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WellCare is the best health insurance company which I have intensely reviewed over the last fifteen years. While retaining a Florida 2-15 Insurance License from 2005 to approximately 2012, I sold life insurance, however, I had several colleagues who enjoyed working with WellCare. Two of my friends have been working there for over ten years which is atypical in this industry. Furthermore, these two WellCare Employees have two children each and are satisfied exclusively offering WellCare Health Products. When my health went from good to poor, I had other health carriers which performed fair with regards to my health.
Of course, one might say that I am being too generous. In actuality, healthcare insurance is difficult for most people to quickly understand which is unlike most products in which people have a consistent need. Why is this the case? There are hundreds of choices of plans, and within each plan, there are many other choices. In addition, the plans are constantly changing due to many factors such as laws, demographic age changes, demographic health changes, and many other variables. In short, the reason I like WellCare is that they are extremely responsive to letters which are sent to them. Their WellCare Healthcare Telephone Representatives repeat what they have told their clients through the telephone because they are well aware that most people say they understand a specific policy issue when, in fact, most people do not understand, at least, some provisions in their policy.
In general, most conversations through the telephone which deals with businesses take, at least, two if not three telephone calls by the customer until the customers and customer service representatives are completely satisfied that a full understanding of the topics has been executed. With health insurance, this scenario could be fifteen or more calls. With WellCare, I do not need to continuously call for three weeks or more, in order, to come to a satisfactory discernment of the specific subject matter.
Moreover, WellCare is the first healthcare company which sent me a check for hundreds of dollars for a specialist physician's visit of which they had absolutely no contract obligations whatsoever to perform. This action by WellCare is not a phenomenon. This is not an accident. This is beautiful, and this is virtually unheard of in the industry. In closing, when receiving your group, individual, supplement, Part D (PRESCRIPTIONS, and/or any other health insurance product), I suggest that one take a week or more to carefully read and understand how health insurance works in regards to all the terminology.
In turn, you will be able to understand your policy and know pretty much all the questions to ask the representatives. This is the truth and the facts, and, in fact, long term studies show this improves your health. In other words, there is a strong connection between one's understanding of health care insurance and their own health. I do not in any way have a connection or interests with WellCare. I am just trying to express what WellCare has done for me, and what WellCare will do for you if one takes the time to gain an understanding of healthcare. I know that if a small education is gained you will not spend countless hours on the telephone, and, more significantly, you will be a lot more successful in maintaining your health. Now, I just have to figure out how I am going to lose all my weight.
They are receptive to adding new providers for specialized services. They provide local customer service follow up sessions after enrollment so you can maximize the insurance benefits. The list of toll free telephone numbers for each department is also helpful.
Once you navigate the system, it runs very smoothly. I pay no premium and my prescriptions are zero. They offer a 20.00 over the counter choice per month. They do have a 192.00 deductible, however if you are healthy you don't use it. They allow for chiropractic and Acupuncture Which I was interested in. I have been with them since 2012.
I flossed out a filling that became extremely painful. I first tried the VA emergency room. They wanted $325.00 up front just to put me in a chair. I am a veteran but could not afford their services. I called around locally at several private dental offices but could not get an emergency appointment. Then I remembered my WellCare coverage. I called my assigned PCP under their plan and got an appointment for 6:30 that evening. The DDS prescribed a round of antibiotics and put in a temp filling and prescribed meds that eased the pain. A week later she pulled the tooth. The entire process was friendly and easy and the dentist was the best. Great experience, certainly the best dental appointment I can recall.
WellCare took over Today's Options this year. If I had known how awful WellCare would be I would have found another provider. Three times at the beginning of 2019 doctors and pharmacists were told I was an "inactive" member. Each time when I called WellCare they somehow found me to be a paying member and had to contact my medical provider. Thank heavens I don't have my script coverage with them. Last year I had knee injections for which I had $25 co-pay and 20% off the medication charge. This year I had shoulder injections at the same facility, same room, same practitioner. Cost was $200 more for each injection which WellCare kept insisting was a surgical outpatient charge. No amount of arguing could convince them that this was a quick injection and did not involve any "surgery" or surgical facility. I have filed an appeal with them and complaints with Medicare. Stay away from this company.
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I work in insurance and billing and have been dealing with WellCare for only a couple of weeks, but they are by and far one of the worst companies I've ever had the displeasure to have a relationship with. None of their representatives speak English natively, and when I try to press an issue to get claims paid, they just repeat the basic information back at me and tell me they'll "escalate" it and nothing ever happens. They seem to love denying prior authorization requests for inpatient hospitalizations because they don't want to fork over the money when someone is genuinely ill, and forget about a timely response.
Some claims have been sitting for years and the only things they can say are, "It's still under review" or "I will escalate this to corporate." I can't tell if their reps just don't know what the heck they're doing or if the corporate office really doesn't care about its members, but it kills me to see people with their Medicare Advantage plan get billed thousands of dollars because they don't want to pay for a drug WellCare already authorized! From my personal experience, go with Humana or United. Good, American call centers that actually process their claims in a timely fashion!
DO NOT USE THIS COMPANY. The customer service is not in the US. They charge more in premium than they pay in claims. They said one of my drugs cost $452 for a 90 day supply when I can buy it online for $28 without insurance. The cost they quote for drugs is outrageous. They won't let you cancel coverage if you are dissatisfied. DO NOT USE.
Fought to get a prescription that is on their formulary and the bottom line is that I was told it was a mistake. The first of the five people I spoke with over a week told me that just because something is on the formulary doesn't mean it is covered!! Nuts! Supervisor after supervisor kept telling me that the medication was not on the formulary even though I was looking at it right on the formulary. Horrible!!!
I called today to inquire why my medication has risen in price in the middle of contract. The first CR (customer representative) said a whole lot of gibberish and I finally asked if he speaks English, he answered ‘a little’!! Soo asked to speak to someone who speak English. The second CR spoke with heavy accent that I couldn’t understand. Finally she spoke very slow and said I was in the wrong Dept. Got transferred. The 3rd CR was another person whose English was not understandable. Put me on wait for about 15 mins (btw, each transfer lapsed around 15 -20 mins). At last I got transferred to the pharmacy and I barely understand his English and again I was put on hold when he does the investigation. 20 mins has lapsed and I finally gave up and hung up. What a waste of my time!!!! Why can’t company in America hires employees who can speak understandable English????
I attempted to enroll for WellCare Drug insurance as supplemental to Medicare in January 2019. I enrolled after I realized that the drug plan I had selected did not cover either of the two products I was using. I was told that I could enroll in WellCare as I was leaving my provider. WellCare's enrollment agent enrolled me but then I discovered 6 weeks later via snail mail they had terminated me as their agent had transcribed my birth date incorrectly.
When I called in March 2019 after receiving the mail notice, their front line agent said "sorry, nothing we can do" and after I insisted on speaking to a supervisor, she indicated essentially, "oops, our mistake" and informed me that I now was enrolled. I indicated that I was concerned about termination for non-payment so I gave them a credit card that they processed and processed again for a recurring charge.
I still never received an insurance card so I called again today, May 22 and was told that the call in March was out of the renewal window so I was not actually enrolled despite them charging my account every month. Now it's May and I was told during a call today that they cannot enrollment me as I am not eligible to enroll during this time of year. They are the worst! I will go the rest of the year without drug insurance due to these incompetent fools. Meanwhile, their CEO has a compensation package of over $12,000,000. Despicable. Company: WellCare Health Plans. Name And Title Kenneth A. Burdick Chief, Executive Officer. Total Cash Total Cash $4,154,615. Equity Equity $8,499,889. Other Other $20,868. Total Compensation Total Compensation $12,675,372.
So they (WellCare TexanPlus) gave me the name of a specialist. A month later, still no approval. Dozens of phone calls to Wellcare and it took talking to eight people before I got an answer. They refuse to give me approval for the doctor they referred me to. Can't even speak to anyone in the U.S. People I spoke to were from India, Philippines, etc. Will not answer ONE question. Where is my referral for the doctor YOU referred me to??? When TexanPlus joined with Wellcare, it all went to hell. Getting new insurance company.
Stay away from this company!! They are the absolute worse, no one knows anything. They are trying to charge me for a month before I even belonged. My effective date was 2/1/2019. They said they fixed in back in March, now they are threatening to drop my RX plan if it's not paid... and then they are charging me for a rate in a state that I have never lived in, they are incredibly incompetent. No one at the customer service can fix it, and they cannot explain the error either. Run the other way if Wellcare Prescription Drug Plan is ever offered to to you!! They are a nightmare to deal with on any level.
DO NOT USE this company! Customer service is absolutely horrible! No one knew anything about information that needed to be provided for coverage of members/patients. Coming from a dental office that tries to confirm coverage for patients. Highly advise against.
They cancelled my coverage for non-payment. I called them 30 days after applying and they said they would send out my bill and card soon. Never got it. They cancelled my coverage and I still have yet to hear from them. I will call them tomorrow and hopefully get this worked out because now I have no coverage.
Have been trying for over a week about a prior authorization issue. Passed along to 10 reps so far, 7 days of my time, several hours on phone, with 10 reps so far and issue still not resolved. Cannot wait to change companies. ZERO STARS!
We have been trying to get our coverage card for over 5 months. Have called several times... On hold and calls for over 5 hours being bounced around. Filed complaint with Medicare and then WellCare sent sent us a letter stating our coverage effective date. Finally tried to fill a prescription to find out they cannot even find us in the system. Called again tonight. One hour on the phone and no satisfaction. This is a terrible experience!!!! Waiting for another call tomorrow. Cannot wait to get out of this company. But we need drug coverage. Hours on the phone... Horrible. Do not use WellCare!!!!
THE WORST! Totally useless in getting information. When you call you are sent to the Philippines. These people cannot fix, change, or answer any questions. Went up three levels and the information was no better. An example: I sent in a computer form requesting my start date as April 1st. Get my acceptance letter and start date is March 1st. Told me my information was wrong. I am looking at a copy of my form and clearly states April 1st. Then I am told I am late for my March payment?? Never received the requested coupon book. Anyone in Management that would do a call in and would be proud to run this Organization is just collecting a check.
I went to a presentation of a new Senior Care Center I wanted to begin to go there. This pushy, don't take no for an answer insurance agent (salesman) signed
claimed that he could. Before I knew it he signed me up. I informed him that I was previously dropped by Wellcare. That didn't faze him. He made some vague reason why they might have cancelled my policy.
I attempted to contact Wellcare. I asked them to please un-enroll me ASAP. I talked to 7 different departments. I was made to give my personal information all 7 times. Nobody knew anything. I called Medicare and Social Security as well as the Florida Insurance Commission. It seems that I am stuck with the terrible company until the next open enrollment. This is ruining my life. I am leaving the state and moving up north to live with my son. I am chronically ill and do not need this aggravation. Terrible!!!
In 2018 during health coverage enrollment period, I am a disabled government employee, with available self paid coverage through GEHA - Government Employee Health Association. In dropping my Medicare Coverage to join GEHA, everything other than my drug plan WellCare knew they were canceled, due to CHANGE IN COVERAGE. I still received a request for payment - because Medicare STOPPED PAYING, I no longer receive Medicare. Sent in the form that I’m not covered by WellCare - I am not covered by Medicare - I’m covered by GEHA.
Month after month I keep getting letters “we will cancel you for non payment...” NOW, “we’ve enrolled you into a different plan that Medicare doesn’t pay...” All without my agreeing that they are still my insurance. Double talk over the phone that doesn’t say if I will owe or I will owe nothing; that they want me to send in a letter, oh and “may have to pay a fine for disenrolling outside enrollment period.” “Escalations” that go nowhere; only calling my one phone number after I specifically requested they call my secondary number - I cannot answer primary number during the day. Finally today they called my backup number.
I have to drag it out of “Ryan” and “Stacy” of the “Escalation Department” That by sending in a cancellation - they won’t accept it as of Jan 1, 2019 - when my new/current coverage came into effect. I’ve also pointed out that the last three letters on two different dates all contradict themselves. The dollar figures are ALL DIFFERENT. One letter says disenrolled for non payment, being enrolled into another plan because incorrectly disenrolled. It’s amazing that depending on the letter/day of the week, I may or may not be covered by WellCare - WHEN I AM NOT SUPPOSED TO BE COVERED BY THEM AT ALL.
I asked, “Has Medicare paid you at all this year?” Answer was “No.” Medicare CANCELLED because I had shown I now have adequate coverage I am paying fully - I pay no Medicare premium, so WellCare is no longer involved since I am not on Medicare. WellCare - I dare you to escalate this beyond your “Escalation Department Supervisor” “Ryan” “DXSILVA2” — ask for Enrollment Services 888-550-5252 8am EST to 8pm EST.
Hopefully this information will help YOU with your enrollment disenrollment issues. I’ll add in comments other possible departments to contact. When Medicare says to cancel D Drug Plan - they aren’t paying anymore - it’s on WellCare to do their own client rolls. You cannot enroll someone into a plan that THEY DID NOT AGREE TO. That was letter two of the latest three for month of April 2019.
I worked in HR for about 30 years. WellCare's program and Customer Service team are the worst I have ever dealt with. I have spent numerous hours on the phone with them, even enlisting the help of our Agent during the calls, trying to correct a problem on WellCare's end. The calls are unbelievable. They repeat themselves and what they think I said over and over. They don't seem to understand what I am trying to tell them. I had to correct them repeatedly. And, unfortunately, they are very difficult to understand. I had to ask them to repeat what they said throughout the calls. They pass you from one Rep to another. Each time, you have to repeat your name, address, phone number, zipcode, ID number and the reason for the call.
Each Rep places you on hold for extended periods, researching your account and issue. Each hour more call ends with hope they are forwarding the claim to a department to resolve the issue, then nothing. I have been working with them since February, spending approximately 12+ hours on the phone, going in circles, driving myself crazy trying to communicate with this company and its team of so-called Customer Service Representatives.
I finally gave up and filed a complaint with Medicare. We are now in financial limbo. My husband hasn't had coverage since January 31, 2019. We are forced to pay for his expensive prescriptions out of pocket, which is a hardship. And, we can't enroll in any other plan until open enrollment for 2020. This has been unreal. The reason for their actions are patently bogus. They thought my husband had other coverage. He did not. I called to inform them that was not true. The WellCare Rep confirmed his coverage and sent ID cards and plan information out after my call. They proceeded to term is coverage January 31, stating we did not respond in a timely manner. I believe an error was made on their end and they won't acknowledge it, even with confirmation to them from our Agent. If it isn't just a simple error, then what is it? My husband does take several prescriptions, some of which are very expensive. Could that be it?
For those prescriptions that I do have, they have covered them very well. But is it worth putting up with very poor customer service. The one that gets me the most is that on December 3 I requested that they take premiums out of my social security. It is April 22 nearly five months later and they still are not doing that. Despite many followup requests.
This is by far the worst insurance company to sign with. I had them for 4 months and they didn't wanna pay for any script that was given to me. Keep in mind I'm a diabetic. I had to get prior auth. for every script. The customer service forget about it. They will hang up on you bc they don't have a clue. What the heck they are doing! Run run far from this company. They are no good and they are a bunch of liars and are incompetent to do their job!
I expect to be able to view my monthly prescription drug summary (standard Medicare form) online in a timely way as well as reports of recent transactions between statements. This has been true for years with other PDP providers I have used. Printed reports by postal mail are slow, inefficient, costly, and wasteful. It is mid-April and I just received my statement for February transactions. There is not a single thing on the WellCare "member portal" that is of any use to me whatsoever. I chose WellCare because of their low premium and copays for my drug list. I am satisfied with the value provided there, but the total lack of any useful online resources will drive me to another plan at the next open enrollment period. Zero chance I will renew.
Signed up for WellCare Medicare Part D and regret the decision. I spent an entire day trying to contact the company to receive a membership card and information on how to obtain mail order prescriptions. Long hold periods followed by a disconnect, left my phone number for a callback and after the phone call was returned I was answered by a recording and a disconnect. Several phone calls later I was connected to a representative that I struggled to understand and who could not understand me. I asked for an English speaking representative and was transferred, after fifteen minutes, to another person I could not understand. When I again requested an English speaking representative I was told that there weren't any.
I filed a complaint with Medicare and received a phone call from a representative that apologized and gave me a phone number for customer service in the U.S. but informed me that the hold times would be longer. I will not renew with this company and discourage anyone contemplating doing so to pay a bit more and receive competent service. I also encourage Medicare to remove it from the recommended Part D list on their website.
Plan started April 1....first prescription I had to pay 300% more than Blue Cross...from $70 to $210 for a 90 day script. Please do your homework as WellCare's plan, for me, is not one those of us on fixed income should be signing up for.
I just realized on April 3rd that my primary insurance was cancelled as of December 31, 2018. There was a confusion during enrollment. The supplement denied me so I was told I would keep my current insurance at that time. So I thought nothing changed and no one said anything differently. So April 3rd I went to the doctor to get prescriptions renewed. I went to pharmacy and they informed me my insurance was denied. So after making calls I found out my insurance went back to the Medicare and WellCare. I did receive a bill from WellCare but I thought I still had my other insurance so I didn't need WellCare part D.
Now my bill on this was due March 31, 2019 and this was just 3 days later April 3, 2019. They would not accept any payment, told me I had to wait till next enrollment. So I asked her, because of meds I take, which are for high blood pressure and a daily inhaler, it is alright that I could possibly have a heart attack or end up not being able to breathe. Basically could die without these meds, her answer to me was nothing she could do!!! Now the language barrier was also a problem. Could barely understand her.
How sad that that WellCare plays a part on if you live or not. Again, this was only 3 days after my due date, not a month. I would not recommend WellCare for your insurance needs. Being 3 days later, I should of been able to pay the premiums and also pay next premium to catch up, then all would have been fine. Being told you have to wait till next enrollment is unacceptable and totally ridiculous. NEVER USE WELLCARE. They play with your life, can barely understand the representative and there is no extension for payment. This was a horrible experience to know you need meds and can't get them.
Received a letter of acceptance yesterday with no prescription card. Called to inquire about the status of the card. After giving my info I was put on hold for 10 minutes. The customer service person came back and said my application had not been completely filled out, and he was transferring me. After another 5 minutes I was speaking to someone in the application department, who wanted me to fill out a new application. What?!! I had completed the application, had a letter that I was accepted, what?!! I was told no, my application had been denied. What?!! I have a letter of acceptance.
Asked to speak to a supervisor. He confirmed my application had been denied, and needed to re-apply. The start date on my application was incorrect. I had the application right in front of me, and the date WAS correct?!!! After 25 minutes of talking to four people and going nowhere, I have to resubmit my application, again. Not one person took the time to give me any intelligent explanation, and it was frustrating beyond! The only hope I have is once I am in the system, I have NO reason to call this company. It is pathetic!!
In November 2018 I wrote two Medicare policies for WellCare. I am yet to be paid in full. I have been caught the office since January 2019 for my commission. In March 2019 they sent a renewal check in the amount of $20.08. I called in March to ask about the status of my commission for the new application. I was told that the check was in the mail. Each and every staff have lied about when I will receive my commission. Today April 1, 2019 I called and the representative didn't see a check nor info concerning my check. This is a very deceptive and unethical company. I am proof.
This review is based on the multiple occassions that I have had dealings with WellCare during which I have had their insurance. During phone conversations with Customer Service Agents, the Agents often appear to struggle to access information and answer questions appropriately. This results in long hold times. Most recently, information impacting my healthcare was undisclosed to me by Agents, despite the information availability. Generally speaking, training, consistency, and quality are my recommended focal points for improvement to Customer Service and Support.
Do not waste your efforts calling the phone number on the back of your WellCare card and only get marble-mouthed conversations out of it. End nowhere! Go directly to WellCare, located in Florida, escalations department! Phone #866-587-1384. If an associated plan of Medicare, call Medicare first and put a complaint against WellCare -first- and then tell the Escalations agent you had done that before calling. WellCare has to resolve any Medicare complaint it gets but never will or try not to with oddball - half witted excuses.
WellCare advertises unreal great benefits but try to get them! Never will because of all sorts of excuses they will give you not to allow them. Keep calling Medicare on not allowing you your full benefits and eventually it will be passed to the (ARC) Medicare Advanced Resolution Center. WellCare will be forced to follow Medicare guidelines. When ARC is given your case with WellCare problems, the ARC agent can make 3 way calls with you, them and WellCare. If a WellCare escalations agent hangs up on you and the ARC agent, just have the ARC agent hit redial on them. WellCare is the best cat and mouse insurance company you will ever find!
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