The bottom line: Wellpoint Medicare Advantage offers low-cost plans in seven states, but government quality ratings and member experience are subpar for the field. Jump to: Full Review
Wellpoint Medicare Advantage pros and cons
Pros
- $0 premiums: Almost three-quarters of Wellpoint Medicare Advantage plans (73%) are $0 premium.
- Low-cost plans: The average premium for a standard Wellpoint Medicare Advantage prescription drug plan is $11.97, which is lower than the averages from major companies.
- Flexible benefits: Some Wellpoint Medicare Advantage plans offer “Essential Extras,” a feature where members choose up to two extra benefits for their plan. Examples include transportation services and allowances for healthy foods, utilities or dental, vision and hearing services.
Cons
- Limited availability: Wellpoint offers Medicare Advantage plans in only seven states: Arizona, Iowa, New Jersey, Tennessee, Texas, Washington and West Virginia.
- Low star ratings: Wellpoint plans' average quality rating from the Centers for Medicare & Medicaid Services (CMS), weighted by enrollment, is 3.28 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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NerdWallet’s Medicare content, including articles, reviews and recommendations, is produced by a team of writers and editors who specialize in Medicare. Their work has appeared in The Associated Press, Washington Post, Nasdaq, MSN, MarketWatch, Yahoo! Finance and other national and regional media outlets. They have been cited in publications including Healthline, and appeared on NerdWallet's "Smart Money" podcast.
NerdWallet star rating for Wellpoint Medicare Advantage
Wellpoint Medicare Advantage plans earned 3.2 out of 5 stars for overall performance. NerdWallet’s ratings are determined by our editorial team. The scoring formula takes into account premiums, out-of-pocket costs, government quality ratings, customer complaints, disenrollment survey data, third party quality accreditation and more.
NerdWallet star ratings are different from CMS ratings for Medicare plans.
Our data-driven, consumer-first scoring rubric for Medicare Advantage plans includes crucial metrics like cost and a wider range of data sources for quality and customer satisfaction in addition to the information incorporated into CMS ratings.
Government quality ratings for Wellpoint Medicare Advantage
Average CMS star rating, weighted by enrollment: 3.28
Wellpoint Medicare Advantage plans are rated below the industry average, receiving an average rating of 3.28 stars out of 5 from CMS for 2026, weighted by enrollment. For comparison, the average weighted star rating for plans from all providers is 4.02.
There are no Wellpoint Medicare Advantage plans rated 4 stars or above for 2026.
CMS maintains its own database of star ratings, which rank each plan 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.
All Medicare Advantage plans are evaluated on health plan measures, and Medicare Advantage plans that include prescription drug coverage are also evaluated on drug plan measures.
You can find a plan’s rating with Medicare's plan finding tool.
How much does Wellpoint Medicare Advantage cost?
Premiums
About 73% of Wellpoint Medicare Advantage plans have a $0 premium.
Wellpoint plans with a monthly premium cost about $11.97 per month, on average, weighted by enrollment.
You'll also still be responsible for paying your Medicare Part B premium, which is $202.90 per month in 2026.
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.
Prescription drugs
All of Wellpoint Medicare Advantage plans include prescription drug coverage.
Here’s what you might pay for prescription drugs at some common price points.
Tier 1 (Preferred generics) 100% of Wellpoint Medicare Advantage plans have $0 copays/coinsurance.
$0: Average out-of-pocket cost for a drug with a $15 retail price, among Wellpoint plans with copays or coinsurance at Tier 1 (after deductible, if any).
Tier 2 (Most generics) 73.4% of Wellpoint Medicare Advantage plans have $0 copays/coinsurance.
$11.80: Average out-of-pocket cost for a drug with a $50 retail price, among Wellpoint plans with copays or coinsurance at Tier 2 (after deductible, if any).
Tier 3 (Preferred brands) 0% of Wellpoint Medicare Advantage plans have $0 copays/coinsurance.
$48.16: Average out-of-pocket cost for a drug with a $200 retail price, among Wellpoint plans with copays or coinsurance at Tier 3 (after deductible, if any).
Other out-of-pocket costs
Wellpoint Medicare Advantage plans have an average maximum out-of-pocket (MOOP) spending cap of $7,936, weighted by enrollment. That’s higher than average among the companies NerdWallet reviews.
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.
To get a sense of costs, Medicare.gov and most other Medicare shopping tools can help you compare plans' premiums and out-of-pocket costs for certain services and prescription drugs in your location.
Why do people leave Wellpoint Medicare Advantage plans?
CMS surveys people who voluntarily leave their Medicare plans about their reasons for leaving. Here’s the breakdown of problems people identified with their former Wellpoint Medicare plans.
Problems getting covered care: 16% (All-company average: 11%).
Problems with doctor/hospital networks: 18% (All-company average: 17%).
Financial issues: 20% (All-company average: 17%).
Problems with prescription drug benefits: Data not available (All-company average: 3%).
Problems getting information from the plan: 17% (All-company average: 9%).
(Members can give more than one reason for leaving on the survey and might leave plans for other reasons, so the categories won’t add up to 100%.)
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:
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 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.
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 seven states.
Wellpoint's parent company, Elevance Health, is the fourth-largest for-profit Medicare Advantage provider. Wellpoint-branded plans cover more than 117,000 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 Medicare Advantage customer service
Here’s how Wellpoint members can contact customer service:
Call the number on the back of your ID card, available from 8 a.m. to 8 p.m. local time seven days per week from October through March, or Monday to Friday from April through September.
Chat live with a member services representative once you’ve logged into your account online.
Compare Medicare Advantage companies
Get more information below about some of the major Medicare Advantage insurance companies. 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 preferred medical 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).
- Over three-quarters of plans are $0 premium.
- Plans with premiums are cheaper than plans from major companies, on average.
- Flexible options to add on extra perks.
- Available in only seven states.
- Below-average government quality ratings and member experience scores.
- Offers only HMO and HMO-POS plans.
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.NerdWallet analysis of CMS data. 2026 Star Ratings Data Tables. Accessed May 1, 2026.
- 2.NerdWallet analysis of CMS data. Monthly Enrollment by Plan. Accessed May 1, 2026.
- 3.NerdWallet analysis of CMS data. CY2026 Landscape 202603. Accessed May 1, 2026.
- 4.Centers for Medicare & Medicaid Services. Understanding Medicare Advantage Plans. Accessed May 1, 2026.
- 5.NerdWallet analysis of CMS data. Beneficiary Cost File. Accessed May 1, 2026.
- 6.NerdWallet analysis of CMS data. 2026 Star Ratings Data Table - Disenrollment Reasons (Oct 8 2025). Accessed May 1, 2026.
- 7.Chartis. Medicare Advantage Enrollment Depicts Industry at a Crossroads.. Accessed May 1, 2026.
Medicare Advantage review methodology
NerdWallet’s Medicare Advantage ratings are based on premiums, out-of-pocket costs, prescription drug coverage, quality data from the Centers for Medicare & Medicaid Services, consumer experience and more. We calculate each health insurance company’s rating on a curved 5-point scale.
NerdWallet’s editorial team analyzed companies covering about 87% of all Medicare Advantage beneficiaries in the United States. We reviewed 25 Medicare Advantage brands, with some insurance companies having more than one brand under their umbrella. (For example, Blue Cross Blue Shield includes the brands Anthem and Highmark.)
The Medicare Advantage marketplace is concentrated among just a handful of companies. In many places, one company serves more than half of the market. At the national level, NerdWallet’s reviews include each of the 10 largest brands by enrollment.
At the state level, our research includes at least one major insurer in every state where Medicare Advantage plans are sold, and includes the top two insurers in 40 of those 49 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.
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) 432-0512 / TTY 711 M-F 9AM-9PM, Sat 10AM-6PM ETSpeak to a licensed insurance agent on askchapter.orgon NerdWallet | 4.11 | 4.11/5 | 48 states and Washington, D.C. | Medium (50% to 84%) | 3.74 (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 | 3.79 | 3.79/5 | 46 states and Washington, D.C. | Low (49% or less) | 3.82 (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 http://askchapter.org on NerdWallet | 4.20 | 4.20/5 | 43 states and Washington, D.C. | Medium (50% to 84%) | 3.89 (Above average) | (855) 432-0512 / TTY 711 M-F 9AM-9PM, Sat 10AM-6PM ETSpeak to a licensed insurance agent on http://askchapter.org on NerdWallet |
(855) 432-0512 / TTY 711 M-F 9AM-9PM, Sat 10AM-6PM ETSpeak to a licensed insurance agent on askchapter.orgon NerdWallet | 3.76 | 3.76/5 | 29 states and Washington, D.C. | Medium (50% to 84%) | 3.96 (Above average) | (855) 432-0512 / TTY 711 M-F 9AM-9PM, Sat 10AM-6PM ETSpeak to a licensed insurance agent on askchapter.orgon NerdWallet |