Medicare prescription drug plans are a necessary part of the Medicare program. They offer beneficiaries a way to get their medications at a lower cost. In this blog post, we will be reviewing the WellCare Medicare prescription drug plans for 2022. We will take a look at the different available plans, as well as what each one offers. This information can help decide which plan is right for you!
Quick Recap on Wellcare
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 program provider. As well as strong customer service.
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 Medicare Prescription Drug Plans. If you have a WellCare Preferred Provider Organization (PPO) or Health Maintenance Organization (HMO) Medicare Advantage Plan, your plan should include drug coverage.
Pros and Cons of Wellcare PDP Plans
Here are some pros:
- Three standalone plans available with low, medium, and high monthly premiums
- Zero deductible plan available
- Nationwide options
Here are some cons:
- Must use their preferred pharmacies for the lowest costs
- Rules for prior authorizations and step-wise therapy may be burdensome
What Do Wellcare 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. In addition, you will pay a negotiated rate through the program.
Wellcare Medicare Prescription Drug Plans 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. For instance, preferred generic is least expensive drug you can take.
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 The Plans 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 between the plan options lies in the amount you pay for the monthly premium. As well as the deductible.
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. Also being that drugs have multiple choices per class or tier. It is wise to speak with your doctor. As well as know your options
If you are interested in any WellCare plans. Please give us a call!