Updates include a plan name change and a new vendor for eye care
The information in this update provides the changes to Medicare plans starting January 1, 2025, as well as information about the new vision vendor, Premier Eye Care.
Changes – Wellcare Simple (HMO): plan name change
The plan name for Wellcare No Premium Focus (HMO) changes to Wellcare Simple (HMO) for the following list of 2025 plans. The service areas remain the same.
|
2025 H contract & PBP1 |
New plan name |
Service area |
|
H5087-005 |
Wellcare Simple (HMO) |
Los Angeles, Orange |
|
H5087-016 |
Wellcare Simple (HMO) |
Riverside, San Bernardino |
|
H5087-024 |
Wellcare Simple (HMO) |
San Joaquin, Ventura |
Non-renewed – HMO plan not renewing in 2025
The following plan is not renewing for 2025. Members have received a non-renewal notice with their options on how to access their Medicare benefits.
|
2025 H contract & PBP |
Plan name |
Service area |
|
H0587-033 |
Wellcare Giveback (HMO) |
Ventura |
New vision vendor
Premier Eye Care is replacing Envolve Vision effective January 1, 2025. Medicare members with additional supplemental benefits will need to access Premier Eye Care for the covered services. Providers should refer to the member's Evidence of Coverage (EOC) to confirm specific coverage information exclusions, limitations and cost-sharing.
Contact Premier Eye Care from Monday through Friday, 8 a.m. – 8 p.m. Pacific time:
- Phone: 833-883-2339
- Email: info@premiereyecare.net for questions or inquiries.
|
Access the 2025 Medicare Supplemental Vendor Contact Information list for more information. |
Member renewal and non-renewal notices
- September 2024: Renewal notices, or Annual Notice of Change, for continuing plans were sent to members.
- October 2024: Non-renewal notices were sent to members.
New ID cards for all members
All enrolled members will receive a new 2025 health plan identification card by December 31, 2024.
Updated CMS special election periods (SEPs) for dual eligible beneficiaries
- The quarterly SEP for dually eligible beneficiaries will be discontinued in 2025.
- Starting January 1, 2025, Medicare will allow dually eligible members to switch to Original Medicare with a stand-alone prescription drug plan once per month.
- A new type of SEP for integrated care will allow dually eligible members to choose an applicable integrated plan (AIP) once per month, in any month of the year.
- Wellcare By Health Net offers these plans in Los Angeles, Sacramento, Tulare, Fresno, Kings, and Madera counties.
- Dually eligible members will not be able to enroll in, or change, Medicare Advantage plans or other Special Needs Plans outside of the usual times, except if a different SEP applies, such as moving to a different county.
Additional information
Relevant sections of the Wellcare Provider Manual have been revised to reflect the information contained in this update as applicable. The manual is available online at www.wellcare.com/California/Providers/Medicare.
If you have questions regarding the information contained in this update, contact 866-999-3945.
