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Medicare Prescription Drug Plans (PDPs) are also known as Medicare Part D. Medicare Part D is a government program that offers prescription drug insurance to everyone who is entitled to Medicare Part A and/or enrolled in Medicare Part B.

When you are ready to decide on a plan, take the time to understand how the plans work. That way, you can make an informed decision and choose the plan that's right for you.

Different PDPs Cover Different Drugs

The federal government has specific guidelines for the types of medications we must cover as well as a minimum standard of benefits we must follow.

Each plan has a formulary (a list of covered drugs) that meets these requirements as required by law. Keep in mind, not all plans are the same. They may vary in cost or specific drugs covered.

If you enroll in a Medicare Part D plan, please review the plan's formulary to ensure it will meet your prescription drug coverage needs.

If You Have a Current Medicare Advantage Plan

If your Medicare Advantage Plan includes prescription drug coverage and you join a Medicare PDP, you will be disenrolled from your Medicare Advantage Plan and returned to Original Medicare with your Medicare PDP.

Medicare Drug Coverage (Part D) Late Enrollment Penalty

The late enrollment penalty is an amount that’s added to your monthly Medicare drug plan (Part D) premium. You may owe a late enrollment penalty if at any time after your Initial Enrollment Period is over, there’s a period of 63 or more days in a row when you don’t have Medicare drug coverage or other credible prescription drug coverage. You will generally have to pay the penalty for as long as you have Medicare drug coverage.

When It Comes to Coverage, You Have Options:

  • You can get Medicare prescription drug coverage through a Medicare PDP (Part D).
  • You can sign up for a Medicare Advantage plan (HMO or PPO) or other Medicare health plan that offers Medicare prescription drug coverage.

More Savings. More Coverage. Caring Service.

  • Wellcare offers plans designed to help those eligible for Extra Help (Low Income Subsidy) where members may pay no or low premiums and copays if enrolled
  • Low premium plans are also available in all states with copays starting as low as $0 when filled at preferred pharmacies
  • Wellcare also offers plans with no deductible which means the plan begins covering prescription drug costs on day one
  • Thousands of network pharmacies are available nationwide in our network including national, regional and local chains, grocers and independent neighborhood pharmacies
  • We partner with preferred pharmacies to help save member’s money. Preferred pharmacies in our network include many well-known national and regional retailers. Use our
    Find a Provider tool to find a preferred pharmacy closest to you

Member Service representatives are ready to help you with any questions about your coverage or medications. For a complete list of drugs covered by our plan, please call Customer Service.

Important Information

Grievances

You have the right to file a grievance or provide feedback directly to Medicare about our plan. Complete and submit the Medicare Feedback and Complaint Form.

Medicare has an Office of the Medicare Ombudsman (OMO) that can help you with complaints, grievances and information requests. Visit Medicare.gov for more information about Medicare and/or assistance with complaints and grievances.

Disclaimers

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.

‘Ohana Health Plan, a plan offered by WellCare Health Insurance of Arizona, Inc.

Texas Residents: 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.

Washington residents: “Wellcare" is issued by WellCare Health Insurance Company of Washington, Inc.

Wellcare Dual Liberty (HMO D-SNP) Members: Wellcare Dual Liberty (HMO D-SNP) is a Fully Integrated Dual Eligible Special Needs Plan with a Medicare contract and a contract with the New Jersey Medicaid program. Enrollment in Wellcare Dual Liberty depends on contract renewal. This information is not a complete description of benefits. Contact the plan for more information. Limitations and restrictions may apply. Benefits may change on January 1 of each year. Your Part B premium is covered by Medicaid. This plan is available to those who have both Medicare and full Medicaid benefits. Wellcare uses a formulary. Please contact Wellcare for details.

Every year, Medicare evaluates plans based on a 5-star rating system.

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 health care services and coverage through Louisiana Medicaid. Learn more about providers who participate in Louisiana Medicaid by visiting myplan.healthy.la.gov/myaccount/choose/find-provider. For detailed information about Louisiana Medicaid benefits, please visit the Medicaid website at ldh.la.gov/medicaid and select the “Learn about Medicaid Services” link.

Louisiana D-SNP prospective enrollees: For detailed information about Louisiana Medicaid benefits, please visit the Medicaid website at ldh.la.gov/medicaid.

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.

Out-of-network/non-contracted providers are under no obligation to treat Plan members, except in emergency situations. Please call our customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services.

Wellcare’s pharmacy network includes limited lower-cost preferred pharmacies in rural areas of MO and NE. 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 1-833-444-9088 (TTY 711) for Wellcare No Premium (HMO) and Wellcare Giveback (HMO) in MO or consult the online pharmacy directory at wellcare.com/medicare; and 1-833-542-0693 (TTY 711) for Wellcare No Premium (HMO), Wellcare Giveback (HMO), and Wellcare No Premium Open (PPO) in NE or consult the online pharmacy directory at wellcare.com/NE.

Value-Added Items and Services (VAIS) are not plan benefits and are not covered by the plan. Plan enrollees are responsible for all costs.

Please contact your plan for details.

  • Grievances

    Grievances

    You have the right to file a grievance or provide feedback directly to Medicare about our plan. Complete and submit the Medicare Feedback and Complaint Form.

    Medicare has an Office of the Medicare Ombudsman (OMO) that can help you with complaints, grievances and information requests. Visit Medicare.gov for more information about Medicare and/or assistance with complaints and grievances.

  • Disclaimers

    Disclaimers

    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.

    ‘Ohana Health Plan, a plan offered by WellCare Health Insurance of Arizona, Inc.

    Texas Residents: 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.

    Washington residents: “Wellcare" is issued by WellCare Health Insurance Company of Washington, Inc.

    Wellcare Dual Liberty (HMO D-SNP) Members: Wellcare Dual Liberty (HMO D-SNP) is a Fully Integrated Dual Eligible Special Needs Plan with a Medicare contract and a contract with the New Jersey Medicaid program. Enrollment in Wellcare Dual Liberty depends on contract renewal. This information is not a complete description of benefits. Contact the plan for more information. Limitations and restrictions may apply. Benefits may change on January 1 of each year. Your Part B premium is covered by Medicaid. This plan is available to those who have both Medicare and full Medicaid benefits. Wellcare uses a formulary. Please contact Wellcare for details.

    Every year, Medicare evaluates plans based on a 5-star rating system.

    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 health care services and coverage through Louisiana Medicaid. Learn more about providers who participate in Louisiana Medicaid by visiting myplan.healthy.la.gov/myaccount/choose/find-provider. For detailed information about Louisiana Medicaid benefits, please visit the Medicaid website at ldh.la.gov/medicaid and select the “Learn about Medicaid Services” link.

    Louisiana D-SNP prospective enrollees: For detailed information about Louisiana Medicaid benefits, please visit the Medicaid website at ldh.la.gov/medicaid.

    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.

    Out-of-network/non-contracted providers are under no obligation to treat Plan members, except in emergency situations. Please call our customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services.

    Wellcare’s pharmacy network includes limited lower-cost preferred pharmacies in rural areas of MO and NE. 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 1-833-444-9088 (TTY 711) for Wellcare No Premium (HMO) and Wellcare Giveback (HMO) in MO or consult the online pharmacy directory at wellcare.com/medicare; and 1-833-542-0693 (TTY 711) for Wellcare No Premium (HMO), Wellcare Giveback (HMO), and Wellcare No Premium Open (PPO) in NE or consult the online pharmacy directory at wellcare.com/NE.

    Value-Added Items and Services (VAIS) are not plan benefits and are not covered by the plan. Plan enrollees are responsible for all costs.

    Please contact your plan for details.

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Y0020_WCM_100876E Last Updated On: 10/1/2022