One of the best ways to get the most out of your Medicare benefits is to use a private Medicare insurance option. You should consider using one of these plans to lower your out-of-pocket expenses, and maximize your benefits. Consider using WellCare Medicare plans to achieve these goals. In this article we will review WellCare, and the various WellCare Medicare plans available.
WellCare is one of the newer insurance companies providing Medicare plans. WellCare began in 1985 in Florida, and has slowly grown since then to be a nationwide player in the Medicare space. WellCare is involved in Medicare advantage, Medicare prescription drug plans, and Medicaid health insurance coverage on a state by state basis. WellCare has grown by acquiring other health insurers, as well as being acquired by larger Health insurers themselves. Currently, WellCare is owned by Centene Corporation, and is headquartered in Tampa Florida.
You should consider using a private Medicare Plan, including those from Wellcare, to help protect you against some of the out-of-pocket spending that you will encounter with Medicare. As you know, Medicare is split into Part A, which covers Hospital insurance, and Part B, which covers Medical insurance. Both of these Parts require you to pay for a share of the cost out of pocket. For Part A, you're most likely to encounter the Part A deductible, which is $1,600 for 2023. In addition to the Part A deductible, you could encounter daily coinsurance payments if you have lengthy Hospital stay or skilled nursing stay.
For Medicare Part B there is also a deductible, although it is very small, $226 for 2023. Once you have met this deductible, Medicare will cover 80% of your Part B costs. The other 20% is your responsibility. In addition to this, in some cases you might have to pay Part B excess charges, which can be up to 15% of the Medicare approved cost for your Part B care.
You need to know that there is no spending protection for you under the terms of Original Medicare. You will continue to pay your Part A and B costs all year long, no matter how much money you have spent during the year for medical care. In most years this is usually not a problem, but if you have a year in which you need a lot of medical care, or you have major procedures done, like cancer-fighting chemotherapy, you're out of pocket costs can be enormous.
Private Medicare insurance plans are designed to help limit or eliminate this kind of out-of-pocket spending. There are three main types of private Medicare Plan: Medicare Supplement Insurance, Medicare Advantage, and Part D prescription drug plans. WellCare Specializes in two of them.
Medicare Supplement Insurance is a secondary, or supplemental, coverage that works with your original Medicare benefits. This kind of coverage is standardized throughout the United States. WellCare does not provide Medicare supplement insurance. You will need to find a different insurance company if you want Medicare Supplement coverage.
Part D of original Medicare became effective in 2006. Prior to then this time, prescription drugs were generally not covered by Medicare at all. There were some exceptions, like if you were staying in the hospital under Part A, but for routine prescriptions, you were on your own. Since prescription drug costs have continuously risen since Medicare began in 1966, prescription drug spending was a major burden on people, so Congress created Part D to help alleviate this pain. You can get Part D drug coverage in two forms:
We will cover Medicare Advantage plans in the next section. Stand alone prescription drug plans have many common features, regardless of which insurance company you use. They all have a monthly premium, they usually have an annual deductible, and they also all have some kind of co-payment or coinsurance for prescription fills.
Every part D drug plan has a formulary, which is an official list of all the medications and vaccinations that the plan covers. If a medication or vaccine is not on the formulary, that means the plan does not cover it. If you use medications or vaccines which are not on the formulary, you will have to pay full cash price, because the plan will not help pay for them.
All the medications that are on the plan formulary are arranged in tiers, with higher tiers representing more expensive medications. Your co-payment or coinsurance amount depends on the tier level of the medication that you receive and take. How much you pay, your specific copayment or coinsurance amount, changes throughout the year as you and your plan pay for the cost of your medications. There are a total of four coverage stages, and your costs can be different in each one of them. There is no annual cap on the amount you can pay for prescription drugs under Part D, although this will change in the years after 2023. WellCare provides Part D prescription drug plans throughout the United States.
WellCare is a growing provider of Medicare Advantage plans throughout the United States. Medicare Advantage, which is also known as part C, is a private alternative to Original Medicare. Medicare Advantage plans combine Part A and Part B, and are required by law to cover everything that is covered by Original Medicare. This means that any service or procedure that is covered by Medicare must also be covered by your Medicare Advantage Plan. There are some significant differences, though, between Medicare Advantage and Original Medicare. As we saw earlier, under Original Medicare you're responsible for a percentage of the cost of your care. With a Medicare Advantage plan, you are generally responsible only for paying a specified copayment for most services and procedures.
You pay a co-payment at the time you received the service or procedure. Your medical provider also bills your plan, and the Medicare Advantage Plan pays the provider a specified amount for every service and procedure. One of the most important benefits of a Medicare Advantage plan is that it provides an annual out-of-pocket maximum (OOPM) limit. This amount represents the most money you will spend on medical care in any given year. Once you hit that amount, the plan is required to pay 100% of the cost for the rest of the year. In January of the next year, everything starts over.
WellCare Medicare Advantage plans can either be Health Maintenance Organizations (HMO), or Preferred Provider Organizations (PPO). With an HMO, you must use a network facility or provider to receive care. PPOs provide more flexibility. If you use a network provider, you will pay less. But, if you use a non-network physician a PPO plan will help pay for the cost of your care, although your cost might be higher than if you had used an in-network provider. You’re somewhat more likely to encounter HMO based Medicare Advantage plans.
Medicare Advantage plans frequently come with so-called extra benefits. These are benefits that are not normally available from original Medicare, some of the most popular extra benefits include:
These kinds of extra benefits are not required, and they can change on a year-to-year basis. However, these benefits fit a real need felt by many people in Medicare. As mentioned earlier, Medicare Advantage plans may also provide part D drug coverage. The drug coverage for Medicare Advantage plans works exactly like for standalone plans. In most cases, you cannot combine a standalone prescription drug plan with a Medicare Advantage Plan. If you want Medicare Advantage coverage, and you also need drug coverage, you must use a Medicare Advantage prescription drug mapd plan.
Medicare plans are sold based on zip codes, counties, and states. You will need to see if there is a WellCare plan available in your area. One of the best ways to do this is to work with an independent insurance agent. An independent agent can help you find all the WellCare plans available in your area, and help you find one that will cover the doctors and medications that you take. You can then sign up for a WellCare Medicare Plan online, over the phone, or with a paper application.
You can make a decision based on a combination of factors, including the Plan’s CMS star rating, the provider network, if applicable, and its formulary. You always want to make sure that your plan will work with the doctors you need, and the medications you take. Every Medicare Advantage Plan or Part D drug plan receives a star rating from CMS. The star rating can help you decide which plan is the most effective in your area.
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