Wellcare to Offer Medicare Advantage and Medicare Prescription Drug Plans to More than 51 Million Members Nationwide in 2025

Rhea-AI Summary

Wellcare, a Centene company, will offer Medicare Advantage (MA) products in 32 states and 102 Prescription Drug Plans (PDP) nationwide during the 2025 Medicare Annual Enrollment Period. Key highlights include:

- Expansion to Iowa and 126 new counties across seven states
- $22 million investment in digital tools and resources
- Member onboarding videos in eight languages
- Wellcare Spendables™ card for multiple benefits
- $0 copay for primary care visits on all plans
- New Twill by Dario platform for behavioral health support
- Three PDP products offered in all 34 regions across 50 states and D.C.
- $0 copay for Medicare-covered Part D vaccines and max $35 for 30-day insulin supply
- $2,000 cap on out-of-pocket prescription costs

The enrollment period runs from Oct. 15 to Dec. 7, 2024, for coverage starting Jan. 1, 2025.

Positive

• Expansion of Medicare Advantage products to 32 states, including Iowa
• Addition of 126 new counties to Wellcare's footprint across seven states
• $22 million investment in digital tools and resources for members
• Introduction of Wellcare Spendables™ card for multiple benefits
• $0 copay for primary care physician visits on all plans
• Launch of Twill by Dario platform for 24/7 behavioral health support
• Offering of 102 Prescription Drug Plans nationwide
• $0 copay for Medicare-covered Part D vaccines and max $35 for 30-day insulin supply
• Implementation of $2,000 cap on out-of-pocket prescription costs

Negative

• Discontinuation of Medicare Advantage products in Alabama, Massachusetts, New Hampshire, New Mexico, Rhode Island, and Vermont

Insights

Financial Analyst

Wellcare's expansion of Medicare Advantage (MA) and Prescription Drug Plans (PDP) for 2025 is a significant move that could positively impact Centene 's market position. The company is now offering MA products in 32 states, including a new entry into Iowa and maintaining 102 PDPs nationwide. This expansion increases their potential member base to over 51 million beneficiaries, covering 77% of eligible individuals across more than 1,800 counties.

Key financial implications include:

• A $22 million investment in digital tools and resources, which could improve customer acquisition and retention.
• Potential revenue growth from the expanded market reach, particularly in the 126 newly added counties.
• Cost savings and improved efficiency through the Part D Premium Stabilization Demonstration, offering $0 premium plans in 43 states.
• Possible increased market share in the competitive Medicare space, which could drive long-term revenue growth.

However, the discontinuation of MA products in six states may result in some short-term revenue loss. The overall strategy appears focused on optimizing profitability and market presence, which could positively impact Centene's financial performance in the Medicare segment.

Healthcare Policy Expert

Wellcare's 2025 Medicare offerings reflect significant adaptations to the changing healthcare landscape and regulatory environment. Key policy-related aspects include:

• Participation in the Part D Premium Stabilization Demonstration, aligning with government efforts to control drug costs.
• Compliance with new Medicare Part D benefit design, including the $2,000 out-of-pocket cap and monthly payment options.
• Expansion of language accessibility with onboarding videos in eight languages, addressing diversity and inclusion in healthcare.
• Introduction of the Twill by Dario platform for behavioral health support, recognizing the growing emphasis on mental health in Medicare policies.
• Offering $0 copays for Medicare-covered Part D vaccines and capping insulin costs at $35 for a 30-day supply, in line with recent Medicare reforms.

These changes demonstrate Wellcare's proactive approach to aligning with evolving Medicare policies and regulations. The company's strategy appears well-positioned to navigate the uncertain regulatory environment in 2025, potentially giving it a competitive edge in the Medicare market.

Medicare Advantage plans will be offered in 32 states; 102 Prescription Drug Plans will continue to be available nationwide

New in 2025, Wellcare offers member onboarding videos in eight languages and plans in Iowa

TAMPA, Fla., Oct. 1, 2024 /PRNewswire/ -- Wellcare, a company offering a range of Medicare products and the Medicare brand and company of Centene Corporation (NYSE: CNC), will offer Medicare Advantage (MA) products in 32 states, including its newest state, Iowa, during the 2025 Medicare Annual Enrollment Period (AEP), which begins Oct. 15, 2024 and runs through Dec. 7, 2024. Enroll by Dec. 7, 2024, for coverage starting Jan. 1, 2025.

Experience the full interactive Multichannel News Release here: https://www2.multivu.com/centene_corporation/9251052-en-wellcare-medicare-advantage-and-medicare-prescription-drug-plans 

"We have worked hard to build a robust product portfolio that offers outstanding plans to support our members' entire well-being," said Wellcare Chief Executive Officer, Michael Carson. "Wellcare remains focused on meeting the needs of the most vulnerable beneficiaries in our footprint through our strong dual-eligible products, and we continue to invest in services across the organization to provide high-quality care and the best experience possible."

Wellcare's 102 Prescription Drug Plans (PDP) will continue to be available nationwide.

"In the face of rising pharmacy costs in Medicare Part D and an uncertain regulatory environment in 2025, Wellcare is pleased to provide a portfolio of PDPs to support seniors in managing their drug costs," said Centene's Senior Vice President of Clinical & Specialty Services, Sarah Baiocchi. "By participating in the Part D Premium Stabilization Demonstration, Wellcare will offer a $0 premium on the Value Script plan in 43 out of 50 states and will be under the benchmark in 49 of 50 states."

The company has invested $22 million into its member online Find a Provider tool, campaign platforms, member website and portal accounts, creating an enhanced set of digital tools and resources for members and prospective members. Key member onboarding videos are also now available in eight languages: Spanish, Vietnamese, Russian, Tagalog, Chinese Traditional, Chinese Taiwan, Chinese Hong Kong and Korean.

This summer, Wellcare announced it will discontinue offering MA products in Alabama, Massachusetts, New Hampshire, New Mexico, Rhode Island and Vermont in 2025. Wellcare will continue to offer PDP in these states, and this decision does not impact the company's Marketplace or Medicaid contracts in these markets. Wellcare will continue serving MA members in these six states through the end of 2024.

The 2025 Medicare AEP begins on Oct. 15, 2024, and continues through Dec. 7, 2024. Most plans selected during AEP are effective Jan. 1, 2025. For more details about Centene's MA plans and Medicare PDPs, visit www.WellcareNow.com.

Wellcare's 2025 Plan Offerings

For 2025, Wellcare will offer plans to more than 51 million beneficiaries, which accounts for 77% of the eligible beneficiaries in 32 states and more than 1,800 counties. Wellcare also added 126 counties to its footprint across the following states: California, Illinois, Iowa, Mississippi, New York, Texas and Washington.

MAPD Highlights:

In 2025, a variety of plan offerings for value-conscious beneficiaries are available with predictable copays and extra benefits:

• The Wellcare Spendables™ card continues to offer members a single card with preloaded funds available at more than 66,000 nationwide retailers across Wellcare's 32-state footprint. Members may use their Wellcare Spendables on multiple benefits. Depending on the plan, benefits may include over-the-counter products; healthy food groceries from a variety of nationwide retailers; rent/utility assistance; pay-at-pump gasoline; and – new for 2025 – home improvement and safety items.
• $0 copay for primary care physician visits on all plans.
• New for all 2025 plans, the Twill by Dario platform provides online social and behavioral health support and is available 24/7. Services available include peer-to-peer support, self-guided behavioral health programs and access to Centene health plan resources.
• Specialist copays of $35 or less on many plans.
• Routine dental, glasses and fitness on all plans.
• $0 copay for Tier 1, 2 and Tier 6 drugs at preferred pharmacies for most plans. Preferred retail pharmacy networks will include Walgreens, CVS and select grocers. A robust network is expected with more than 60,000 total pharmacies.
• Preferred mail order service provider is Express Scripts Pharmacy.

Benefits and allowance amounts vary by plan. Please call for more details. Allowance amounts cannot be combined with other benefit allowances which may be on the prepaid card. Limitations and restrictions may apply.

Medicare PDP Highlights:

• Three products will be offered in all 34 regions across all 50 states and the District of Columbia; 102 PDPs will be offered nationwide.
• For 2025, more than 1.4 million members will benefit from tier decreases, resulting in reduced costs.
• Wellcare will continue to offer products to meet the unique needs of Medicare beneficiaries including:
• Dual eligibles
• Low-premium "value" shoppers
• Those who need richer coverage
• A five-tier formulary design will be offered on all three plans.
• Wellcare's plans offer competitive formularies that are favorable in coverage and tier placement for the top 400 drugs utilized by Medicare beneficiaries.
• The Value Script plan will continue to offer members a cost-effective option.
• All plans feature a $0 copay on Tier 1 prescriptions when filled at a preferred pharmacy.
• PDP members will also pay $0 for all Medicare covered Part D vaccines and no more than $35 for a 30-day supply of all covered insulins.
• New for 2025, the Part D benefit consists of three phases: annual deductible, initial coverage and catastrophic coverage. In addition, members' out-of-pocket prescription costs will not exceed $2,000 with the option to pay in the form of monthly payments over the course of the plan year.

About Wellcare
For more than 20 years, Wellcare has offered a range of Medicare products, including Medicare Advantage and Medicare Prescription Drug Plans (PDP), which offer affordable coverage beyond Original Medicare. Wellcare is the Medicare brand of Centene Corporation, a leading healthcare enterprise committed to helping people live healthier lives. Beginning Jan. 1, 2022, Centene's Medicare brands, including Allwell, Health Net, Fidelis Care, Trillium Advantage, 'Ohana Health Plan and TexanPlus transitioned to the Wellcare brand. For more information about Wellcare, visit www.wellcare.com.

'Ohana Health Plan, a plan offered by WellCare Health Insurance of Arizona, Inc. Wellcare is the Medicare brand for Centene Corporation, an HMO, PPO, PFFS, PDP plan with a Medicare contract and is an approved Part D Sponsor. Our D-SNP plans have a contract with the state Medicaid program. Enrollment in our plans depends on contract renewal. Our plans use a formulary. Washington residents: "Wellcare" is issued by Coordinated Care of Washington, Inc., a subsidiary of Centene Corporation. Health Net Life Insurance Company is contracted with Medicare for PPO plans. "Wellcare by Health Net" is issued by Health Net Life Insurance Company. "Wellcare" is issued by WellCare Health Insurance of Washington, Inc., a subsidiary of Centene Corporation. "Wellcare" is issued by WellCare Prescription Insurance, Inc. For accommodations of persons with special needs at meetings, call [1-877-MY-WELLCARE] TTY (711). There is no obligation to enroll. Wellcare's pharmacy network includes limited lower-cost, preferred pharmacies in rural areas of Nebraska. The lower costs advertised in our plan materials for these pharmacies may not be available at the pharmacy you use. For up-to-date information about our network pharmacies, including whether there are any lower-cost preferred pharmacies in your area, please call 1-800-977-7522 (TTY: 711) for Wellcare Assist Open (PPO), Wellcare Giveback (HMO-POS), and Wellcare Simple Open (PPO) in NE or consult the online pharmacy directory at www.wellcare.com/NE. For Louisiana D-SNP members: As a Wellcare HMO D-SNP member, you have coverage from both Medicare and Medicaid. You receive your Medicare health care and prescription drug coverage through Wellcare and are also eligible to receive additional healthcare services and coverage through Louisiana Medicaid. Learn more about providers who participate in Louisiana Medicaid by visiting www.myplan.healthy.la.gov/en/find-provider or https://www.louisianahealthconnect.com. For detailed information about Louisiana Medicaid benefits, please visit the Medicaid website at https://ldh.la.gov/medicaid and select the "Learn about Medicaid Services" link. To request a written copy of our Medicaid Provider Directory, please contact us. Louisiana D-SNP prospective enrollees: For detailed information about Louisiana Medicaid benefits, please visit the Medicaid website at https://ldh.la.gov/medicaid or https://www.louisianahealthconnect.com. To request a written copy of our Medicaid Provider Directory, please contact us. Notice: TennCare is not responsible for payment for these benefits, except for appropriate cost sharing amounts. TennCare is not responsible for guaranteeing the availability or quality of these benefits. Any benefits above and beyond traditional Medicare benefits are applicable to Wellcare Medicare Advantage only and do not indicate increased Medicaid benefits. Texas D-SNP prospective enrollees: For detailed information about Texas Medicaid benefits, please visit the Texas Medicaid website at https://www.hhs.texas.gov/services/health/medicaid-chip/medicaid-chip-members/starplus. To request a written copy of our Medicaid Provider Directory, please contact us. New Mexico (NM) Dual Eligible Special Needs Plan (D-SNP) Members: As a Wellcare by Allwell D-SNP member, you have coverage from both Medicare and Medicaid. Medicaid services are funded in part by the state of New Mexico. NM Medicaid benefits may be limited to payment of Medicare premiums for some members. Louisiana D-SNP prospective enrollees: For detailed information about Louisiana Medicaid benefits, please visit the Medicaid website at https://ldh.la.gov/medicaid or https://www.louisianahealthconnect.com. To request a written copy of our Medicaid Provider Directory, please contact us. Wellcare by Allwell (HMO and HMO SNP) includes products that are underwritten by Superior HealthPlan, Inc. Wellcare (HMO and HMO SNP) includes products that are underwritten by WellCare of Texas, Inc., WellCare National Health Insurance Company, and SelectCare of Texas, Inc. Please contact your plan for details. Other Pharmacies/Physicians/Providers are available in our network.

Y0020_WCM_133812E1_M CMS Accepted 10012024

 

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SOURCE Wellcare

FAQ

When is the 2025 Medicare Annual Enrollment Period for Wellcare (CNC) plans?

The 2025 Medicare Annual Enrollment Period for Wellcare plans runs from October 15, 2024, through December 7, 2024, for coverage starting January 1, 2025.

How many states will Wellcare (CNC) offer Medicare Advantage products in for 2025?

Wellcare will offer Medicare Advantage products in 32 states for 2025, including its newest state, Iowa.

What new features has Wellcare (CNC) introduced for its 2025 Medicare plans?

Wellcare has introduced member onboarding videos in eight languages, the Wellcare Spendables™ card for multiple benefits, and the Twill by Dario platform for 24/7 behavioral health support.

What is the cap on out-of-pocket prescription costs for Wellcare (CNC) Medicare plans in 2025?

Wellcare has implemented a $2,000 cap on out-of-pocket prescription costs for its Medicare plans in 2025, with the option to pay in monthly installments.

How many Prescription Drug Plans (PDPs) will Wellcare (CNC) offer nationwide in 2025?

Wellcare will continue to offer 102 Prescription Drug Plans (PDPs) nationwide in 2025.