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:09/08/2023

  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 is charging me $35 dollars for a 7.5 day supply of insulin. The new drug reduction act effective January 1, 2023 caps the cost of insulin at $35 per 30 day supply. Due to manufacturer packaging of my dosages, the pharmacy dispenses it in a **** day supply. Wellcare charges me $70. They are calculating the 7.5 day overage as 8 days and in addition they are charging me for a 30 day supply, rather than prorating the cost for 7.5 days.

  Business Response

  Date: 09/19/2023

  Hello and Good Afternoon, This matter was escalated to our Pharmacy team and it was determined the correct copay amount was applied. The Inflation Reduction Act ***** has a set structured copay that I have listed below, the set structured copay is determined in the Act and is not influenced by WellCare, therefore WellCare must follow the structured copay and cannot prorate days' supply for *** covered insulins. **** Day Supply = $35 Copay ***** Day Supply = $70 Copay ***** Day Supply = $105 Copay. Thank you.

• Initial Complaint

  Date:08/24/2023

  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.

  ******** being denied and constantly given fraud an-deceptive practicesand constantly been given the constant run around daily where it clearly states? On the back of the card it clearly states that a client can have there medicines delivered? And I am being forced to pick up my medicines at a cvs I never really cared to pick them up? Also please have my case sent to a worker that can read speak and comprehend english? I have felt with enough liers on and filing a complaint against this company? Even though I know that you will not persue or even take notice of my complaint? I am sure that ? I would? Like have my case thoroughly investigated and vigorously and seriously investigated? I would like to be updated on a progress report on the status of my case? And be honest with me you do not need to send me unproffessional tactics to not persue my case?

  Business Response

  Date: 09/07/2023

  Hello and Good Afternoon, We have made multiple outreach to **************** with no success. If he could please return our call to the phone number left in the voicemails it would be greatly appreciated. Thank you.

  Customer Answer

  Date: 09/07/2023

  I would like for them not to  abuse the mail privaledges they have to send unimportant mail? Also I would appreciate that they not send me no mail at all? And that this should long have been corrected from the  start? I do not care for them I tolerate them? The sad part about this company? They are trying to act like they are really a good company when they have taken me through? Alot of unneccessary changes that long could have been prevented? And I am not impressed with them at all? And for right know? I really dont care to say nothing good about them at no time? All the so called lies and deceptive unfair practices that I was told! By various untrue so called representatives and ESCALATION supervisors? Will not ever have me to say anything  ever good about them and there services,? I rate them an (F-) they will never get a good comment and never will get a good grade nor recommendation from me ever? And if they ever send me a survey it will be trashed and the attorney general of that state will be contacted for harrassement? This is just letting you know what this company took me through? Which was unnecessary? It did not have to happen this way? And know they are trying to correct it by having there ? ESCALATION  manager purposely hang ** in my face last Friday evening?
  
  Sincerely,
  
  ***************************

  Business Response

  Date: 09/15/2023

  Hello and Good Morning, We are happy to share we spoke with **************** yesterday 9/14/2023 and were able to conference call Mail Order to successfully end deliveries. **************** was please to reach resolution and understands he may contact me in the future if he needs any further assistance. Thank you.

• Initial Complaint

  Date:08/22/2023

  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.

  They couldn&#**;t find me an eye doctor or phone number of one I can get an appointment with and I waited 2-3 months for an eye doctor that they said I could go to only to find out they didn&#**;t take my insurance. They gave me 2-3 different phone numbers and they all did not take my insurance. I need to get an eye doctor that covers my insurance.

  Business Response

  Date: 08/28/2023

  Hello,
  The plan has made outreach to the complainant: ************************* and the vision vendor: Envolve Vision to locate her a provider. A provider was located:Retina Consultants at contact: ************ and location: **************************************************************** ************. The plan confirmed the provider is accepting the insurance via a phone call on 8/23/23 at 4:23pm EST/ 3:23pm CST where we spoke with *****. She transferred us to ***** to go over the earliest available date for the complainant to be seen and explained, they would need a diagnostic from the provider that advised her of the condition as they specialize in the back of the eye conditions, the retina. During that call, the availability was: ************* on 9/6 at 8:30am and ************ on 9/7 at 8:30am. In trying to update the member, the plan was unsuccessful. This issue has been closed on our end due to no response.
  Thank you.

• Initial Complaint

  Date:08/17/2023

  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.

  ABSOLUTELY NO CONTACT FROM WELLCARE ABOUT THESE ISSUES.I AM MY MOTHERS POWER OF ATTORNEY FOR EVERYTHING. I SENT TO CENTENE ON 7/5/23' A COPY OF THE *** THAT THEY REQUESTED, SIGNED BY MY MOTHER.MY MOTHER HAS DEMENTIA AND ALSO HAS AN IILEOSTOMY SINCE SHE WAS 16, SHE IS 78 YRS OLD NOW. My mother has been in our local hospital for one month and WellCare does not call me, they call my moms house (she is in the hospital), they should know this as they are her insurance and can see the paperwork from the hospital. I have filed grievance after grievance. Never been resolved. I am my mothers only child and I am trying desperately to help her. To get her insurance to assign a case manager to help me has never happened, I've been asking and asking. I call every single day to talk to a different person each day and they say they are

  Business Response

  Date: 09/07/2023

  Good morning, 

    This case has been reviewed, contact was made with the complainant who we have advised she is now in the system labeled as the *** for the member. Case management was able to coordinate and approve the Single Case Agreement that was requested for the member, communication was done via email with the complainant. The complainant has requested a case manager but it has been determined the member was unable to have a case manager assigned due to the member being inpatient. Case Managers are assigned after facility discharges, The situation was managed by our vendor Carecentrix. We apologize for the inconvenience and your dissatisfaction, please let us know if there is anything else we can do to assist. 

  Thank you 

  Business Response

  Date: 09/12/2023

  Good afternoon,

     This case has been reviewed, The complainant has been made aware she is now listed as the *** on file as of 8/18/23. The *** has been approved and the complainant was emailed to notify her the member was able to be transferred to the rehabilitation center. The member was unable to have a case manager assigned due to the member being inpatient.  Case Managers are assigned after facility discharges, The situation was managed by our vendor, Care Centrix who emailed the resolution to the complainant. 

  Thank you

• Initial Complaint

  Date:08/16/2023

  Type:Billing 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 am a surgical ****** with a small business practice that has been calling since January of 2023 in regards to the over 50 outstanding claims. I have several different denial reasons and everytime I call I am told ***** days and still no calls from provider relations to help assist with the incorrectly denied claims. Reference numbers:2599229413 ********** ********** ********** ********** ********** ********** ********** ********** ********** ********** **********

  Business Response

  Date: 08/31/2023

  Good afternoon, 

   This case is currently under review, we have been in contact with the provider via email and have escalated this issue to our provider relation team for further assistance.

   

  Thank you 

  Customer Answer

  Date: 08/31/2023

   
  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:08/16/2023

  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.

  Not comfortable about giving my account number. If you need it and speak to you I will give it.This has been an on going complaint with Wellcare for my Rx. plan.They want me to pay for services in advance. The payment date is the 20th of each month which I do, but I have received letters stating that if I don't pay a month in advance they will cancel me. I CONSIDER THIS SERVICES NOT RENDERED. I have spoken to Davante 7/17/23, ticket #**********; Amini Ref #**********; Nailah Ref #********** ..With this call I paid my premium for ************* of $142.60, so I was all paid in advance since I paid both months at the same time. This was done as they had sent me a letter telling me they would cancel me otherwise. I don't think what they are doing is ethical and I shouldn't have to pay them for services a month in advance. Since I am now paid through all of *************, according to the payment coupon I have from them, my next payment is not due until September 20th. They should not be contacting me looking for payment prior to this date. The people I have been speaking with have all been in customer service. They said they would have billing contact me, but that has never happened at this point. I just want to make sure they stop harassing me for payments before the actual due date.

  Business Response

  Date: 08/31/2023

  Good morning,

   This case has been reviewed, call review confirmed agents had advised the member multiple times incorrectly about payment due. Billing team has determined In June, the payment was delayed and received after the billing cycle timeframe. The payment was applied to the past due invoice for June 20th, 2023, due to the double payment made on July 24th,The next payment due will be on 9/20/2023. The members account is currently in good standing we have been unable to contact the member 3 attempts have been made via phone call, email has been sent and a letter mailed to the member regarding the case. 

  Thank you 

• Initial Complaint

  Date:08/14/2023

  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.

  They called me up wondering if I would be interested in a $100 gift card , ok what's the catch , they send an in home nurse for an evaluation , ok , when will I get the card , 2 , 3 weeks , asked the so called nurse that needs her license pulled and sued , she also said 2. 3 weeks, 2 months goes bye nothing I call them up they said 90 days , then we'll over 90 days they said we will mail it on October maybe , such a scam , so many liers work for this company , I had just gotten out of the hospital 2 days earlier with every test done to man kind , the wellcare nurse said I had Ling cancer , a big lie , said I would eventually lose my legs from poor circulation , another lie these people should be shut down

  Business Response

  Date: 08/29/2023

  Good morning, per *** the gift card was delivered: Monday Morning 08/28/2023. 
  
  

• Initial Complaint

  Date:08/09/2023

  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.

  When I was "sold" my ****************** with Wellcare, I was told I would have a $750.00 "Flex Card," which I could use for Vision, Dental or Hearing. Neither of the agents with whom I spoke explained it was distributed by Wellcare among the three options, and I believed I could use it as needed. My hearing is fine as are my teeth; however, this is the year I was getting new glasses. When I went to my optometrist, and they attempted to run my flex card, I found out the limit for vision was $250.00. I spent one hour twenty minutes on the phone with numerous Wellcare agents, being transferred numerous times with no one willing to transfer funds from hearing or dental to vision. Today, I sent an email to *****************************, Wellcare CEO explaining my problem. I paid $526.75 of my own funds for my glasses. After this year, I will never use nor recommend Wellcare to anyone. Each week, I receive number mailings from them. Perhaps they could uses that money to assist their customers. I don't know if you can help or not, but I thought I would give you a try. If so, you have my undying thanks. ************************** (I can send you a copy of my letter to their CEO if requested)

  Business Response

  Date: 08/23/2023

  Good afternoon, 

    We apologize for your inconvenience and dissatisfaction with the plan. This case has been reviewed we have confirmed error on the vendor agent during enrollment per call review. The member purchased glasses on 8/1/2023 after being advised by Vision provider the flex card was showing $250.00 available. The member contacted WellCare the same day and was advised he was unable to transfer remaining funds from hearing and dental benefit, the member paid the remaining balance of $526.75 OOP. There is no plan error as $250.00 is the correct amount the flex card covers for vision. The post enrollment Materials were mailed on December 14, 2022, explaining the benefits and costs for the plan year 2023.

   

  Thank you

  Customer Answer

  Date: 08/23/2023

   
  Complaint: 20441455
  
  I am rejecting this response because: Originally, after receiving your letter or email, I received a call from ******* representing the Executive Response Team.  I explained everything to ******** and he assured me he would research the problem and get back to me.  After one week, I tried calling the Executive Response Team, only to get a recording.  I left two messages and actually was on hold the third time for over 30 minutes with no on answering the phone.  No one returned my call.  After two weeks, someone actually answered the phone.  It was answered with a **** "Hello."  I had to ask if I had reached Wellcare and ask for the person's name. It was "****," and he transferred me to ******* who says, he was just going to call me.  ***** informed me I had indeed been repeatedly misled by their representative(s), and they were going to institute training for everyone involved.  Unfortunately, they would make no exception even though I had been given incorrect or misleading information.  After all, they had indeed mailed me a massive book once I enrolled, and I failed to read it thoroughly since I had already been told what I could expect when I enrolled.  Therefore, it was my fault, and they would/could/chose to do absolutely nothing to help me.  I have sent two emails to their CEO, and I plan on sending a third.  As it turns out, they have only six agents on the Executive Response Team, and, I can assure you they are incompetent to be dealing with the public.  I waited for two weeks to actually reach someone again.  My messages were ignored, and they were unwilling to make any exceptions even when they had given me incorrect information.

  Thank you for your concern and involvement. 
  
  Sincerely,
  
  ***********************

  Business Response

  Date: 08/24/2023

  Good afternoon, 

   This case has been reviewed, the member has been advised we are unable to transfer benefits from dental or hearing from the flexcard. The member is not eligible for a refund as he was made aware at the dentist office the *** benefit that was being allowed was $250.00, the member contacted WellCare before purchasing the glasses and was informed of the *** benefit again. Error was found on the agent for not informing the member of the $250.00 *** benefit for vision during enrollment. The member confirmed he received the **** that was sent to him on December 14, 2022, explaining his benefits and costs for the plan year 2023. An **** is also mailed prior to the start of the Centers for ******** and ******** Services' (CMS) Annual Election Period so that he can make any necessary plan changes. We apologize for your dissatisfaction and have made note that you have sent multiple letters to the executive office regarding this issue. 

   

  Thank you 

  Customer Answer

  Date: 08/24/2023

   
  Complaint: 20441455
  
  I am rejecting this response because:
  They actually admitted to me I had been misled when I originally signed up for their plan.  They also admitted I had repeatedly been incorrectly informed when I called back on the day I actually ordered and purchased my glasses and gave no explanation as for why I had to spend over one hour twenty minutes on the phone while being transferred multiple times.  Their resolution was to increase training for the public contact personnel.  It is obvious to me their concern isn't for their customers.  Rather their concern is for the "mighty dollar."  I expect nothing from Wellcare, but I have learned a great lesson.  

  Thank you,at the ************ Better Business Bureau, for you follow through.  Without you, I doubt I would have ever spoken with their so-called "Executive Response Team."  
  Sincerely,
  
  ***********************

• Initial Complaint

  Date:08/08/2023

  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/Medicare will not disenroll me for there health plan

  Business Response

  Date: 08/22/2023

  Good afternoon, 

   This case has been reviewed, the member did not have a valid election period for disenrollment per our enrollment team. Contact was made with the complainant who is not the member and would need to have the member submit a disenrollment letter. Outreach has been made to the member to convey the resolution.

   

  Thank you 

• Initial Complaint

  Date:08/04/2023

  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.

  This company is harassing not only me but other people by calling all the time and non stop. I feel bad for the others and myself having to deal with calls about you need to do this we said so.This company has been told by myself to stop the harassment on calling. I signed a piece of paper by them stating not to contact me by phone because of their behavior on harassment. If they are to contact me it will be by mail only. I have also contacted Social security about this and my Governor

  Business Response

  Date: 08/16/2023

  ****************** desired resolution is no further contact by the business - We will not be making outreach to prevent further abrasion. Thank you.