Wellcare Medicare Advantage 2024-2025 Review: Pros, Cons, Costs

Wellcare's Medicare Advantage plans struggle to keep up with other companies' ratings.

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The bottom line: Although Wellcare offers low-cost Medicare Advantage plans in 32 states, plans are consistently rated lower than competitors. Jump to: Full Review

Wellcare Medicare Advantage

Wellcare

3.2

CMS Star Rating

(855) 432-0512

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Wellcare Medicare Advantage pros and cons

Pros

Funds for extra benefits: Some Wellcare plans include the Spendables card, which comes preloaded with funds members can use on over-the-counter items, groceries, rent or utility assistance, gasoline, or home improvement and safety items, depending on the plan.

Part B premium coverage: Some plans include a Giveback benefit that refunds some or all of your Medicare Part B premium.

Cons

Star ratings: For 2025, Wellcare’s average star rating from Medicare — weighted by enrollment — is 3.2 stars (out of 5 stars), which is lower than the overall average among all plans.

Member discontent: Member experience on metrics like care coordination and customer service is below average.

Shrinking footprint: Wellcare offers Medicare Advantage plans in five fewer states in 2025 and is seeing declining enrollment overall.

Compare against other providers

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UnitedHealthcare Medicare Advantage - UHC (product card)

UnitedHealthcare

3.93

CMS Star Rating

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Aetna Medicare Advantage

Aetna

4.27

CMS Star Rating

(855) 432-0512

TTY 711

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Humana Medicare Advantage - Chapter

Humana

3.63

CMS Star Rating

(855) 432-0512

TTY 711

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We will connect you with Medicare companies based on the information you provide. They will help you find a plan that suits your needs. If you prefer to speak to a licensed insurance agent right away, please call the number listed below.

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TTY 711

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Cigna Medicare Advantage

Cigna

3.93

CMS Star Rating

(855) 432-0512

TTY 711

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TTY 711

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» More options in our roundup of the best Medicare Advantage plans

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UnitedHealthcare Medicare Advantage - UHC

UnitedHealthcare

3.93

CMS Star Rating

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Humana Medicare Advantage - Chapter

Humana

3.63

CMS Star Rating

(855) 432-0512

TTY 711

Speak to a licensed insurance agent on askchapter.org
GET A QUOTE

on NerdWallet

We will connect you with Medicare companies based on the information you provide. They will help you find a plan that suits your needs. If you prefer to speak to a licensed insurance agent right away, please call the number listed below.

M-F 8am-10pm EST, Sa-Su 9am-9pm EST

Speak to a licensed insurance agent on askchapter.org
(855) 432-0512

TTY 711

IS THIS PROVIDER AVAILABLE IN MY STATE?

» More options in our roundup of the best Medicare Advantage plans

Our full review

45+ Medicare companies and brands analyzed by our team of experts.

30+ years of combined experience covering Medicare and personal finance.

Governed by NerdWallet's strict guidelines for editorial integrity.

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.

Wellcare Medicare Advantage star ratings

Average star rating, weighted by enrollment: 3.2

Wellcare Medicare Advantage plans are rated well below the industry average, receiving an average rating of 3.2 stars out of 5 from Centers for Medicare & Medicaid Services (CMS) for 2025, weighted by enrollment. For comparison, the average weighted star rating for plans from all providers is 3.95.

Only one of Wellcare’s 2025 plans received a star rating of 4 stars. The rest of the company's plans are rated 3.5 stars or lower

Centers for Medicare & Medicaid Services. 2025 Star Ratings Data Tables (ZIP). Accessed Dec 6, 2024.
.

CMS maintains its own database of star ratings on every Medicare Advantage and separate Medicare Part D plan, ranging 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.

December update

Medicare star ratings are typically released once per year, but CMS recalculated its 2025 star ratings for Wellcare’s parent company, Centene, in December 2024. Updates took place after multiple lawsuits from insurance companies alleging that CMS improperly calculated the 2025 star ratings. NerdWallet has updated this article accordingly.

What does Wellcare Medicare Advantage cost?

Of Wellcare’s HMO, PPO and PFFS plans in 2025, 7 in 10 offer a $0 premium. Of Medicare Advantage prescription drug plans with a monthly cost, the average premium in 2025 is $36.67, which is lower than most major providers. You'll also be responsible for paying your Medicare Part B premium, which is at least $174.70 per month in 2024 ($185 in 2025)

Centers for Medicare & Medicaid Services. Costs. Accessed Dec 6, 2024.
.

(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. Out-of-pocket costs to consider include:

  • The plan's deductibles.

  • 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, and how often you may go out-of-network for care.

  • Whether you require extra benefits, and if the plan charges for them.

Here are some examples of Wellcare Medicare Advantage costs for some popular plans in a mid-range city:

Wellcare Medicare Advantage plan

Pricing

Wellcare Simple (HMO-POS)

Monthly premium: $0.

Deductible: None.

Out-of-pocket max: $3,500.

Copays:

  • Primary care: $0.

  • Specialist: $20.

  • Emergency care: $140.

  • Inpatient hospital: $350.*

Dental allowance: $2,000.

Wellcare Giveback Open (PPO)

Monthly premium: $0.

Deductible: $270 for some Part B services.

Out-of-pocket max: $8,300 in-network.

Copays:

  • Primary care: $0.

  • Specialist: $45.

  • Emergency care: $110.

  • Inpatient hospital: $325.**

Dental allowance: No limit, but most comprehensive dental services aren't covered.

Wellcare Simple Open (PPO)

Monthly premium: $0.

Deductible: None.

Out-of-pocket max: $4,200 in-network.

Copays:

  • Primary care: $0.

  • Specialist: $20.

  • Emergency care: $125.

  • Inpatient hospital: $325.*

Dental allowance: $3,000.

Selected plans are available in ZIP code 27513.

*Inpatient hospital copay is per day for days 1-6.

**Inpatient hospital copay is per day for days 1-8.

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 Wellcare plans, or compare across carriers.

Wellcare Medicare Advantage plan types

Wellcare offers Medicare Advantage prescription drug plans as well as stand-alone prescription drug plans and Medicare Advantage plans without 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.

Preferred provider organization (PPO) plans provide the most freedom, allowing you to see any provider that accepts the insurance. You may not need to choose a primary doctor, and you don’t need referrals to see specialists. You can seek out-of-network care, although it may cost more than seeing an in-network doctor.

Wellcare’s private fee-for-service (PFFS) plans allow you to see any Medicare-approved provider who accepts your Wellcare plan. You won’t have to pick a primary doctor, and you won’t need a referral to see a specialist.

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. Wellcare offers two 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 disorder.

  • Dual-Eligible SNP: For people who are entitled to Medicare and who also qualify for assistance from a state Medicaid program.

Third-party ratings

J.D. Power Ranking

In its 2024 U.S. Medicare Advantage Study — the 10th it’s done so far — J.D. Power measured member satisfaction with Medicare Advantage plans based on eight factors ranging from level of trust to how well a provider resolves problems or complaints. The study was fielded in the 10 biggest state Medicare markets, and here’s how Wellcare ranked in the locations where it had enough market share to be considered

:

NCQA Score Range: 2.5 to 3.5 out of 5

The National Committee for Quality Assurance rates health insurance plans on a 5-point scale (with 5 being best) based on clinical quality, member satisfaction and results from the NCQA Accreditation Survey. The ratings highlight the results of care and what patients say about their care.

In September 2024, the NCQA ranked Wellcare plans between 2.5 and 3.5 stars, with five of the nine rated plans scoring 2.5 stars

NCQA. Health Plans. Accessed Dec 6, 2024.
.

Wellcare Medicare Advantage service area

Wellcare offers Medicare Advantage plans in 32 states.

Parent company Centene is the fifth-largest Medicare Advantage provider among for-profit health plans. More than 1.1 million Medicare beneficiaries are enrolled in a Centene Medicare Advantage plan, but the company lost 212,000 members for the 2024 plan year

.

About Wellcare

Wellcare was founded in 1985 and became a subsidiary of Centene in 2020. The company's headquarters are in Tampa, Florida. Wellcare offers coverage through Medicare Advantage and Medicare prescription drug plans.

Wellcare customer service

Wellcare members can contact their plan’s customer service in the following ways:

  • Send a question through a Contact form.

  • Visit your Wellcare state page (search “Wellcare” and your state) and select Contact Us. This page contains phone numbers for current and prospective Medicare members, prescription drug plan members and a Nurse Advice Line, depending on the state.

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).
Wellcare Medicare Advantage

Wellcare

3.2

CMS Star Rating

Wellcare offers some perks, such as Giveback plans that cover part or all of your Part B premium, but star ratings and member satisfaction fall below other major providers.

(855) 432-0512 / TTY 711

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Speak to a licensed insurance agent on askchapter.org

GET A QUOTE

on NerdWallet

We will connect you with Medicare companies based on the information you provide. They will help you find a plan that suits your needs. If you prefer to speak to a licensed insurance agent right away, please call the number listed above.

States available

32 states


Members in high-rated plans

Low (49% or less)


Member experience

2.72 (Below average)

IS THIS PROVIDER AVAILABLE IN MY STATE?

States available

32 states


Members in high-rated plans

Low (49% or less)


Member experience

2.72 (Below average)

IS THIS PROVIDER AVAILABLE IN MY STATE?

Pros

  • Some plans offer the Spendables card, which is preloaded with funds members can use on things like over-the-counter products or home safety items.
  • Some plans offer a Part B Giveback benefit.

Cons

  • Low star ratings from CMS.
  • Below-average member experience ratings on things like care coordination and customer service.

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.

Medicare will have big changes in 2025. Compare Medicare Advantage plans