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.

  PO Box 22348 Tampa, FL 33622-2348

• 

  WellCare Health Plans, Inc.

  PO Box 31389 Tampa, FL 33631-3389

• 

  WellCare Health Plans, Inc.

  PO Box 31503 Tampa, FL 33631-3503

• 

  WellCare Health Plans, Inc.

  PO Box 31397 Tampa, FL 33631-3397

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:01/23/2024

  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.

  Wellcare should have zero ($0) payments for preferred generic meds at the preferred pharmacy as a part of the ******** Plan D (PDP) - Annual Notice Of Changes for ****, Page 4 (See Section 1.3 for details).In reality Wellcare charges 25% for meds instead of $0.It means that Wellcare incorrectly charges 25% co-pay to senior citizens on to increases their profits.I called ******** and was instructed to file a grievance with Wellcare and then if it is not resolved in 30 days, file a formal complaint with the ********. I contacted Wellcare on January 10th and filed a complaint #**********. On January 11 I talked with ****** from the Escalation Response Team. She understood the incorrect charging and escalated it to the Executive offices to be resolved in 24 hours, complaint #**********.I called The Escalation Team the next day was told that my #********** was deleted from the system (?!). Nothing was done.I spoke with ******* from Wellcare on January 12. By then I figured out that a 25% co-pay charge came from faulty programming. I even told her how to fix it. I worked in the Health Care industry developing and coding apps for 12 years. The error is in Stage 2. ******* understood the problem and how to fix it. She said that she will contact the **************** and get back to me. She did not leave a phone number and did not follow up with me.Meanwhile Wellcare continues to charge for preferred generic meds at preferred pharmacies. To sum it up:1. Wellcare knows about the unlawful charges which might affect many members and does nothing, continues to increase their profits at the expense of senior citizen members.2. My complaint #********** was deleted by Wellcare from the system. 4. No one followed up on my first complaint #********** of January 10th.5. Wellcare already charged for 4 medications this month, the latest was today.6. **************** at ********************** is useless, both in US and overseas - empty promises and complete incompetence.

  Business Response

  Date: 01/30/2024

  Dear  ***********************,
  Thank you for bringing this matter to our attention. We are sorry for any inconvenience that you have experienced. We were able to resolve your issues and/or concerns and give you feedback about your out of pocket questions. If you have any further questions or concerns, please do not hesitate to contact us.
  Sincerely,

   

  **** D

  Customer Answer

  Date: 01/31/2024

   
  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:01/19/2024

  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.

  Wellcare Pharmacy changed my ************** plan without my authorization. I went to the Pharmacy to pick up my medication, and after going back and forth, I was told my insurance had changed. This was around the 13th, ****. My previous insurance I have had since 2011. They are sending me through hoops and bounds to get my medication. I have signed back with the previous insurance, but have to wait for approval. I had to contact my Doctor for this particular medication to get a pre authorization sent over, then wait to see if Wellcare will approve it. Wellcare stated I can get 7 pills at thus time, but have to pay so much for it. (As you can see I am already having problems with this Pharmacy and Company. I pray someone will help me with this. CHANGING MY DRUG WITHOUT MY APPROVAL.

  Business Response

  Date: 02/05/2024

  Contact has been established with the member. We were able to assess the problem, and fix it accordingly. No further action was required by the member and we reached a satisfactory resolution. Member wanted to retract BBB complaint, I assured her I would answer in a timely fashion.

   

  Thank you.

  Customer Answer

  Date: 02/05/2024

   
  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:01/19/2024

  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.

  i am the executor of my late fathers estate.. he passed on August 1, 2023. Wellcare continued to draw the monthly premium for 3 months amounting in $225 of premium. i requested a refund and while requested the refund, i learned that wellcare had been overcharging him for a few years. they agreed refund an additional $282.50 to pay back the overcharges... to date, i have received only one check for $75. wellcare claims to have refunded the remaining outstanding funds but i have not received them by check or ACH to the originating account. i have made multiple contacts to their customer service ********************** but can not seem to reach anyone interested or capable of looking further into this matter.... i give up. i think these guys do this by design. can you help?

  Business Response

  Date: 02/02/2024

  Please be advised, plan sent check for $75.00 on November 22th, 2023 this check has already been cashed, please see attached image. Plan sent check for $75.00 on November 16th, 2023 this check was not cashed, we requested billing for check to be re-issue to third party. Billing responded: The third-party refund has been entered and sent for approval. Once approved, the third-party refund will be issued in the amount of $75.00. Please allow 21 days once approved for third party to receive check.

• Initial Complaint

  Date:01/18/2024

  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 member Id ********. While under prescribed meds. I mistakenly enrolled to WellCare. However, on January 2, ****. Before receiving their medical card, I contacted WellCare to be disenrolled and place back to my original healthcare provider. I spoke with ***** on Jan. 2, **** she informed me that I had to write a letter, with my member number and the reason I wanted to disenroll. I followed her instructions and fax the information immediately the same day. ***** informed me that it would take 10 business days for the process of disenrollment to be complete. That was a lie. ******************* supervisor stated that that information was wrong, it would actually take until Jan. 31st to be disenrolled. I informed them that would not work for me because I have a major procedure on Jan. 30, **** that could not be rescheduled, and I asked what else can I do to expedite this disenrollment, they said there was nothing that I could do but wait! They lied about that! After speaking with at least 12 reps and supervisors combined through this frustration I checked online and found that WellCare has a grievance **** and they expedite customers complaints. They lied to me over and over again. I made 25 telephones calls to WellCare on this matter! To no avail! Ive missed 2 other Dr. ************* I received a letter Jan. 17, **** stating that I will actually be disenrolled on February 5th instead of Jan. 31st. It seems that WellCare is trying to manipulate me into using their coverage! Even after I informed them that I do not want their coverage any longer! They could careless about my upcoming vascular procedure on January 30th. I have general anxiety disorders and this situation has triggered my anxiety on multiple occasions. I need help! Thank you.

  Business Response

  Date: 02/01/2024

  Good afternoon, 

    The member has verified the submission of her disenrollment letter and acknowledged the explanation regarding the disenrollment effective date at the month's end. Expressing gratitude for the call, the member conveyed that her concerns had already been resolved and no further assistance was required. Additionally, she declined to receive the ticket and or any further information.
  
  
  

  Business Response

  Date: 02/01/2024

  Good afternoon, 

    The member has verified the submission of her disenrollment letter and acknowledged the explanation regarding the disenrollment effective date at the month's end. Expressing gratitude for the call, the member conveyed that her concerns had already been resolved and no further assistance was required. Additionally, she declined to receive the ticket and or any further information.
  
  
  

• Initial Complaint

  Date:01/18/2024

  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.

  because of company changes ,employees were forced to go on ***** care or ********* since Jan .1 , **** , I had to go on Wellcare value script ,I have called 6 times , every 2 weeks to get my persciption card. I have told them to correct my address , they had , W332S7670 as my address.the correct address is W332S7670 ************* , I just called today and they still had it wrong.I am on 11 pills a day and am running out.getting very frustrated trying to work with people that don't do there job.

  Customer Answer

  Date: 01/31/2024

   
  Better Business Bureau:
  
  
  Finally after 6 calls and ******************************************** 2 weeks , it finally showed up on1-30-24 
  
  ***********************

• Initial Complaint

  Date:01/18/2024

  Type:Sales and Advertising 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 was enrolled by ********* I called last month wellcare. I exsplained that i had humana and i wanted to keep that plan. I also contacted humana. I was told to call welcare and cancel coverage. I then called humana back. I ended up with no perscription coverage. Ive spent 3 days on the phone with ********* wellcare and humana. I had to re apply and lost coverage for a month plus paid full price for my medication. I fel that we should not have coverage changed without a call. Today i was assured my humana would start in feb. T aslo had to sign up online. Again contaced *********. Thinking all was well. Then i get a letter from wellcare this afternoon saying my coverage would change back to them on 3/1/2024. I do not give my permission for this. Would they like to cover my time and money? If my insurance is changed again do i get a lawyer? Do i send a certified letter? Because i just spoke to Social security today and they stated i had humana which ive had since 2007 Attached 2 letters from wellcare. I do not want your plan. I went a month with no coverage because you switched me. I dont even have my new humana cards yet and your doing it again. STOP Furthermore there is no email address or online chat as your website states. False advertising?

  Business Response

  Date: 01/23/2024

  Hello, 

   

  We have contacted the member and addressed her concerns. She was auto-disenrolled and placed under the Wellcare plan. This has been mitigated and she has been placed back with her rightful insurance. The wellcare plan is no longer in effect and have reached a satisfactory resolution. We apologize for any inconvenience.

   

   

  Thank you.

• Initial Complaint

  Date:01/18/2024

  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 a member of wellcare prescription plan. I applied for this plan in December 2023 for plan to commence on January 1 2024.I have since then tried 10 times to log on the website without success.I have contacted customer service at least 5 times.I was told that it was a technical problem and some one will call back in few days. I have been given this answer 3 times and no one has called back.Customer service group says that this problem is technical in nature and they can not do anything.

  Business Response

  Date: 01/31/2024

  Dear ************,
  Thank you for bringing this matter to our attention. We are sorry for any inconvenience that you have experienced. Our web support department was able to correct the issues you were having with your member portal and we verified that you were able to log on and have access. If you have any further questions or concerns, please do not hesitate to contact us.
  Sincerely,

  **** D

  Customer Answer

  Date: 01/31/2024

   
  Complaint: 21158947
  
  I am rejecting this response because:

  While the log in problem is now solved, the problem remains with following:

  1. System does not report history of the medication taken and paid for.

  2. Pricing of the medications is not clear 

  And finally and most important for the company to know is following

  1. None of the technical people ever contact the customer directly

  2. ************** agents do not have training to understand operating system whether it is Mac or *** or apple IOS. web browser and apps etc. 

  3. I took 8 calls and many tries to explain to the member service agents the settings.

  4. ************** group is trying very hard to be courteous but they do not have proper training or access to department that can solve the problem in terms of log in problem or access to pharmacists on real time.

  I hope problem is some what resolved in that I can log in but to check the history and future prices remain unresolved.

  It seems company does not seem to have a plan to address the serious deficiencies which requires escalations.

  
  
  Sincerely,
  
  ***********************

  Business Response

  Date: 02/06/2024

  Dear ************,
  Thank you for bringing this matter to our attention. We are sorry for any inconvenience that you have experienced. We apologize for the miscommunication in retrospect to your member portal. Your access was corrected with the assistance of web support  , pricing on the member portal are only estimates and out pocket will depend on the member plan, and I made web support aware of your concerns to make the member web portal more user friendly.  If you have any further questions or concerns, please do not hesitate to contact us.
  Sincerely,

  **** D

• Initial Complaint

  Date:01/17/2024

  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.

  Company not delivering online access or competent phone support to get prescriptions. we have tried for over a week to get online access and we cannot log in. we cannot get anyone to help straighten this out and be sure our prescriptions are ordered before we run out. It is very dangerous to run out of some medications.

  Business Response

  Date: 01/30/2024

  Contact has been established with the member and complainant and we have successfully resolved the issue. Wellcare apologizes for any inconvenience on the matter. 

   

  Thank you.

  Customer Answer

  Date: 02/01/2024

   
  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.  

  They contacted me right away and were diligent in following up until it was resolved. 
  
  Sincerely,
  
  *************************

• Initial Complaint

  Date:01/16/2024

  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 began membership w/ Wellcare on 1/1/24. Since that time I have NEVER been able to log in to their member portal - NEVER. It actually accepts my ID/PW, but then freezes after I enter the validation code they send by email. I've tried with three different browsers with all extensions turned off. All do the same thing - nothing. I have contacted Wellcare via email and over the phone. The "customer support agents," all three of them, were unable or unwilling to get me access to the wellcare.com portal.I want them to FIX THEIR WEBSITE.

  Business Response

  Date: 01/30/2024

  Good afternoon,

    This case has been reviewed,the member initially declined to collaborate with the investigation during the initial contact. The complainant expressed a desire for me not to initiate a return call, and the member refused to undergo HIPAA verification for their account. Subsequent escalation to the web support team proved unsuccessful, as the member did not respond to phone calls.. Consequently, the root cause of the issue remains undetermined, and it is uncertain whether the problem can be resolved due to the unavailability of additional information.

   

  Thank you 

   

  
  

  Customer Answer

  Date: 01/30/2024

   
  Complaint: 21150646
  
  I am rejecting this response because:

  "This case has been reviewed,the member initially declined to collaborate with the investigation during the initial contact. The complainant expressed a desire for me not to initiate a return call, and the member refused to undergo HIPAA verification for their account."

  Simply wrong.  Their website was not working and they knew it. This was a 1.5 HOUR call which produced nothing.  HIPAA:  Are they refering to the 4th or 5th time during the call that I authenticated with the SAME INFORMATION EACH TIME?  Passing members around to different agents whose job it is to buffer and obfuscate the problem, while requiring the same info from the participant OVER AND OVER is a time-honored way of denying help/service to customers.  Wellcare has taken this tactic to the next level.  I have evidence to this effect - I recorded the call and can produce the recording if necessary.

  "Subsequent escalation to the web support team proved unsuccessful, as the member did not respond to phone calls."

  Funny, my phone was on me each time Wellcare left a message.  I never even got a ring.  I checked to see if my phone was having problems by calling it via a landline, my wife's phone, and through a web app.  ALL caused my phone to ring.  This is also a tactic used by scurrilous business to drop voicemails without actually calling the number:
  ******************************************************************************************************************************************************************************************************************************.
  ********************************************************************************

  These tactics demonstrate the lengths that Wellcare will go to in order to deny service to their customers.

  
  Sincerely,
  
  *********************

  Business Response

  Date: 02/01/2024

  Hello, 

   The member declined cooperation during the initial contact with the executive response team on January 17, ****, at 4:44 PM. The complainant explicitly expressed a refusal to receive a callback from me and declined HIPAA verification for the account. Subsequent escalation to the web support team proved unsuccessful, as the member remained unresponsive, not answering calls. Consequently, the root cause of the issue could not be determined, and it remains unclear what is causing the problem due to the unavailability of additional information. I have requested for the web support team to make another attempt, if websupport is unsuccessful the member must call in to have the issue addressed. 

  Thank you

  Customer Answer

  Date: 02/01/2024

   
  Complaint: 21150646
  
  I am rejecting this response because:  This was simply an IT website issue.  No "verification" should be needed.  They simply needed to FIX THEIR WEBSITE.  No HIPAA compliance necessary to fix your IT infrastructure.  They finally fixed it after THREE WEEKS.
  
  Sincerely,
  
  *********************

• Initial Complaint

  Date:01/16/2024

  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.

  To use this service you must be able to use their website. It is impossible to sign on. I know people who work there who say this is not an accident but rather a planned strategy to deny claims

  Business Response

  Date: 01/26/2024

  Hello. We apologize for the dissatisfaction that you experienced. The plan has made contact with the member/ complainant regarding their concern and escalation to our web support team confirmed that the issues has been resolved. No further action necessary.