
- 2.Centers for Medicare & Medicaid Services. CY2025 Landscape (202412) (ZIP). Accessed Apr 22, 2025.
- 3.Centers for Medicare & Medicaid Services. Understanding Medicare Advantage Plans. Accessed Apr 22, 2025.
- 4.Chartis. Medicare Advantage market growth slows amid intensified headwinds. Accessed Apr 22, 2025.
Medicare Advantage review methodology
The Medicare Advantage marketplace is concentrated among just a handful of companies; in many places, one insurer serves more than half of the market. NerdWallet reviewed 26 Medicare Advantage brands, with some insurers having more than one brand under their umbrella. (For example, Blue Cross Blue Shield includes the brands Anthem and Highmark.) At the national level, these reviews include nine of the 10 largest brands by enrollment. At the state level, our research includes at least one major insurer in 47 of the 49 states that offer Medicare Advantage plans, and includes the top two insurers in 35 of those states. (Alaska doesn't offer Medicare Advantage plans.) We also look at online search volume to identify regional and other notable players in the space.
NerdWallet’s Medicare Advantage reviews are based on ratings data from the Centers for Medicare & Medicaid Services, as well as pricing, plan availability by state, plan types available, consumer experience, extra benefits offered and more. These reviews are a guide, but we encourage you to shop around and compare several plans to find the best coverage and rate for you. NerdWallet does not receive compensation for any reviews. Read our editorial guidelines for additional information.
Compare Medicare Advantage plans
Insurance company | CMS star rating | States available | Members in high-rated plans | Member experience | Learn more |
|---|---|---|---|---|---|
(855) 821-0556 / TTY 711 Call UnitedHealthcarefrom UnitedHealthcare | |||||
3.95 | 3.95/5 | 49 states and Washington, D.C. | Medium (50% to 84%) | 3.41 (Average) | |
(855) 432-0512 / TTY 711 M-F 9AM-9PM, Sat 10AM-6PM ETSpeak to a licensed insurance agent on askchapter.orgon NerdWallet | |||||
(855) 432-0512 / TTY 711 M-F 9AM-9PM, Sat 10AM-6PM ETSpeak to a licensed insurance agent on askchapter.orgon NerdWallet | 3.63 | 3.63/5 | 48 states, Washington, D.C., and Puerto Rico | Low (49% or less) | 3.62 (Above average) |
(855) 432-0512 / TTY 711 M-F 9AM-9PM, Sat 10AM-6PM ETSpeak to a licensed insurance agent on askchapter.orgon NerdWallet | |||||
(855) 432-0512 / TTY 711 M-F 9AM-9PM, Sat 10AM-6PM ETSpeak to a licensed insurance agent on askchapter.orgon NerdWallet | 4.29 | 4.29/5 | 44 states and Washington, D.C. | High (85% to 100%) | 4.01 (Above average) |
(855) 432-0512 / TTY 711 M-F 9AM-9PM, Sat 10AM-6PM ETSpeak to a licensed insurance agent on askchapter.orgon NerdWallet | |||||
(855) 432-0512 / TTY 711 M-F 9AM-9PM, Sat 10AM-6PM ETSpeak to a licensed insurance agent on askchapter.orgon NerdWallet | 3.97 | 3.97/5 | 29 states and Washington, D.C. | Medium (50% to 84%) | 3.82 (Above average) |