Business Profile

HMOs

WellCare Health Plans, Inc.

This business is NOT BBB Accredited.

Find BBB Accredited Businesses in HMOs.

Complaints

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

Customer Complaints Summary

376 total complaints in the last 3 years.
103 complaints closed in the last 12 months.

If you've experienced an issue

Submit a Complaint

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:03/08/2024
Type:Order 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 father, ***********************, had a lapse in payment in the fall of 2022 due to a hospitalization. Upon his release from the hospital, he contacted WellCare to be reinstated. They agreed to reinstate him. He paid in full, including a late fee, and has paid the premiums for ******** February, and March of 2024.Numerous calls have been made to WellCare by my father and myself, and the replies have always been "in 3 days someone will call you back", or "it will be resolved". Today a "supervisor" named ******* tried to tell me that the money has not been paid. We have bank record which indicate otherwise. I told "*******" that this is not true, and that I wanted her supervisor. Now she is "checking again".
Business Response
Date: 03/13/2024
Dear *************************,
Thank you for bringing this matter to our attention. We are sorry for any inconvenience that you have experienced. A refund was issued to your father to address we gave on file, If you have any further questions or concerns, please do not hesitate to contact us.
Sincerely,
**** D
Initial Complaint
Date:03/07/2024
Type:Product Issues
Status:
UnresolvedMore 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 ************************* had cataract surgery on December 8th and December 15th, 2023.Before having surgery I contacted Wellcare and was assisted by an agent with the set-up for the surgery. The agent gave me the information for the eye doctor and hospital. She advised me that they were in my plan's network. I also received approval from Wellcare before attending the doctor's ******* I was satisfied that the information was correct and I would only be out of only my CO-PAY amounts for the services.After the services were complete I paid my co-pay of $250. Then, I received an enormous bill for $644.40 on January4, 2024 for the hospital and $30.00 for an office visit, in which I satisfied my $20 Co-Pay for that visit too. I contacted Wellcare and advised them of this balance dues.The agent checked and advised me that Wellcare made a mistake and coded this as an Out of ******* hospital. I advised the agent that Wellcare set this whole thing up and approved it as In-******* before I went to the doctor and scheduled the surgery for this hospital. (Also, this hospital was miles and miles away from my home) but I accepted it from Wellcare's agent because I did not want any financial issues.After the Wellcare agent looked into this she said that it was a mistake and they will send the hospital the correct code for IN-******* and that would eliminate the balance due. This was on January 4, 2024 and the balance has not been satisfied or removed. I contacted Wellcare multiple times and was advised it would take ***** business days and nothing has been done.I have names, dates and Ref#'s for my calls if you need them. I did not want to write a book regarding this matter, but I will supply them if needed.I would like the $644.40 and $30.00 balance dues satisfied or removed by Wellcare.****** WrightWellcare Member ID# ********
Business Response
Date: 04/03/2024
Hello. We apologize for the dissatisfaction that you experienced. The plan has made contact with the member/complainant and have escalated the issues. We are currently working on the complainants billing issues.
Customer Answer
Date: 07/03/2024

Complaint: 21400520

I am rejecting this response because: I ************************* had cataract surgery on December 8thand December 15th, 2023. Before having surgery I contacted Wellcare and was assisted by an agent with the set-up for the surgery. The agent gave me theinformation for the eye doctor and hospital. ********** me that they were in my plan's network. I also received approval from Wellcare before attending thedoctor's office. I was satisfied that the information was correct and I would only be out of only my CO-PAYamounts for the services. After the services were complete I paid my co-pay of $250. Then, I received an enormous bill for $644.40 on January 4, 2024 from the hospital I contacted Wellcare and advised them of this balance dues. The agent checked and advised me that Wellcare made a mistake and coded this as an Out of Network hospital.I advised the agent that Wellcare set this whole thing up and approved it as In-Network before I went to thedoctor and scheduled the surgery for this hospital.(Also, this hospital was miles and miles away from myhome) but I accepted it from Wellcare's agent becauseI did not want any financial issues. After the Wellcareagent looked into this she said that it was a mistakeand they will send the hospital the correct code for IN-Network and that would eliminate the balance due.This was on January 4, 2024 and the balance has notbeen satisfied or removed. I contacted Wellcaremultiple times and was advised it would take 30-40business days and nothing has been done. I have names, dates and Ref# for my calls if you need them.I did not want to write a book regarding this matter, but I will supply them if needed.I would like the $644.40 balance due satisfied or removed byWellcare. I have been in contact with RomeoWellcare **************** over the past months he advised me a month ago that he resolved this matter with the hospital and the balance due is gone. I have now received a balance due from a collection agency. Please BBB HELP. ****** WrightWellcare Member ID#********

Sincerely,

*************************
Business Response
Date: 07/12/2024
Hello.We apologize for the dissatisfaction that you experienced. The plan has made contact with the member/complainant regarding their concerns, and we are currently working on getting this matter resolved.
Customer Answer
Date: 07/16/2024

Complaint: 21400520

I am rejecting this response because: I am receving telephone calls and statements from a third part debt collector regarding this issue. This has been 6 months of agony with Wellcare and I feel like they are taking advantage of seniors by continue telling me that this issue is being worked on.
I spoke to *****/Wellcare last week and he advised me that a BULK check was sent to Advent on May 1,2024 and that this payment on my account was included on that check. So why am I continuing to get harassed by a third party collector?
This on-going issue is affecting my health and well-being.
Why can't a health organization correct their mistakes in a timely matter?

Sincerely,

*************************
Business Response
Date: 07/18/2024
We made outreach your contact number on file on 7/17/24 and left a message for a return phone call to update you on your case. We will try again today to reach you.
Thank you,
**** D
Customer Answer
Date: 07/20/2024

Complaint: 21400520

I am rejecting this response because: I have not received a phone call from WellCare on 7/17/24. My telephone contact number is ************ if they wish to reach me via phone. My email address is: ********************** if they wish to reach me via email.

Sincerely,

*************************
Initial Complaint
Date:03/05/2024
Type:Sales and Advertising 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.
******** has assigned Wellcare as my prescription drug insurer. I have since been getting mailings (via postal mail) continuously to apply for "additional" benefits. These mailings were not asked for but Wellcare decided on their own to flood my mailbox with advertising spam mail. I have asked by telephone, messages sent on their website to STOP these postal mailings. Evidently Wellcare does not think that my option to opt out of these mailings is not important to them. I'm asking that Wellcare stop these mailings to my address, including mailings to resident, occupant or any other non-specific person. My personal info attached to this complaint DOES NOT give Wellcare permission to flood my email box or telephone me for their advertising.
Business Response
Date: 03/07/2024
Dear ************,
Thank you for bringing this matter to our attention. We are sorry for any inconvenience that you have experienced. We have removed your address from the mailing list for marketing.
If you have any further questions or concerns, please do not hesitate to contact us.
Sincerely,
**** D
Customer Answer
Date: 03/07/2024

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.
If I should receive further mailings I will make another complaint here and the Attorney General of the State of Florida for breach of your actions.

Sincerely,

***************
Initial Complaint
Date:03/05/2024
Type:Service or Repair 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.
The WellCare enrolled me automatically as of January 1, 2024 without my permission. And has charged me 2 times of *****. I have sent 2 disenrollment forms in by mail and was told I was disenrolled. But wasnt. I have faxed 1 disenrollment form in recently. Please help! Name is ALHetzler. Thanks.
Business Response
Date: 03/11/2024
Hello, the plan has been terminated as of 2/29/2024 and the billing has ceased. The premium that was paid via autopay has been returned and we apologize for any inconvenience this may have caused. If there's any further questions please don't hesitate to reach out to us.

Thank you.
Customer Answer
Date: 03/11/2024

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:03/05/2024
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.
NOvember 14th tooth extraction that should be covered by ta flex cared issued by Welcare but the card was declared invalid the first week of January even though they said it was good for 2023 expenses through March.
Business Response
Date: 03/18/2024
Good afternoon,
On 3/12/24 ************** supplied details for reimbursement for the cost paid to dental provider out of pocket and this is currently under review. The plan will reach out to ************** via phone and BBB (Better Business Bureau) once details are provided.
Thank you,
*******
Initial Complaint
Date:03/04/2024
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.
Per ticket #**********, WellCare Prescription Drug Plan wrongly canceled my Prescription Drug Plan even though I had a credit balance and will not either reinstate the plan, or make a new one, despite me having a credit (Wellcare owes me money) and I desperately need my heart medication or I could die.
Business Response
Date: 03/06/2024
Good afternoon, we confirmed the complaint on 03/06/2024, the member advised he wanted the BBB to resolve not the plan, i advised we review the BBB complaints and escalate and respond. The member advised he would send back to the BBB, I advised, it would just be sent to the plan..We forwarded the issue to our Billing department for review, they advised: The member last payment on this account was for $11.30 on 10/3/2023. The member did make a payment on 2/7/2024 for $30.40, however, CMS guidance does not permit reinstatement based on receipt of a payment after the end of the grace ******* The member was notified that payment was due 1/31/2024. No Plan Error found. Any credits or additional payments made on these termed accounts will be applied to any open invoices and any additional credits will be refunded. Coupon Book was sent on 12/21/2022. Member was included in the ***** PR campaign on 11/21/2023. PDZ019 sent 12/4/2023 payment of $11.30 due by 1/31/2024. ***** calls were made on 10/13/2023 and 11/13/2023. PDZ19A sent 1/10/2024 payment of $11.30 due by 1/31/2024. PDZ020 sent on 2/1/2024 notification of termination due to non-payment. No calls were made before termination. Member has a credit balance of $3.90. Refund of $3.90 has been submitted for member back to ACH# ****. Please allow 7 to 10 business days to receive funds back on account. thank you.
Customer Answer
Date: 03/06/2024

Complaint: 21284143

I am rejecting this response because: WellCare is completely wrong about everything they wrote there. They even canceled me when I had a $3.90 credit. Please have someone in charge (other than the person who called me from Wellcare) about this issue. WellCare are LIARS!

Sincerely,

*************************
Business Response
Date: 03/08/2024
Good morning, we forwarded the to our billing department for review, they advised: The member last payment on this account was for $11.30 on 10/3/2023. The member did make a payment on 2/7/2024 for $30.40, however, CMS guidance does not permit reinstatement based on receipt of a payment after the end of the grace ******* The member was notified that payment was due 1/31/2024. No Plan Error found. Any credits or additional payments made on these termed accounts will be applied to any open invoices and any additional credits will be refunded. Coupon Book was sent on 12/21/2022. Member was included in the ***** PR campaign on 11/21/2023. PDZ019 sent 12/4/2023 payment of $11.30 due by 1/31/2024. ***** calls were made on 10/13/2023 and 11/13/2023. PDZ19A sent 1/10/2024 payment of $11.30 due by 1/31/2024. PDZ020 sent on 2/1/2024 notification of termination due to non-payment. No calls were made before termination. Member has a credit balance of $3.90. Refund of $3.90 has been submitted for member back to ACH# ****. Please allow 7 to 10 business days to receive funds back on account. Thank you.
Initial Complaint
Date:03/04/2024
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.
2/24/2024, My Doctor has been trying to get a medication approved that she feels I need only to keep being turned down because they thing they know better than her. Say there is other options which all cost more than I can afford, due to the fact that they have put all the diabetes drugs that are newer in a Tier 6. I don't believe a Health insurance company has the right to dictate what I should take. Also when I call them it is very hard to understand the people on the phone.
Business Response
Date: 03/14/2024
Good morning, the complainant has been unable to be reached by telephone, and email to further assist.
Initial Complaint
Date:03/04/2024
Type:Product 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.
Wellcare continues to send me solicitations after I wote them, and asked them to stop.I've seen their product, and I don't like it.
Business Response
Date: 03/08/2024
Hello and Good Afternoon, We sincerely apologize for the inconvenience caused to you. ******************************* has been added to our Marketing Suppression List as of 3/6/2024, which will cease further marketing attempts. Thank you.
Customer Answer
Date: 03/08/2024

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:02/29/2024
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.
Politely ask that a member of you corporate offices team with in ******* that deals with customer escalated issues to contact me @ ************
Business Response
Date: 03/01/2024
Good afternoon,

The plan was able to contact the member, on 3/01/24. **************** refused to continue to discuss the complaint issue until his address was reflecting the correct address in our database and wanted it in writing confirmed it has been corrected, and then he will discuss his complaint issue. I am updating BBB (Better Business Bureau) that **************** account is reflecting the correct address in the WellCare system to move forward in resolving other issues.

Thank you,
Desiree
Customer Answer
Date: 03/06/2024

Complaint: 21366724

I am rejecting this response because:

Sincerely,

*********************
wellcare is wrong on the address
Customer Answer
Date: 03/07/2024
I keep calling them and either no one answered or they hang up or they have dogs and children in the background and very unprofessional I again ask for some on from the corporate offices contact me at ************
Business Response
Date: 03/08/2024
Good morning,
When reaching out the member on 3/07/24 member let me know that the city and state zip is still incorrect. Per Enrollment review this member was written with a Florida address on a Florida plan. The member also has a Florida address in CMS ****. If we change the address to ********, the member will term for Out of service area. If the member wants his address in ********, he will need to complete an enrollment for a plan in ********. The Plan will contact **************** on 3/08/24 to provide these details.

Thank you,
Initial Complaint
Date:02/27/2024
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.
Wellcare charged me over $15000.00 for medical bills that I was covered for. My lawyer paid this amount to Wellcare when I was already insured through ******** and ********* I would like to be reimbursed. Date of birth: 11-01-1974.
Business Response
Date: 03/05/2024
Dear *************************
Thank you for bringing this matter to our attention. We are sorry for any inconvenience that you have experienced. We have determined that your attorney did not submit a payment to WellCare in the amount of $15,000.00. After review and conversation with your attorney your lien will be satisfied based on the amount your attorney approved and agreed to. We ask that you please follow up with your attorney office for clarification on the settlement agreement that you received.
Sincerely,
**** D
Customer Answer
Date: 03/05/2024

Complaint: 21354510

I am rejecting this response because: I should have never been charged out of pocket for medical care. I contacted ******** and ******** and they both unformed me that I didn't owe any part due medical bills. Wellcare took it upon themselves to cheat me out of nearly $5000.00. I will argue this matter in court for a resolution. Thank you!

Sincerely,

*************************
Business Response
Date: 03/20/2024
Dear **************,
Thank you for bringing this matter to our attention. We are sorry for any inconvenience that you have experienced. This matter has been addressed with you and your attorney , please refer to your attorney to provide you with correct and update information. Your claims was paid based on how your Provider billed them, I would also suggest that you reach out to your Providers.
Sincerely,
**** D
Customer Answer
Date: 03/20/2024

Complaint: 21354510

I am rejecting this response because: I have consulted with ******************, which have been very helpful with adjusting these charges. I'm just the patient and should not have to research anything. My doctor has already informed me that he did nothing wrong and that he never wanted any involvement with my auto accident. He was already treating me prior to the accident for scoliosis *** lordosis to the spine. ******** and ******** are also looking into this claim with Wellcare and the Rawlings. I no longer have an attorney. The medical claims from Wellcare were never sent to me and perhaps were changed in the system to reflect an auto accident. My lawyer never reviewed these medical claims with me. This is why, I am not a member with Wellcare anymore. I'm still receiving medical bills from providers that were in network. I'm digging deeper in to this because, I have been cheated out of money from Wellcare and the Rawlings Company.

Sincerely,

*************************

BBB Business Profiles may not be reproduced for sales or promotional purposes.

BBB Business Profiles are provided solely to assist you in exercising your own best judgment. BBB asks third parties who publish complaints, reviews and/or responses on this website to affirm that the information provided is accurate. However, BBB does not verify the accuracy of information provided by third parties, and does not guarantee the accuracy of any information in Business Profiles.

When considering complaint information, please take into account the company's size and volume of transactions, and understand that the nature of complaints and a firm's responses to them are often more important than the number of complaints.

BBB Business Profiles generally cover a three-year reporting period, except for customer reviews. Customer reviews posted prior to July 5, 2024, will no longer be published when they reach three years from their submission date. Customer reviews posted on/after July 5, 2024, will be published indefinitely unless otherwise voluntarily retracted by the user who submitted the content, or BBB no longer believes the review is authentic. BBB Business Profiles are subject to change at any time. If you choose to do business with this company, please let them know that you checked their record with BBB.

As a matter of policy, BBB does not endorse any product, service or business. Businesses are under no obligation to seek BBB accreditation, and some businesses are not accredited because they have not sought BBB accreditation. BBB charges a fee for BBB Accreditation. This fee supports BBB's efforts to fulfill its mission of advancing marketplace trust.

Cookies on BBB.org

Complaints

Customer Complaints Summary

If you've experienced an issue

Filter and sort by

Sort by

Complaint status

Complaint type

Complaint statuses

Business Response

Complaint statuses

Business Response

Customer Answer

Business Response

Customer Answer

Business Response

Customer Answer

Complaint statuses

Business Response

Customer Answer

Complaint statuses

Business Response

Customer Answer

Complaint statuses

Business Response

Complaint statuses

Business Response

Customer Answer

Business Response

Complaint statuses

Business Response

Complaint statuses

Business Response

Customer Answer

Complaint statuses

Business Response

Customer Answer

Customer Answer

Business Response

Complaint statuses

Business Response

Customer Answer

Business Response

Customer Answer

WellCare Health Plans, Inc. is NOT a BBB Accredited Business.