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Breaking Down Wellcare by Allwell Medicare Advantage Plans

Written by 
Katee Fletcher

Article at a glance

  • Medicare Advantage (MA) plans are supplemental insurance plans that help fill coverage gaps in Original Medicare. MA plans have a Medicare contract with the Federal Medicare Program and are therefore authorized to provide healthcare to Medicare beneficiaries.

  • Wellcare by Allwell offers a wide range of MA plans in 19 states for interested beneficiaries.

  • MA plans through Wellcare by Allwell include additional benefits such as vision services, meal delivery services, annual hearing aid coverage, and more.

  • Cost is a huge deciding factor when choosing an MA plan. With Wellcare by Allwell operating differently in each state, costs may vary on a state-by-state basis.

What Are Medicare Advantage Plans?

Medicare Advantage plans, otherwise known as Medicare Part C” or MA Plans,” are considered Medicare supplement plans. MA plans work to fill the coverage gaps in Original Medicare by wrapping Part A, Part B, and Part D insurance into one plan alongside potential coverage for dental, hearing, and vision. Medicare Advantage plans are offered through private insurance companies that have contracts with the Federal Medicare Program. 

Any individual that’s eligible for Original Medicare is also eligible to enroll in a MA plan. However, while Original Medicare does not require plan renewal after initial enrollment, MA plans may change annually inciting plan changes for various enrollees.


Note: To learn more about Medicare Advantage plans, visit this source.

Overview of Wellcare by Allwell

Wellcare is the Medicare brand for Allwell insurance, a product of the Centene Corporation. Wellcare by Allwell offers four distinct Medicare Advantage plan types in 19 different states that operate in unique ways based on their individual communities and populations.

Allwell Locations

Wellcare by Allwell operates as a collective group of individual, local insurance companies based in the following 19 states:

  • Arkansas

  • Arizona

  • California

  • Florida

  • Georgia

  • Indiana

  • Kansas

  • Louisiana

  • Mississippi

  • Missouri

  • Nebraska

  • Nevada

  • New Mexico

  • Oklahoma

  • Ohio

  • Pennsylvania

  • South Carolina

  • Texas

  • Wisconsin

Allwell Contact Information

With each state being operated on an individual basis, it’s important for new or potential members to speak with a licensed insurance agent in their state. To find the contact information for one’s local Allwell insurance company, visit this source.

Note: Medicare evaluates plans based on a five-star rating system. To learn more about Medicare’s reviews on Allwell and customer reviews of this insurance company, visit this source.

Allwell MA Plan Options

When it comes to Medicare Advantage plans, Wellcare by Allwell provides a variety of health plans such as health maintenance organization (HMO) plans, preferred provider organization (PPO) plans, and special needs plans (SNPs). Allwell does not offer stand-alone Part D prescription drug plans. Although, most MA plans include prescription drug coverage for beneficiaries as they are an approved Part D sponsor.

Note: To find an Allwell plan in one’s area and explore their options, visit this source.

Health Maintenance Organization (HMO) Plans

HMO plans are known for being cost-effective and convenient as they require a provider to have a primary care physician (PCP). This primary care physician works to coordinate a holistic healthcare experience for the patient; they guide the patient’s health and wellness by coordinating the patient’s care and various providers. For example, a PCP keeps track of any vaccines or screenings a patient needs like an annual flu shot or a colonoscopy and will guide a patient on where to go and who to see for those appointments.

The downside to this plan is that all care must be done in-network, otherwise, enrollees may face high costs. Not to mention, referrals are required if patients wish to see a different provider or specialist.

Note: To learn more about HMO plans, visit this source.

Preferred Provider Organization (PPO) Plans

PPO plans are also known to be cost-friendly and popular as they provide a patient with more flexibility over their care. A PCP is not required with this plan, nor are referrals or in-network coverage. However, it should be noted that out-of-network providers may be more expensive.

Note: To learn more about PPO plans, visit this source.

Special Needs Plans (SNPs)

SNPs are Medicare Advantage plans that cover individuals with specific diseases or illnesses. The benefits, providers, and drug coverage provided with this plan are uniquely tailored to the individuals being treated and covered under a special needs plan. In most cases, a PCP is necessary along with referrals for other providers or specialists.

Wellcare by Allwell specifically offers the following two SNPs:

  • Dual Eligible SNP (D‑SNPs): D‑SNPs are for individuals that are eligible to enroll in both Medicare and Medicaid. Allwell dual-Medicare members use Medicare as their primary insurance and the state Medicaid program acts as the supplementary insurance. For more information on Allwell Medicare Advantage Dual Special plans, visit this source.

  • Chronic Condition SNP (C‑SNPs): C‑SNPs are for individuals who are suffering from severe or disabling chronic conditions.


Note: To learn more about SNPs, visit this source or this source.

Additional Allwell MA Plan Benefits

Wellcare by Allwell Medicare Advantage plans offer loads of additional benefits and coverage for their participating beneficiaries, such as:

  • Dental Services: Most Allwell MA plans offer preventive dental coverage for little to no copayment.

  • Hearing Services: Every Allwell MA plan offers preventive hearing services along with two hearing aids (any size or style) each calendar year.

  • Convenient Telehealth Options: Allwell offers their beneficiaries access to telehealth appointments for reasons stemming from routine preventive care visits, smoking cessation sessions, behavioral health sessions, and more.

  • Meal Services: For members that recently experienced an in-patient stay, Allwell provides them with meal delivery services that include two meals per day for up to 14 days.

  • Over-the-Counter (OTC) Allowance: Allwell provides beneficiaries with a quarterly balance of $50 to purchase any OTC medication they need or want (vitamins, allergy care, first aid, cold remedies, etc.).

  • Fitness Program: The Silver&Fit fitness program is available for all Allwell beneficiaries to use. Silver&Fit includes a wide range of benefits such as 48 online classes, an interactive fitness app, nutrition classes, and more.

  • Nurse Hotline: Nurses are available to answer any questions or concerns 24 hours a day, seven days a week for Allwell beneficiaries.

  • Vision Services: All Allwell plans offer vision services for beneficiaries that include one routine eye exam and $200 towards a pair of glasses or contact lenses annually.

Note: To learn more about the added benefits of being a Wellcare by Allwell beneficiary, visit this source.

Cost of Allwell MA Plan

A variety of factors are included when considering the cost of any MA plan such as monthly premiums, deductibles, out-of-pocket costs, copayments, and coinsurance. The cost of one’s Allwell Medicare Advantage plan is dependent on where one lives, which plan one chooses, and what one’s specific health needs are. 

Regardless of specific Allwell plan costs, all MA plan beneficiaries are required to pay their Part B premium which is projected to be approximately $164.90 per month in 2023. 

Note: To learn more about costs associated with Allwell’s Medicare Part C plans, visit this source.

How to Enroll in a Wellcare by Allwell MA Plan

One can enroll in an Allwell Medicare Advantage plan online, via phone, or by mail/​fax. Use Allwell’s search tool to find local MA plans and see what is offered in one’s community. Enrollment in Allwell MA plans depends on contract renewal.

Any eligible Medicare beneficiary is able to enroll in an MA plan during their Medicare annual enrollment period otherwise known as the initial enrollment period (IEP), switch their plan during the open enrollment period (OEP), or enroll in an MA plan during the general enrollment period (GEP). The dates for these enrollment periods are as follows:

Initial Enrollment Period

The initial enrollment period spans a total of seven months and is the same as Original Medicare’s IEP. These seven months include three months prior to an individual’s 65th birthday, the month of one’s 65th birthday, and the three months following one’s 65th birthday. 

Open Enrollment Period

October 15th to December 7th is considered Medicare’s OEP and it allows beneficiaries to switch their current plan, e.g., switch from Original Medicare to an MA plan, switch from one MA plan to another, etc.

General Enrollment Period

The GEP for Medicare Advantage spans from April 1st to June 31st and is an additional timeframe for eligible individuals to register for a MA plan.

Note: To discover more enrollment Medicare resources and information, visit this source.

How to Choose the Best Medicare Advantage Plan

Before choosing a Medicare Advantage plan, one should use the government’s Medicare Advantage plan comparison tool to evaluate and compare plans. Things to consider before deciding on the best supplemental Medicare plan:

Cost:

  • How much are they willing to spend monthly on a premium?

  • What do they want their deductible to look like?

Coverage:

  • Will their prescriptions be covered under this plan?

  • Is additional coverage offered for dental, vision, or hearing services?

  • Will their current doctors or specialists be covered?

Convenience:

  • Where is their insurance office in case they need assistance?

  • Does their insurance provide transportation to and from healthcare appointments if needed?

Note: Oak Street Health provides transportation to and from healthcare appointments for patients that need assistance. They also have providers that are trained and willing to guide patients through their insurance benefits whenever needed.

FAQ

Did Allwell merge with Wellcare?

Yes, starting in January of 2022, Centene's Medicare brands (including Allwell) transitioned to the Wellcare brand.

Sources

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