Business Profile

HMOs

WellCare Health Plans, Inc.

This business is NOT BBB Accredited.

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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.

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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:02/12/2024
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.
Jan, 2024. I signed up with Wellcare Plan * ******** this year. The cost for my prescription is very WRONG! $320 for a month supply. Tier 2. I Kept trying to call Wellcare and CVS told me Wellcare disconnects a lot and puts on hold 1.5 hours. Then Wellcare charged $32.for the medication. In their book, it states the medication is $5. Hard to reach them. *isconnected constantly. Hard to understand foreign languages from them. Nothing is solved! I feel this company is a scam! I read reviews now and see the very same issues occur from 95% of the customers!
Business Response
Date: 02/26/2024
Good morning, we were unable to reach the complainant by phone as well as by email. We are requesting the member ID to assist, thank you.
Initial Complaint
Date:02/12/2024
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.
FAILURE TO FILL PRESCRIPTIONS SENT BY MY DOCTORS
Business Response
Date: 02/15/2024
Dear ********************,
I am so sorry to hear that your experience with our company has not met your expectations.
Customer satisfaction is our top priority, and I am truly sorry that wasn't demonstrated to you. We have tried to address your concerns , but unable to get additional information for you.
Please let us know if you have any additional questions, concerns, or comments, or if we may be of assistance at any point in the future.
Best,
**** D
Customer Answer
Date: 02/15/2024

Complaint: 21274427

I am rejecting this response because:
My doctor has ordered the following prescriptions as specified below:
lisinopriL 40 mg tablet

Commonly known as: Zestril
Learn more
TAKE 1 TABLET DAILY
Prescription Details
PrescribedFebruary 14, 2024
Approved byG *******
Refill Details
Quantity90 tablets
Pharmacy Details
*************** HOME DELIVERY - *********, ** - *********************************************
****************************************************************************
************
Map
Request refillRemove
naproxen 500 mg tablet

Commonly known as: NAPROSYN
Learn more
TAKE 1 TABLET TWICE A DAY IF NEEDED FOR MILD PAIN (1-3 ON PAIN SCALE) with food prn pain
Prescription Details
PrescribedFebruary 14, 2024
Approved byG *******
Refill Details
Quantity270 tablets
Pharmacy Details
*************** HOME DELIVERY - *********, ** - *********************************************
****************************************************************************
************
Map
Request refillRemove
atenoloL 100 mg tablet

Commonly known as: TENORMIN
Learn more
Take 1 tablet (100 mg total) by mouth 1 (one) time each day.
Prescription Details
PrescribedFebruary 14, 2024
Approved byG *******
Refill Details
Quantity90 tablets
Day supply90
Pharmacy Details
*************** HOME DELIVERY - *********, ** - *********************************************
****************************************************************************
************
Map
Request refillRemove
tamsulosin 0.4 mg capsule

Commonly known as: FLOMAX
Learn more
TAKE 1 CAPSULE DAILY
Prescription Details
PrescribedFebruary 14, 2024
Approved byG *******
Refill Details
Quantity90 capsules
Pharmacy Details
*************** HOME DELIVERY - *********, ** - *********************************************
****************************************************************************
************
Map
Request refillRemove
finasteride 5 mg tablet

Commonly known as: PROSCAR
Learn more
Take 1 tablet (5 mg total) by mouth 1 (one) time each day.
Prescription Details
PrescribedFebruary 14, 2024
Approved byG *******
Refill Details
Quantity90 tablets
Day supply90
Pharmacy Details
*************** HOME DELIVERY - *********, ** - *********************************************
****************************************************************************
************
Map
Request refillRemove
levothyroxine 125 mcg tablet

Commonly known as: Synthroid
Learn more
Take 1 tablet (125 mcg total) by mouth 1 (one) time each day.
Prescription Details
PrescribedFebruary 14, 2024
Approved byG *******
Refill Details
Quantity90 tablets
Day supply90
Pharmacy Details
*************** HOME DELIVERY - *********, ** - *********************************************
****************************************************************************
************
Map
Request refillRemove

Thus far, Wellcare and Express Scripts refuse to fill these prescriptions.

Sincerely,

*****************************
Business Response
Date: 03/01/2024
Dear ********************,
I am so sorry to hear that your experience with our company has not met your expectations. We have provided you with several resolutions to your complaint as well as reached out to Express Scripts and your Provider offices.
Customer Answer
Date: 03/01/2024

Complaint: 21274427

I am rejecting this response because:
No effort whatsoever has been made to resolve my complaint. I have not received my prescriptions and Wellcare so far has given me nothing but the runaround. I believe Wellcare is engaged in blatant ******** fraud by taking my monthly premiums for this Part D plan, but not providing the prescriptions I am ***********, according to their formulary. Wellcare via Express Scripts has received my doctor's prescriptions, but refuses to fill them. Until the prescriptions are filled and I have received them, THIS COMPLAINT HAS NOT BEEN RESOLVED, and will NEVER BE RESOLVED.

Sincerely,

*****************************
Initial Complaint
Date:02/02/2024
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.
I could not stop unnecessary payments to Wellcare and cancel the Prescription Drug Plan. I sent letters to WellCare 3 times and called several times without any results. I have the drug coverage now from my employer.
Business Response
Date: 02/13/2024
Dear **************,
Thank you for bringing this matter to our attention. We are sorry for any inconvenience that you have experienced. We have submitted your disenrollment and this information was relayed to you via email. If you have any further questions or concerns, please do not hesitate to contact us.
Sincerely,
**** D
Initial Complaint
Date:02/01/2024
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.
On 11 30 2023 I filled for prescription drug coverage with WellCare. The phone interveiw asked if I had previous prescription coverage and I told them yes and added that it was an Anthem plan threw my employer. I was offed the WellCare plane at $8.50 permonth.Well care sent letter to me that I did not have coverage for the prescribed time. I provided ********** accounnt number and also a document from anthem proving I had coverage.WellCare sent a letter saying I would not have a penalty and my premeum would be $8.50.Now I receive letters from well care saying I didnt have coverage for the prescrided period and I will in deed have a penalty and my rate will be $34.00.MY complaint is the WellCare is ignoring my documented proof and continues to ascert that I must be penalized. I need assistance dealing with WellCare Thank You ***********************
Business Response
Date: 02/20/2024
Hello.We apologize for the dissatisfaction that you experienced. The plan has made contact with the member/complainant regarding their enrollment concerns,and was provided resolution. No further action necessary.
Initial Complaint
Date:01/29/2024
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.
I have been a member with WellCARE in excess of 13 years. Until **** this company has taken well care of my medical and pharmacy needs. A prescription I have taken these past 14 years has a high copay and every year the doctor writes a "Tier Exception" for this medication and there has always been a zero copay after the approval of this exception. I went to pick up the medication on 1/2/2**** and the copay was $31.03. Realizing the doctor did not write the exception, I called and within two days it was submitted and I received a letter stating that a "Formulary" was approved. Twenty six days later I went to pick up the medication and the copay is now $56.07. I contacted WellCARE Saturday, spent 1 1/2 hours on the phone with no resolution.Today, Monday, I contacted WellCARE three times, (21 minutes and got disconnected), (41 minutes and got disconnected), then (1 hour 55 minutes and 21 sec.). I found out that WellCare approved a "Formulary" and not the ***** Exception". End result, my issue is going to have to be escalated and I should be contacted within ********************************************************************* excess of $40.00. This is a necessary pain medication and I have been without for the past 3 days. I could purchase the medication at the higher price and submit a claim but I hesitate because of the response I am getting here. Besides the "Disability" I receive will require me to make a decision between groceries or the medication.
Business Response
Date: 01/30/2024
Dear Mr. **** ,
Thank you for bringing this matter to our attention. We are sorry for any inconvenience that you have experienced. We were able to provide resolution to you and address your concerns. If you have any further questions or concerns, please do not hesitate to contact us.
Sincerely,
**** D
Initial Complaint
Date:01/29/2024
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.
Wellcare just terminated my coverage because of an error right in the middle of chemo treatments for bladder cancer causing me great anxiety. Had to cancel last two chemo treatments and hope cancer doesn't recurr. Spent 5 hours on phone with them and even after admitting their mistake, they would not reinstate my insurance until the "grievance" department reviewed the mistake. I had to pay for my blood pressure medication out of pocket in the meantime and lost two chemo sessions.
Business Response
Date: 02/14/2024
Hello.We apologize for the dissatisfaction that you experienced. The plan has made contact with the member/complainant regarding their enrollment concerns and have educated them on the reimbursement process. No further action necessary.
Initial Complaint
Date:01/25/2024
Type:Order 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 signed up for WellCare this year for my ******** drug plan. They were supposed to take the premium out of my social security check.( which they did). But, in the mean time they sent me a bill. I called them and they said they werent going to start taking the premium out of my S.S. until Feb. so I paid the bill on line. Ive called them over 5 times, they keep telling me they didnt get my payment from S.S. yet so they wont give me a refund. I think they are just very dishonest. I will never sign up with them again and I will tell anyone who will listen how dishonest I think this company is!
Business Response
Date: 02/08/2024
Hello. We apologize for the dissatisfaction that you experienced. The member was provided resolution where she was advised she is to receive a refund by 2/14/24. The member understood and had no further concerns. No further action necessary.
Customer Answer
Date: 02/08/2024

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:01/25/2024
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.
I am unable to connect to Wellcare's web site to check on billing, providers, formulary, etc. I have contacted them by phone and in writing on multiple occasions to no avail. There people have tried to connect using my log in and they could not gain access either. They told me they escalated my case but that has gone nowhere. All they tell me is to call their standard Cust Svc number and they will resolve the issue but every time I do that it involves 30 minutes on hold waiting for an agent, then the agent fails to access the site using my log in credentials, they tell me they will escalate my case and then nothing happens. I have been through this drill a few times already. They did call me back once a couple of weeks ago but it was at 6:30 in the evening and I couldn't work with them at that time because I was out to dinner with my family. Since then I have fallen into a black hole with them and any contact I make goes unanswered. I also see on your web site that others have had the same complaint with them and had to come to you for help resolving the problem.
Business Response
Date: 02/08/2024
Through communication with our Executive team and Web Support, we have successfully resolved the issue. We apologize for any inconvenience.

Thank you!
Initial Complaint
Date:01/25/2024
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.
This is what i finally tried to send in a contact form. It does not work either. I have been left with no other option than this. They say its been escalated but that apparently is a worthless feel good offered by these customer service folks. I have made three attempts to log into my account and still cannot. And have made long drawn out calls with non English speakers to no avail. I get the same message and the same run around and someone is supposed to call me. Has never happened. It says my online account is already in use? There does not seem to be a problem getting billed or you getting paid but unsure whether I could actually use my benefits if I should need to. That is BS. I signed up early setup auto pay and get treated like I dont exist.My next call is to ******** and the BBB.Thank you for your time and consideration.
Business Response
Date: 02/08/2024
After attempting to reach out to the member via phone multiple times, I emailed offering assistance. I attempted to inform him that Wellcare is trying to make contact with our own systems. He then stated the issue has been resolved already. We apologize for any inconvenience beforehand.
Customer Answer
Date: 02/08/2024

Better Business Bureau: The business response is true. Unfortunately I do not feel that they have listened or taken any action to prevent this type of issue from continuing. They just stomped out the situation when confronted by in this case the only known available option. The BBB.
i want the BBB to how much I appreciate their efforts to resolve this matter.
Thank you

I have reviewed the response made by the business in reference to complaint ID ********.

Sincerely,

*************************
Initial Complaint
Date:01/25/2024
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.
I joined Wellcare Prescription Drug Plan and was told this was a zero $0 plan. After enrolling, I received paperwork saying I was being penalized for not having a prescription drug plan the previous year and would have a monthly penalization fee. I immediately called the company to handle the issue. Two different representatives assured me that I would not be charged or penalized. I then received a bill stating I would be charged the penalty fee each month. This company is criminal. I wish I would have read all the other reviews and complaints before joining. It's bad enough they don't cover any of my prescriptions, but now I will spend over a hundred dollars in bogus penalty fees this year, due to no fault of my own. I'm disabled and facing brain surgery, and the last thing I need is a crooked company costing me extra money for no reason.
Business Response
Date: 02/02/2024
We have contacted the member and explained the situation. We've provided the necessary information to rectify the issue and member has had satisfactory service from Wellcare's side. We apologize for any inconvenience.

Thank you.
Customer Answer
Date: 02/11/2024

Complaint: 21194366

I am rejecting this response because: it is currently still unresolved. They've sent paperwork which I have filled out, but their responses do not correlate with my situation. This matter remains unresolved and as of now, I am still charged fees I was told I would not be charged.

Sincerely,

***************************
Customer Answer
Date: 03/01/2024
I received the paperwork from Wellcare, filled it out, and faxed it to them the next day to ensure it wasn't lost in the mail. I have had zero correspondence from Wellcare after they received the fax with the filled out paperwork.
I am having brain surgery next Thursday March 7th, and do not know if I will be capable of responding to future messages in a timely manner. Thank you for your assistance.
Business Response
Date: 03/14/2024
Hello *******, I sincerely apologize this issue still persists, I will investigate further in hopes we can reach a resolution.
Business Response
Date: 03/20/2024
Hello, I have initiated a new presidential case for the matter. According to my research, the Late Enrollment Reconsideration team has not received the Reconsideration Form and believe she has faxed it to C2C Innovative Solutions. They do not have a sufficient **************** number, and I have also not had success contacting *************************** to explain the situation.
Customer Answer
Date: 03/20/2024

Complaint: 21194366

I am rejecting this response because:

I faxed the paperwork to the number provided on Feb 12, 2024. I called ******* for 2 days, and finally was able to reach him. Unfortunately, he had left the wrong number so the calls were not going through. It appears to be a runaround on Wellcare's part. I'm doing everything they ask, yet this remains unresolved. This is frustrating to deal with, as I just had major brain surgery and I am needing to rest.

Sincerely,

***************************
Customer Answer
Date: 03/20/2024
This is the paperwork that was faxed to #************, the number the company listed as the fax number on the paperwork. These 3 pages were faxed on 2/12/2024. Thank you.
Business Response
Date: 04/17/2024
As of right now, I have established further contact with *******, and worked with her to ensure the documents were correctly submitted. There was accepted and our LEP team will be able to reach a decision within 90 days. Thank you for your patience in this matter.
Customer Answer
Date: 04/18/2024

Complaint: 21194366

I am rejecting this response because:

It's just more run-around from the business. They say they will respond in 90 days, which takes us into July, and is 7 months of me paying their bogus fees. Additionally, their "making sure the documents were received" ... I sent the documents to the number listed on the documentation. The company waited weeks to respond, then tried to blame me that I sent it to the wrong place. There was only one number listed, and I sent it to that number. It's a lot of going in circles and smooth talk from the resolution representative, but no actual action to resolve. And now we wait another 90 days. In the meantime, they're not covering any of my medications, and this has been a lot of unnecessary stress and additional $$ spent, when I am trying to recover from brain surgery. Very disappointed and dissatisfied with ********* PDP.

Sincerely,

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

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