Wellcare Medicare Advantage Plans

With the Medicare Open Enrollment coming up in October, many people are looking to compare Medicare Advantage Plans for the new year. In this quick article, we’ll be sharing about WellCare Medicare Advantage Plans. Please be aware, we’re not affiliated with WellCare and this is a general overview of the Medicare Advantage plans they offer. Please speak to a licensed insurance agent or contact WellCare directly for plan details.

Types of Wellcare Medicare Plans

• Health Maintenance Organization (HMO)
• Preferred Provider Organization (PPO)
• Private Fee-For-Service Plans (PFFS)
• Chronic Special-Needs Plan (C-SNP)
• Institutional Special Needs Plans (I-SNP)
• Dual Special Needs Plan (D-SNP)

Which Medicare Plan is Most Popular

Which WellCare Plan is most popular varies with the region and service area you live in. Medicare Advantage Plans are among the most popular WellCare health plans with a growing segment of the population and continue to grow in popularity.

This is largely due to the ‘extras’ it provides, such as Dental, Vision, Hearing, Fitness, and prescription drug benefits.

Many Medicare Advantage Plans have Part D prescription drug plans bundled in. If you take even one prescription drug (or you might take a prescription drug in the future), it would be wise to choose one of these plans or purchase a stand-alone prescription drug plan.

HMO Medicare Advantage Plans

One of the Medicare Advantage Plan options from WellCare is the Health Maintenance Organization (HMO). A WellCare HMO Plan generally requires choosing a Primary Care Physician (PCP) who will manage your healthcare needs. When a specialist is needed, the PCP will make a referral to a specialist in the provider network. If an out-of-network specialist is needed, it will be a good idea to get a PCP referral. HMO plans offer extra benefits like dental, vision, hearing, fitness, transportation to doctor’s offices and pharmacies, and some over-the-counter products for no extra charge. It is not necessary to purchase a stand-alone Part D Prescription Drug Plan because pharmacies are in the HMO network.

PPO Medicare Advantage Plans

Another option in Medicare Advantage Plans is a Preferred Provider Organization (PPO). PPO insurance plans offer lower rates for receiving care from in-network providers. There may be reimbursement for seeing an out-of-network physician, but there could be greater out-of-pocket costs. Ordinarily, in a Medicare Advantage Plan PPO, you will not need a referral to see a specialist. If the specialist is out-of-network, it might be wise to consult your PCP for a referral or pre-authorization.

Special Needs Medicare Advantage Plans

Those with special needs, whether medical or financial, may be candidates for a WellCare Special Needs Plan (SNP). Three kinds of SNPs include:

• Chronic Condition Special Needs plans (C-SNPs) – For those who have chronic health problems
• Institutional Special Needs Plans (I-SPNs) – People living in long-term-care facilities or nursing homes
• Dual Eligibility SNPs (D-SNPs) – For those who are eligible for Medicare and Medicaid

Private Fee for Service

In some parts of the country, Private Fee For Service Medicare Plans (PFFS) are available. These plans typically offer a pre-determined rate to doctors and hospitals for services. The patient will share the cost with a pre-set copay or coinsurance.

Some PFFS plans have their own doctor network. With other PFFS Medicare Plans, the individual may see the provider of their choice. Ask the provider if they accept Medicare assignment or will accept the plan’s terms for payment.

When Can I Apply for a WellCare Medicare Advantage Plan

The first opportunity to apply for a Medicare Advantage Plan is during your Initial Enrollment Period (IEP) beginning three months before your 65th birthday month and ending three months after. During your IEP, you can choose Original Medicare (Medicare Part A and Medicare Part B). You can also purchase a prescription drug plan during your IEP.

Original Medicare covers only 80% of approved amounts for most medical expenses. You would have to pay the remaining 20% of Medicare costs out of pocket. ”To help with paying the out-of-pocket costs, many people choose one of the many Medicare Supplement plans (which do not have prescription drug benefits). These health insurance plans can only be purchased from government-approved private insurance companies by a person who is at least 65 years old and enrolled in Part B.

Medicare Supplement Plans cannot be purchased by people with Medicare Advantage Plans. Medicare Supplement plans work alongside Original Medicare to keep out-of-pocket costs manageable.

Medicare Advantage Plans take the place of Original Medicare, which pays the insurance company a pre-set amount of money to take care of each policyholder.

An Annual Enrollment Period (AEP) takes place yearly from October 15 to December 7.

An Open Enrollment Period (OEP) begins on January 1 and ends on March 31 annually.

During these times, you can review Medicare Advantage plans and enroll in the plan that best fits your medical and financial situation.

What Do Wellcare Medicare Advantage Plans Cover?

In addition to everything covered by Medicare Part A and Part B, WellCare Medicare Advantage plans cover things like:

• Dental care services, both preventative and treatment
• Medicare Part D prescription drug coverage for those with prescription drug needs
• Coverage for vision services – help with purchasing glasses and contact lenses
• Transportation to pharmacies and doctor visits
• Yearly fitness benefit

Are Medicare Advantage Plans Affordable?

WellCare Medicare Advantage Plans often have $0 to low monthly premium and deductible amounts, $0 to low, pre-set copayments and coinsurance, and limits on out-of-pocket spending. For people who are on a limited income, as well as for those who are not, Medicare Advantage Plans are high in affordability.

What is Medicare Advantage (Medicare Part C)?

Medicare Advantage Plans (Medicare Part C) are ‘bundled’ plans that incorporate the Medicare benefits of Part A, Part B, and usually Part D Prescription Drug Plans. For people who do not travel a lot and who are comfortable with going to a doctor in their service area, Medicare Advantage Plans can be a great choice.

In your search for the best Medicare coverage for prescription drugs and other healthcare needs, consult a licensed insurance agent who specializes in Medicare about the Medicare Advantage Plans and other options in your service area. With so many Medicare plans available, the two of you can find the best Medicare coverage for you.

Feel free to give us a call at 800-974-0552 if you have questions.

Learn more: https://www.nerdwallet.com/article/insurance/medicare/wellcare-medicare-advantage