The Centers for Medicare & Medicaid Services (CMS) regulations require that health plans provide their Special Needs Plan provider network with information on their basic Model of Care. This applies to our Dual-Eligible Special Needs Plan (D-SNP) members who are eligible for both Medicare and Medicaid, and Chronic Needs members (C-SNP), who have one or more qualifying conditions.
Please review WellCare's self-study program that outlines the basic Model of Care requirements for our providers. Frequently asked questions outline other information you may find helpful.
Medicare Provider Expectations - Model of CareWellCare asks that you partner with us to ensure we are giving the highest quality of care possible to our SNP members by performing the following steps:
- Review the member Care Plans faxed to you by a WellCare Case Manager.
- If necessary, update the Care Plan with any required changes and fax the revised plan back to WellCare at 1-866-287-3286.
- Call 1-866-635-7045 for questions or to further discuss the Care Plan; or you can call the Case Manager directly at the phone number listed on the fax cover sheet of the Care Plan.
- Please keep a copy of the updated Care Plan to review with the SNP member during their next office visit.
- Participate in Interdisciplinary Care Team (ICT) for all SNP members and give feedback as appropriate.