WellCare Health Plans Reviews 

WellCare should be sued for false advertising in its name! They seem to do little to help people become 'well,' but rather contribute to patients experiencing challenges to health created by the company's delay and denial tactics.
As seems to be the experience of so many other WellCare subscribers, a recently prescribed drug was denied coverage. After spending nearly an hour on the phone with a rather inept agent to try to find out why the drug was denied, it looked like the reason was only the cost and that it is not normally included in the formulary. Earlier I had been able to successfully get an "exception" for an expensive topical preparation with my physician's help. I didn't expect it to be easy this time around, but thought that it would be worth the try to get the exception. I was told by the agent that the medication was a 'tier-three' and the request for the drug would be 'expedited.' It was odd that later in the day I received a call back from the agent saying that the drug was not a "tier-three" but "rather a tier-four" drug. I thought that was a little strange to get a call back just to correct what was said about the tier group for the drug; oddly the cost of the drug was not mentioned at that time. Given the difficulty in dealing with WellCare, my physician's office was busily trying to remedy things from their end to find a way to get me a comparable medication quickly and my physician even offered to do a "peer to peer" consultation with WellCare to convince them to approve the drug. The next call back I received from WellCare was to share the news that the drug had been approved for coverage. Sounds good, right? WRONG. They 'approved' the drug but said that it would cost over $400! I went into a tirade and badgered the agent to tell me just how much money WellCare would be contributing to the cost of that drug... it's only about $7! That's right. They would only be chipping in about seven dollars and change (under $8)! Almost 2 days and who knows just how much aggravation just for a pittance from them! The co-pay for an E.R. visit would be cheaper than the cost of that respiratory medicine! I explained to the agent that they could have saved lots of time and aggravation if they could have first indicated how expensive the drug would be, so that another option could have been initiated. The agent said she would be escalating the matter to a customer service manager of some kind. However, she came back on the line several times to say that they were busy, one transfer to a supervisor got disconnected and then that she had successfully connected the call to someone else, and while wickedly laughing, supposedly 'connected' the call, but there was nothing or nobody there! Bear in mind, I didn't demand to speak with a supervisor! The agent offered that 'service.' They behave like charlatans. For those of you who also have WellCare, do file complaints directly with Medicare. WellCare's inept and potentially unethical behavior needs to be reported and followed up on by CMS. American Senior citizens deserve better.

Wellcare by Health Net has been a very difficult Insurance Company to work with. The communication and clarity from the help line has been difficult, plus their understanding of the DentaQuest coverages are less than sufficient. The policy I selected covered 1500.00 (Dental). Prior any treatment, I'd reach out to Wellcare and DentaQuest (multiple times) and told "the dental insurance policy covers 1500.00". However, this coverage is limited, subpar and selective to what they will truly cover. For example, an emergency dental treatment was necessary which their contracted company (DentaQuest), denied to pay. Wellcare couldn't comprehensively explain the denial. I was bounced around to several different representatives without any resolution to the claim denial. My final contact at Wellcare suggested an Appeal be filed. To date, case is still outstanding. The coverages of this policy have been misleading. If you need dental coverage, beware, this policy isn't what it seems!

Denying medications is how Michael Carson is able to make over $20 Million a year!
I switched to Wellcare during the last open enrollment period. I have had nothing but trouble and have had to file 2 complaints with Medicare! They DENY the medications, even though they are listed on the enrollment application! These medications are what I need to LIVE! They believe they know more than my Cardiologist and Electrophysiologist!

Seniors beware! My first year on Wellcare Part D my deductible was $200 and then I paid a very small amount for my meds the rest of the year. I didn't take many drugs and it wasn't until November that I met my deductible. After my first full year, my deductible went to $600 and now I pay 25% of all drugs and one of my prescriptions is expensive. This company reels you in and then screws you. i would never recommend to anyone that they use Wellcare! I will be finding someone else for sure.

One weeks worth of pain meds, primary care co-pay going thru the roof. These are but a few of the reasons I canceled them as well as espress script, Medicare has an issue, it's called Marketing Misrepresentation. For those that may need it.,

THE WORST customer service of any company i have dealt with. Their reps don't speak English, hold times insane, you won't understand them unless you ask to be transferred to a US rep and even then, they stink. Coverage is awful, they nickel and dime you to death.
Go elswhere.

I thought the Wellcare Part D was going to be a great plan. Wrong....they are a bit choosy about what drugs they will cover. In addition, the customer service is really bad. Every time I have called, I have gotten wrong information. One call suggested a substitute drug that could have harmed me. They are nice, but very hard to understand and not trained well at all

I am so freaking happy with my Wellcare Part D plan! I honestly can't believe all the bad reviews. Wellcare decided to cover a drug I require for a very rare neuromuscular disease. The list price of this drug is between $150,000 and $360,000 per year, but it'll only cost me about $2,000. I can't thank Wellcare enough and the service personnel I spoke to were extremely nice and helpful. I can obviously only talk about my experience, but right now I'm delighted with this company.

Before the switch insurance without asking, I had no problem getting my Bp meds filled. Now here comes wellcare, first thing I ask them was the meds I take will they be approved? I was told yes. Now it's time for refill, now they're telling me my Bp meds isn't approved I need generic brand, THIS IS GENERIC BRAND. Customer service who repeats themselves with a script don't know anything.So now my doc has to fill out and fax why I need these meds and WellCare said it will take 72hrs to find out. Called 2/14/25, WellCare still haven't made a determination, and they want another determination done again that's another 72hrs, while this is going on I have no Bp meds, I have my pharmacy and doc trying so hard so I can have my meds. These so call customer service are crap. WellCare is playing God to peoples meds and that's dangerous. Get people who's professional in answering the phone not these robots who can't answer anything.

Apparently Medicare auto enrolled me and when I went to disenroll Medicare and social security said I was all set yet the company kept charging me for a year even though I had other insurance. They refuse to do anything.

i signed up for wellcare part d for 2025. wanted to get some estimated drug cost on the website. they have a tab for estimated drug cost, but you cannot get a cost. you need to contact a pharmacy to get cost. so call 10 different pharmacies if you want to get a cost comparison. ridiculous!

Have been using them less than a year. Premiums are not bad, and my medicines are cheap. However, I was being charged an $8.00/month penalty, and no one at WellCare could tell me why (my HR department submitted the paperwork). This was eight or nine months ago, and I went ahead and paid it under threat of coverage being dropped. I just renewed coverage and paid the full year. I could not access my online account and by the time I talked to the third person this was not something they could fix. I paid with a credit card in full for the year so I would not have to deal with it. Also, my penalty increased to $8.50, and I suspect will increase each year until I die. I am going to contact Medicare and see if they can give me the reason. It is upsetting because I felt I did everything possible to avoid this
very situation.

This company is a joke. They advertise dental and vision coverage for Medicare patients. Hardly. Not a single dentist or optometrist in my entire county accepts Wellcare, including the offices where I've been an established patient for years.

And good luck finding a specialist who accepts Wellcare. The dermatologist I've seen for years is within walking distance. Of course they don't accept Wellcare. The "nearest dermatologist who accepts my insurance"? Nearly 200 miles away. One way. I kid you not. Literally the other side of the state. It would cost more in travel than it would to just walk to my current derm and pay out of pocket.

What's the point in having "insurance' that no one accepts? Completely worthless.

i dropped these people like a hot potato after i got screwed an had pay for my pain meds out of my pocket. they have a policy they DO NOT disclose to people when they sign up. STEP THERAPY, remember those words. they insist you get a 7 day script of your pain meds before you can get more. it totally screwed me up when i could not contact my provider to change prescription an these people refused to help me, hence i had pay for my meds myself. if you take pain meds BEWARE of these people!

CUSTOMER SERVICE AT BEST IS TERRIBLE ! THERE SERVICE REPRESENTATIVES CAN BARELY SPEAK ENGLISH. THEY YES YOU TO DEATH....AND NEVER TAKE CARE OF YOUR REQUEST .....

Terrible customer service, taken in circles for 1.5 hours and still no resolution. Staff has no idea what they are talking about.
The WellCare Spendables Debit card is a joke, most of the herbal over the counter meds my doctor recommended are not allowed (but a kitchen scale is). Even for Fish Oil, which is on their list, it was declined.

I switched to Wellcare this year. That was one big mistake i made. I checked into the vision plan they offer. I think they use a third party vendor named Premier Eye Care. I checked around my home town in Des Moines,ia. Most places i contacted never heard of them or would not accept the insurance. The small list of eye clinics i was recommended would only do exams, but not eyewear. I finally gave up looking. The i enrolled in Silver Sneakers fitness Program and they had my first name wrong. Called silver sneakers and they told me only wellcare could request to change it. Called Wellcare and was told they sent Silver Sneakers the correct information. Finally Wellcare contacted Silver Sneakers after i called several times. I was told it would be corrected in 24 to 48 hours "still waiting". I will put up with till the end of the year and switch plans as soon as i can. Biggest mistake i ever made, and worst insurance i ever saw.

Horriffic ripoff company. Have wellcare Rx plan. Doc prescribed pitavastatin. Wellcare wants a copay of $282 for 1 month supply. I can buy this cash without insurance using Goodrx for $48. Spent hours in admin with these yokels ( and their philippine call center reps who literally dont understand english) in order to get the Rx approved. They wasted my doctors time asking for justifications, they happily tell me its in formulary so im in luck, then ask for a $282 copay. Interesting that they are actually making a ton of money upcharging on the med. i thought insurers were supposed to simply pay a part of the actual drug cost charged by the pharma companies, not act as a second retailer to jack the price up further. Want to know why people hate these insurers? There it is. And they pitch themselves as do gooders. Avoid this horrific dishonest company and spread the word.

I hadn’t had my teeth cleaned in 12 years because I couldn’t afford coverage. I have had 3 deep cleanings done on 3 quadrants of my mouth because my X-rays showed buildup and bone loss. WellCare has denied all 3 and seems to be looking for any excuse not to cover it.

At first, they said there was no buildup or bone loss. Right, that’s why I’ve lost two teeth and have several loose ones… Now, they say that my dentist is not in their network. (I found my dentist through WC’s provider search.) AND… they say I’ve already had this procedure done in the last 24 months. I have not been to a dentist until the past few months. As I said, I haven’t had any cleanings done since 2012.

I’ve lost so much sleep over this. I’ll call my dentist’s insurance person on Monday and start there. Then, I’ll call WellCare and start fighting…

Iv called numerous times,iv ask to speak to a English speaking agent,they put me on hold 20 minutes, then disconnect me