Certified Senior Advisor [CSA]®
Certified Senior Advisor [CSA]®
Kelly Blackwell is a Certified Senior Advisor [CSA]®. She has been a healthcare professional for over 30 years, with experience working as a bedside nurse and as a Clinical Manager. She has a passion for educating, assisting and advising seniors throughout the healthcare process.
Quick WellCare Medicare Prescription Drug Plans review: WellCare offers Medicare Part D prescription drug coverage through standalone Part D plans and Medicare Advantage Plans. Monthly premium prices vary depending on where you live and which type of plan you choose. You can find Centers for Medicare and Medicaid Services [CMS] quality rating information for each plan by searching Medicare.gov.
WellCare Healthplans, Inc. began offering Medicare Part D prescription drug plans [PDPs] in 2006. WellCare was founded in 1985 and acquired by Centene Corporation in January 2020. Since then, WellCare has been Centene’s largest government-sponsored health care programs provider.
If you have Original Medicare Part A and/or B or a Private Fee-for-Service [PFFS] Medicare Advantage Plan, you can purchase one of WellCare’s standalone Part D plans. If you have a WellCare Preferred Provider Organization [PPO] or Health Maintenance Organization [HMO] Medicare Advantage Plan, your plan should include drug coverage.
Compare Wellcare’s Prescription Drug Plans [PDPs] available in your area on Wellcare’s website.
Pros and Cons of WellCare Medicare Part D Plans
What do WellCare Medicare Part D Plans cover?
WellCare Medicare Part D plans are regulated by CMS and must cover a wide range of prescription drugs that people with Medicare take. Plans include a coverage gap that begins when you and your plan have spent a certain amount [$4,430 in 2022] on prescription drugs and ends when you’ve spent $7,050 and enter the catastrophic coverage period. You then will pay a small coinsurance percentage or copay amount for drugs you need until the end of the year. When you are in the coverage gap, you will pay up to 25% of drug costs.
WellCare has a formulary [list of drugs] and separates drugs into tiers that correspond to costs. Lower tiers include generic, lower-cost medications, and higher tiers include higher-cost, brand name, or specialty drugs.
Your share of costs for each prescription drug may change depending on which pharmacy you choose, the tier of the drug, and when you enter each coverage phase. You must meet your annual deductible before your plan pays. Wellcare’s Part D plans include:
- Discounts for preferred retail pharmacies [CVS and Caremark] and three-month prescriptions.
- Options for one-month and three-month mail-order prescriptions
- Permission to use any pharmacy if you get Extra Help to to pay for medications
- Senior Savings Program for select insulins to keep your costs below $35/month
What are WellCare’s Medicare Part D Plan options?
WellCare offers three different Part D Plan options, including a value plan with lower monthly premiums, a medium range plan, and a value plus plan. Initial coverage limits and annual out-of-pocket threshold amounts are the same for all three plans. The difference among the plan options lies in the amount you pay for the monthly premium.
WellCare’s Value Script plan has the lowest monthly premium and no deductible for drugs in tiers one and two. It may be best for you if you don’t need prescription drugs but need prescription drug coverage to avoid paying late penalties. The Value Plus plan has a higher monthly premium but no annual deductible. The WellCare Classic plan includes a moderate monthly premium, but you still pay an annual deductible before your plan starts paying.
Before choosing a plan, make sure your drugs are on WellCare’s formulary, and your pharmacy is in WellCare’s network. Wellcare’s preferred pharmacies are CVS and Caremark. You can keep your costs lower by using preferred pharmacies and asking your doctor for generic versions of drugs if possible.
Understand Wellcare’s rules about how you get your prescription drugs. Prior authorizations may apply. You may have to try drugs on a lower tier first before your plan approves higher-cost drugs. This is called step-wise therapy.
Compare these 2022 WellCare Medicare Part D Plans in Cook County, Illinois:
*Based on pricing in Cook County, Illinois
Wellcare Medicare Part D Plans Reviews and Ratings
The Centers for Medicare and Medicaid Services [CMS] rate Wellcare’s Medicare Part D and Medicare Advantage plans. The Better Business Bureau [BBB] rates Centene, WellCare’s parent company. Consumer Affairs, NCQA, and J.D. Power don’t rank WellCare’s Part D plans separately, but provide insight into Wellcare’s health and Medicare Advantage Plans.
Learn More From Our Sources
Drug List [Formulary] and Other Documents
Have questions about which medications are covered by your plan? Access your formularies here or search a drug via the search tool.
Drug Search Tool
Search a Drug via the Search Tool
Members can complete this form to order prescriptions from CVS Caremark Mail Service Pharmacy, WellCare's preferred mail-order pharmacy.
This document outlines your rights with regards to your Medicare drug plan.
Use this printable form to ask us for a decision about a prescription drug and your specific plan coverage. Providers and members should fax form to 1-866-388-1767.
Complete this printable form to ask for an appeal after being denied a request for coverage or payment for a prescription drug. This is the same form as above but cannot be submitted electronically.
2022 Wellcare Drug List [Formulary] Search Tool
The Wellcare Drug List [Formulary] tool allows you to search prescription drug names to determine 2022 plan coverage for your formulary.
Perform the search via the following steps:
- Search for a Drug by Name, First Letter, or by Therapeutic Class.
- If searching by drug name, choose drug, strength and dosage form. If searching by therapeutic class, select a subclass.
- Search result is displayed, including:
- Formulary ID
- Brand Name/Generic Name: Name of drug [generic drug will be listed in italics under brand name drug] and applicable strength and dosage form. Brand name drugs will appear in capitalized letters. Generic drugs will appear in lower case letters and italicized.
- Therapeutic Class/Sub-Class: Indicates the drug’s class and sub-class. Both the class and sub-class are hyperlinked to provide a listing of all formulary drugs within the sub-class selected.
- Dose/Strength: indicates the drug's dosage form and strength.
- Status: Indicates the drug’s formulary status [tier number or non-formulary]
- Notes and Restrictions: Details any formulary restrictions on medications such as quantity limits, prior authorizations or step therapy requirements. Also indicates limited access medications and mail services availability when applicable.
- Formulary Alternative[s]: Indicates alternative drugs available within the formulary.
Wellcare covers both brand name drugs and generic drugs. Generic drugs have the same active-ingredient formula as a brand name drug. Generic drugs usually cost less than brand name drugs and are rated by the Food and Drug Administration [FDA] to be as safe and effective as brand name drugs.
To get updated information about the drugs covered by Wellcare, please Contact Us.
Y0070_WCM_64252E Last Updated On: 10/1/2020