Complaints

This profile includes complaints for WellCare Health Plans, Inc.'s headquarters and its corporate-owned locations. To view all corporate locations, see Find Local Branches.

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  WellCare Health Plans, Inc.

  PO Box 31370 Tampa, FL 33631-3370

• 

  WellCare Health Plans, Inc.

  8735 Henderson Rd Tampa, FL 33634-1143

• 

  WellCare Health Plans, Inc.

  PO Box 25735 Tampa, FL 33622-5735

• 

  WellCare Health Plans, Inc.

  PO Box 31401 Tampa, FL 33631-3401

• 

  WellCare Health Plans, Inc.

  PO Box 31370 Tampa, FL 33631-3370

The complaint text that is displayed might not represent all complaints filed with BBB. Some consumers may elect to not publish the details of their complaints, some complaints may not meet BBB's standards for publication, or BBB may display a portion of complaints when a high volume is received for a particular business.

• Initial Complaint

  Date:06/10/2025

  Type:Product Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  I can't get my benefits that I'm enrolled for. I file complaints and no one calls me back. This is my second bbb complaint

  Business Response

  Date: 06/18/2025

  WellCare received your grievance
  on 6/11/25 concerning Domonique Gordon, BBB Complaint Case# 23451023. Due to federal and state privacy and confidentially regulations, we are unable
  to disclose any protected health information, including eligibility, claims,
  and billing information, with anyone other than our members or their authorized
  representatives. We will be sending a detailed response directly to Domonique Gordon addressing BBB Complaint Case# 23451023. A member of the WellCare escalation team will contact you within 24
  business hours.

   

  Member outreach was made on 6/11-6/12/25, on 6/18/25 during an update outbound call to the member she has requested the case to be closed. 

• Initial Complaint

  Date:06/10/2025

  Type:Customer Service Issues
  Status:

  ResolvedMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  I tried to register for an account, but was unable to. I called Wellcare on 5/27/25 and they took me through all different steps to try and resolve. They told me they escalated to the IT department and I would receive a call back in 10 days, which I did not. I called on 6/10/25 and spoke to Maeve and spent close to an hour with her on the phone troubleshooting. Still no success....she was apparently consulting her web escalation team (not IT ****** This complaint is not against ***** as she did everything in her power to help. It is against Wellcare in general and their lack of having the right resources and timeliness to address issues.....not cool at all!!! I get the error message, "application error: a client-side exception has occurred (see the browser console for more information). I DO NOT want someone to call me back and waste more time trying different browsers, clearing cache and cookies. Wellcare needs to troubleshoot internally and call me back when there is a solution ************. Thank you!!

  Business Response

  Date: 06/23/2025

  Wellcare received your grievance on 06/16/2025 concerning ***** *********, BBB Complaint Case# ********. Due to federal and state privacy and confidentially regulations, we are unable to disclose any protected health information, including eligibility, claims, and billing information, with anyone other than our members or their authorized representatives. We will be sending a detailed response directly to ***** ********* addressing BBB Complaint Case# ********. 

  Customer Answer

  Date: 06/23/2025

   
  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me.
  
  Sincerely,
  
  ***** *********

• Initial Complaint

  Date:06/09/2025

  Type:Billing Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  I never received a bill from WellCare because they admittedly had the wrong address for me & therefore the bill did not get paid. How could I pay a bill that I never got! I would gladly just pay for the year but now they are telling me that I cant do that & am knocked out of the system until the next special enrollment period & then will continue to get fined throughout the rest of my life! Is this fair?

  Business Response

  Date: 06/18/2025

  Thank you for bringing this matter to our attention. We have completed a thorough review of the concerns raised regarding the termination of coverage due to non-payment.

  Upon investigation, we confirmed that all required billing notifications and outreach efforts were conducted in accordance with regulatory standards and internal protocols.These included:

  Multiple outreach campaigns and reminder notifications between January and March 2025.
  Two formal advance notices of disenrollment due to non-payment.
  Final termination notice issued on April 1, 2025.
  

  All correspondence was sent to the address on file, which matched the information provided through the application submitted via the CMS portal. There were no updates to the address prior to the payment deadline, and no inquiries or payments were received before the termination date.
  While we understand the member’s concern and willingness to resolve the matter, the request for reinstatement was reviewed and ultimately denied, as all required procedures were followed and the plan was not at fault for the address discrepancy. The member may be eligible to re-enroll during the next Special Enrollment Period.
  

  We remain committed to supporting our members and ensuring clear communication throughout their enrollment. Should additional documentation or clarification be needed, we are happy to assist further.

• Initial Complaint

  Date:05/15/2025

  Type:Billing Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  My plan is not paying my doctors visists like it is supposed to. I have had to call wellcare several times for office visits that are supposed to be covered and my doctors office sends me a bill stating they were not paid by my insurance company. I have called wellcare several times on this matter and they tell me they will take care of it. Today my doctors office told me they will be putting me in collections if i do not pay. Each time i call wellcare they claim the issue is an "incorrect" doctor listed on my plan as my primary, which they refuse to correct. The first one is 1-20-25. This is for a "new patient" visit. I am tired of calling each month for problems with my insurance coverage.

  Business Response

  Date: 05/23/2025

  Dear ******* *******,
  Thank you for bringing this matter to our attention. We are sorry for any inconvenience that you have experienced. The plan that you have under WellCare is considered a PPO plan , which means you are not obligated to be assigned to a primary care physician. Your plan terms state if the provider is in network with WellCare and accepts your plan that you can be seen, and claims will be processed as such.
  Please be advised ***** **** is not contracted with your plan, we contacted her office also and spoke with *** who also verified that ***** **** is not contracted with WellCare. ***** **** office is aware of this, and *** at ***** **** office suggested to assign you to a provider in that group that is contracted with WellCare which is Dr. **** ******* who is the doctor overseeing ***** ****.
  You are more than welcomed to continue to see ***** ****, if that is your preference but those claims submitted will be processed out of network until ***** **** chooses to change the contract with WellCare and be established as a Nurse Practitioner and not a specialist. So, the issue with who you are assigned to is not the reason your claims are processing the way they are, instead it is the status of ***** **** within Wellcare.

  
  If you have any further questions or concerns, please do not hesitate to contact us.
  Sincerely,
  **** D

  Customer Answer

  Date: 05/27/2025

   
  Complaint: 23334078
  
  I am rejecting this response because: no matter how ***** is listed it doesn't change the fact that i was referred to her from your website.  And furthermore have been complaining about coverage with her since February, wecare failed to tell me each and everytime i brought her up with them about her not beeing listed on my policy as my doctor (which there was many times) they never once told me she was listed as a specialist or that she was out of network.   Wellcare has lied and misled me since the beginning as well as changed policies AFTER i signed up.
  
  Sincerely,
  
  ******* *******

• Initial Complaint

  Date:05/13/2025

  Type:Customer Service Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  Wellcare has been contacting me for the past two years for someone by the name of *******. I do not know (nor have I met) anyone with the name *******. I have spoken to 3 managers to remove my phone number and they have yet to do that. They stop calling for a week and then they are back at it. I know telephone rules and regulations state to never contact me again if I ask to be taken off the list. If they do not stop harassing me when I am not even the person they are looking for, I will not hesitate to move forward with a lawsuit. I have not yet as I have not had the time. I really would rather the calls to stop so we can all move on with our lives but if the calls do not stop, I have no choice. I have blocked their calls numerous of times and they somehow continue to get through. I AM DONE

  Business Response

  Date: 05/15/2025

  Hello. We apologize for the dissatisfaction that you experienced. The complainant has been added to the Do Not Call List.

  Customer Answer

  Date: 05/16/2025

   
  Complaint: 23320619
  
  I am rejecting this response because this is the same answer I got from the 3 managers I spoke with during the past TWO YEARS and my number keeps being put back in their "autodialer".  I believe that I will be getting calls within a week and I will be keeping all of the messages left to add to the ones I have already.  
  
  Sincerely,
  
  ******** ******

  Business Response

  Date: 05/20/2025

  Hello. We apologize for the dissatisfaction that you experienced. Please be assured that your concerns have been addressed and resolved. The complainant has been added to the Do Not Call List and removed from the dialer. No further outreaches will be made. We are truly sorry for the inconvenience this has caused.

  Customer Answer

  Date: 05/20/2025

   
  Complaint: 23320619
  
  I am rejecting this response because I literally just received another call from your autodialer at 10:16 today 5/20/25.  I am not trying to be difficult, it's just you do not believe that your removal is not working and your company keeps harassing me for someone I do not know and I am not affiliated with by any means.  I am sorry that I have no faith - this just proves my point of after speaking to 3 managers it did not fix.  Going through the BBB to be taken more serious, still not fixed.  I would like for BBB to guide me on how to take this to the next step.  I have already looked into attorney fees.  It's the principle now.
  
  Sincerely,
  
  ******** ******

• Initial Complaint

  Date:05/07/2025

  Type:Billing Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  My mother passed away in Feb/2025. I notified social security, WellCare, and a few other companies in Feb. on March ****** WellCare sent a later sending their condolences and stated that they will no longer be taking any policy premiums out if our account and if any were taken after March ****** the would refund the money within 30 days. WellCare continued to take a monthly premium out of our account for the month of March, April and May. I have called them at least 10 times throughout the last 3 months. They told me to mail a copy of my moms death certificate along with my parents marriage license I did in March. They then told me that I cant notify them social security needed to notify them. I had a meeting with social security on May 1st they stated that they dont inform them of my mothers death and that they had all the information the needed and they notified who they are required to. I called WellCare back and they told me to go to a court house and obtain some document and send it to them. I told them whatever form they need send me and I will fill it out they said they dont have the form they want me to send. I called social security again May 5 after checking my bank and seeing another withdrawal they told me to file a claim with the better business bureau and that this was criminal being my mom has passed and they continue to take money. I called my bank requested them to block any further payments and submitted a unauthorized withdrawal for the last three months. The bank also stated this is criminal especially being my moms name is no longer on the account. I have tried at least 10 times to resolve this and requested they stop withdrawing money with no success. I think its terrible that they are taking premium payments from a deceased person. I had the letter I received from them on March 2 stated the acknowledged that my mothers death passed. I dont know what else to do to get this resolved.

  Business Response

  Date: 05/09/2025

  Hello. We apologize for the dissatisfaction that you experienced. Escalation to our Enrollment and Billing department confirmed the complainant's concern have been resolved. 

  Customer Answer

  Date: 05/12/2025

   
  Complaint: 23290249
  
  I am rejecting this response because: The money taken from my bank account has not been returned. 
  
  Sincerely,
  
  ***** *********

  Business Response

  Date: 05/15/2025

  Hello. We apologize for the dissatisfaction that you experienced. The complainant was advised to review her bank statement and to call the company listed, in order to obtain a refund.

• Initial Complaint

  Date:05/07/2025

  Type:Customer Service Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  I keep getting calls about a missed script. The situation was explained to them but they keep calling. Worse they are sending medical information/prescription information to a third party without authorization. My daughter called and they were disinterested. She asked to speak to a supervisor who honestly didn't sound like one and was promptly put on hold or mute. 40+ minutes in, the call is still going on!!! They essentially parked the call about their sending private information to a third party and refuse to handle it. She plans to let it remain so it triggers a review at a higher level. A several hour long call looks very suspicious I am sure. Pretty sure this is a Hiipa violation.

  Business Response

  Date: 05/14/2025

  Good morning, the complainant was unable to contact via phone and email, however, we contacted the pharmacy department for assistance, they advised The Medication Therapy Management (***) program is a service provided by the ******************** and ***************** (CMS) to help ******** beneficiaries manage their medications more effectively. The program aims to ensure that individuals are receiving the appropriate medications for their conditions, improving health outcomes, and reducing healthcare costs. *** services are designed for people with multiple chronic conditions, those who take multiple medications, and those who are at risk for adverse drug events or interactions. At this time offline team is unable to assist in disenrolling members from automated messaging. Member will need to contact ************* at ************ to request this to be done.  The information has been emailed to the member as well. thank you. 

• Initial Complaint

  Date:04/29/2025

  Type:Service or Repair Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  My daughter has a chronic disease and is in need of a certain medication. for starters, wellcare stopped the ********** approval stating that they want us to use a biosimilar product. wethe doctor then prescribed a biosimilar. WellCare has refused to cover the brand name of the medication, stating that a generic is available. we have been busy for about two or three weeks trying to just get this medication. after going through the process with two specialty pharmacies, we have learned that the medication is NOT available in the generic form. our doctor and pharmacy liaison for the doctor and us ourselves are trying all ways to get this medication through but the insurance is stubbornly refusing again and again with unsubstantiated reasons. my husband and i have spent exorbitant amounts of time on the phone with the insurance, and we feel we are speaking to a brick wall, where no one is willing to help. my daughter is already a week overdue for her medication injection and i hold WellCare of fidelis accountable for this.all this has been taking a tremendous amount of time and energy and we are left extremely frustrated.her member id is ********

  Business Response

  Date: 05/04/2025

  good morning, we have made several attempts to contact ******-Specialty Pharmacy Liaison at ************ to confirm because she is managing the patients order that was submitted. She has not responded. 

  Customer Answer

  Date: 05/05/2025

   
  Complaint: 23260944
  
  I am rejecting this response because:
  i myself have spoken to to pharmacy lisason today and she is back in her office. this means that wellcare has not reached out today at all. either way, there are plenty of other people in the pharmacy that are abble to help with such a matter, as i myself spoke to someone else  on friday even when ***** was not in. if they truly wanted to to help and cared enough that my daughter is now waiting fourteen days and counting for her medication, they'd put forth some other efforts to make this happen instead of letting lots of time pass as they wait for one individual woman in the the nyp pharmacy. the doctor herself is also willing to help and can be contacted as well as others. such a response is not appreciated. and also, ***** was in her office earlier in the week, so they had plenty of time to reach her before waiting all that time.
  Sincerely,
  
  ******** ****

  Business Response

  Date: 05/27/2025

   Multiple outreach attempts have been made to the pharmacy with no call back or response. Research has already been provided on how the pharmacy should proceed.  We are unable to further assist with any additional outreach to the pharmacy. 

• Initial Complaint

  Date:04/25/2025

  Type:Service or Repair Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  My mother was disenrolled from WellCare as of April 1, 2025. The first notice I had of her potential disenrollment was via letter dated 4/1/25 which I did not receive until after she had already been disenrolled. They claim to have sent one notice in February that she would be disenrolled if the bill was. not paid, but I did not receive the notice. I find it outrageous that only one notice is deemed sufficient prior to disenrollment and seek reinstatment. I am happy to pay the mere $177 that was overdue. I would rather work this out with them, but they have been very uncooporative and not forthcoming as to the procedure to challenge the disenrollment.

  Business Response

  Date: 04/29/2025

  Good afternoon, ********* *****,
  I hope this message finds you well. My name is *******, and Im following up regarding your recent complaint. Ive left a couple of messages for you, but I wanted to reach out by BBB as well.
  To continue researching your case, well need a bit more information from you. Please contact us at ************ and reference case number PRC-***** when you call.

  
  Thank you for your attention to this matter, and I look forward to speaking with you soon.

   

  *******

• Initial Complaint

  Date:04/07/2025

  Type:Customer Service Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  It is for my prescriptions and I was told you did t have to reapply unless you changed anything. Nothing was changed on my end but when I went to get my meds filled they said it was canceled. I called them on march7 and was told I had to reapply. I did and the sent me confirmation and said we would receive my new care in 5-7 days. Nothing came so we called again. Literally after 2 hours on the phone I was told I cant be covered until January 2026 and cant apply with anyone else. What am I supposed to do to get my prescriptions and he said Goodluck. Please help

  Business Response

  Date: 04/08/2025

  Thank you for bringing this matter to our attention. We appreciate you sharing your experience with us. We are sorry to hear that you had a negative experience, and we understand your frustration. We have reviewed your complaint and determined that your coverage was terminated at the request of ************. I made outreach to you via phone and email to provide you with this information. Please contact CMS ******** at 800-******** *************) to inquire why they requested your coverage to be terminated with WellCare. Please be advised CMS ******** governs your ******** coverage.
  
  Thank you,
  **** D