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Overview & Resources

WellCare of South Carolina partners with providers to develop and deliver high-quality, cost-effective health care solutions. We understand that maintaining a healthy community starts with providing care to those who need it most. We are committed to improving the quality of life of our millions of members, who often include some of our nation’s most vulnerable populations.

Medical Expense Initiative

In 2016, edits will be derived directly from the state and national Medicaid editing guidelines. This will save money on vendor fees and additional costs each year. To learn more, please review the National and State-level Medicaid rules.


Get detailed health plan information on important topics such as coverage procedures and policies.

Contains key phone numbers and information on claims, appeals and more.

Online Tools for WellCare Providers


The Early and Periodic, Screening, Diagnostic and Treatment (EPSDT) program is Medicaid’s federally mandated comprehensive and preventive health program for individuals younger than 21.

Guidelines for submitting HEDIS Flat Files, ESD, and Active DX codes.

Guidelines for submitting HEDIS Flat Files, ESD, and Active DX codes.

Details the various tools available to help providers do business with Staywell.

How to quickly get in touch with WellCare to get your questions answered.

ProgenyHealth Frequenetly Asked Questions

METS takes a unique approach to member care. We partner with the provider and member to ensure that the member achieves the ultimate level of recovery and resiliency.

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Last Updated On: 3/23/2021