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:06/13/2023

  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.

  Member ID ******** I initially selected Wellcare because the I was informed this plan offered in-network and out-of-network medical and dental services.On 6/2/23 I received a Resolution Grievance from WellCare regarding dental reimbursement under WellCare Plan *** (1112-038-000) plan. At this time the dental vendor's name was disclosed with no contact information. The letter stated that we spoke with a dental representative yet this was never disclosed to us; it appears as if we were always speaking with a WellCare representative. I am upset and I am disputing this entire process:According to Wellcare, the *** policy (attached) does offer in-network coverage and no out-of-network coverage. However, when you go to the link to find dental providers based on the ***** zip code it takes us to the Pharmacy look-up (attached).As I explained to the representative on December 16, 2022 call, (after receiving the letter on 12/12/2022) my daughter and I previously contacted WellCare in November 2022 to discuss what dental coverage was available under this *** plan. We were told that the allowable was $1000.00 any amount above this would be my out-of-pocket expense. AT NO TIME WHERE WE INFORMED THAT THIS PLAN DID NOT HAVE OUT-OF-NETWORK DENTAL COVERAGE.This is the premise why we initiated a request for reimbursement. We were told at that call a Wellcare Rep would contact us in 3-4 wks and this never happened. This is what prompted the 4/17/23 fax from my daughter to WellCare. I find it awkward that the letter dated 6/2/23 did not mention our call speaking with a WellCare Representative, about dental and other co-pays, for services like mammogram and colosphy. Based on the fact that the initial WellCare representative informed me incorrectly as to dental coverage, and it was reaffirmed when my daughter and I phone to verify which is apparent because I initially request reimbursement I would like a refund based on Wellcare misinformation.

  Business Response

  Date: 06/27/2023

  After the dental vendor reviewed, they advised **************** did not utilize anything toward her $1,500 annual benefit maximum for 2022, she will be reimbursed $1,064. 

• Initial Complaint

  Date:06/08/2023

  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.

  January 2023 payment ** made and received may 5 a check was mailed *****. As of today no record of it nor did it clear my bank. Another check was mailed 5/24/2023 for *****due to WellCare harassing me over ***** and not willing to do something. The second check as of 6/8/2023 has not been posted. An investigation was asked to be done aster 12 hours they told me no response .a proper one would have take. A couple of days.they have not tried to fixed the problem.

  Business Response

  Date: 06/19/2023

  The member advised on 06/19/2023, the checks posted and cleared her bank

• Initial Complaint

  Date:06/08/2023

  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.

  We have been trying to submit a claim for a patient who was active at the time of service and the plan is stating the patient never had insurance with them. When the patient has an insurance card and ID# they're stating they don't know how the patient has a card number or member ID. Spoke with ************, asked to speak to supervisor multiple times rep refused to escalate the problem. When she finally has after about 10 attempts the supervisor never got on the line have been waiting on hold for ************************************************************************************************************************************************ if their application was never approved. Now this is becoming pt responsibility because they believed they were covered with and insurance company who apparently hands out ID's to any one. Finally got a supervisor name ***, but they are "unable to connect me with them". Wellcare Giveback HMO is the plan the patient has a card from their phone # is ************

  Business Response

  Date: 06/21/2023

  Good afternoon, 

   

   We have made outreach to the provider and the case is currently under review. We apologize or any dissatisfaction or inconvenience. We will provide resolution/ determination once the review is completed. 

• Initial Complaint

  Date:06/07/2023

  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.

  I complete all task wellcare asks and they never send rewards cards. They offer services but never follow through. Never uphold policy

  Business Response

  Date: 06/20/2023

  Good afternoon, 

   The Healthmine portal is live for all eligible members to attest to the completion of their health activities. Eligible rewards available through the My WellCare Rewards program will require both self-attestation as well as an eligible claim on file. Members must attest to completion of the activity, and we require receipt of eligible claims data to earn the reward.  Registration is required to redeem rewards. The digital registration reward requires no action from the members other than completing registration and providing an email on file.  The Flu health action is self-attestation only, this will not be available until flu season, later in the year. Claims are loaded on a weekly cadence.  Once an eligible claim is received, any qualifying healthy activity a member has completed after 1/1/2023 will appear as redeemable in the member's Healthmine portal as long as self-attestation is completed.  Please reach calling Healthmine directly ************ 8:00 AM to 8:00 PM Monday through Friday or Accessing the Healthmine mobile app
  A link within an email to go directly to the Healthmine page: ****************************************************************************;

• Initial Complaint

  Date:05/19/2023

  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.

  I have tried to go to my rewards program and it keeps saying that I have been terminiated. When I go to my benefits, they say it is active. Today, I spent over two hours on the phone with eleven different Wellcare associates and two supervisors that could not resolve my probelm.

  Business Response

  Date: 06/02/2023

  Good afternoon,  

  The plan has review members complaint. Member was sent out annual change of plan back in 2022 for any changes for 2023. Eligibility this year for the rewards program is determined by the health plan and can change from year to year. This member's plan is not participating in the 2023 rewards program. We are sorry for any inconvenience. 

  Customer Answer

  Date: 06/13/2023

   
  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:05/19/2023

  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.

  Wellcare by Allwell is a ******** Advantage Program through the ******************** As a member, I received marketing materials to sign up for the "My Wellcare Rewards program. When you complete eligible health-related activities you earn rewards to be redeemed for gift cards. I signed up for the program,completed the eligible health related activities, and earned the rewards.But I was not given the $40,$50,and $25 gift cards as promised. This was false advertising.

  Business Response

  Date: 04/19/2023

  Please review the attached acknowledgement letter.

  Customer Answer

  Date: 04/19/2023

  Complaint: 19953910
  
  I am rejecting this response because:
  
  
  
  Sincerely,
  
  ***********************

  Customer Answer

  Date: 04/19/2023

  Complaint: 19953910
  
  I am rejecting this response because:
  
  
  
  Sincerely,
  
  ***********************

  Customer Answer

  Date: 04/20/2023

  I have attached additional important information about the Wellcare Rewards program that is relevant to this complaint.

  Customer Answer

  Date: 04/21/2023

  I have not received anything.

  Business Response

  Date: 05/19/2023

  The plan has resolved this issue via multiple complaints. An emailed resolution has been provided to the complainant: *********************** on Tuesday May 2, 2023 at 6:21pm EST to the email provided: From: ********************* with the Subject: [Secure] MCRC-******: BBB complaint ID ********. 
  
  Resolution:Attached (to the sent email) are 2 of the requested gift cards specific to colorectal cancer screening (completed on 12/21/22 to earn the $25 gift card) and breast cancer screening (completed on 11/22/22 to earn the $40 gift card). This was granted as a courtesy due to ** we receiving the call on 1/5/23 where it was only a mention of the 2 screenings of colorectal cancer screening and breast cancer screening. 

  No further action necessary as this issue has been closed. 

  Customer Answer

  Date: 05/23/2023

   
  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is not completely satisfactory to me.

  But I am willing to take my losses to resolve this complaint. 

  Thank you Better Business Bureau for your assistance in resolving this complaint.Without you a resolution would not have been possible.

  The reason I am not completely satisfied is because on 1/5/23,I did request, on a recorded line, to the customer service representative that I earned the $50 gift card for the bone density screening.

  Here again, Wellcare by Allwell is deceitful and dishonest in their dealings with their healthcare members.

  And I am asking Wellcare by ******* to remove my mailing address from their marketing list and from all of their affiliates that they gave my information to.
  
  Sincerely,
  
  ***********************

• Initial Complaint

  Date:05/19/2023

  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.

  Husband and I got WellCare prescription drug coverage effective 03/01/23, as our primary employer coverage ended February 28, 2023. I have been having issues with wellcare not covering my prescription because it shows that I have other primary care insurance. I have called Wellcare twice and both times they mentioned that the issue has been resolved and the 2nd time I called they said that it should no longer happen again and they filed a grievance on my behalf so it doesnt happen again. I went to the pharmacy to get a shingles shot that I got a prescription for and again Wellcare is not covering because its showing other primary health coverage. So here I am calling a third time to WellCare to take care of this should be easy fix since I have called two previous times about the same issue but apparently the workers dont read case notes but each time I call I spend over 40 minutes on the phone I have now been on the phone for over an hour still trying to fix this issue for the 3rd time and keep getting a run around and being told different things. WellCare what do I need to do so I dont have to call you guys each time I go to the pharmacy?!? Please get better trained staff that can explain things and can be easily understood. I think a lot of the time it could be a language barrier

  Business Response

  Date: 05/23/2023

  Good afternoon **** and *********,  

  My name is *******, I have tried to reach out to you and left serval messages. I would like to assist you both with the issue you are having with your pharmacy coverage. Please reach out to me call back number ************ use PRC-11853.   

• Initial Complaint

  Date:05/11/2023

  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.

  see Attached document

  Business Response

  Date: 05/26/2023

  Good morning,

    We apologize for your dissatisfaction and any inconvenience this issue has caused. We have attempted to make outreach to the member who picked up the phone and on introduction and stated "she does not care and she does not do WellCare". Review was conducted with the information provided and determination has been made the member was enrolled under MEPS application. We were unable to confirm with member due to member disconnecting the line abruptly on initial contact. Member submitted cancellation request which was confirmed via Enrollment and termination date reflects enrollment team response.

• Initial Complaint

  Date:05/08/2023

  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.

  Refusal to Correct Phone Number. When my mother got a policy with WellCare they incorrectly placed my number as her contact number, but it was only to be used in case of an emergency. I started getting calls and text from WellCare in February 2023, which I immediately called and informed them that they were contacting the customer at the wrong number and it was the emergency contact person only. I have also sent multiple emails with no response; filed complaints through their online system and through third party complaint sites and still haven't received as response or a correction. I have proof of these calls and text in my phone, which I have submitted to WellCare, still no correction is done. Every week we have called WellCare to get it corrected, only to receive the same lie, "it has been corrected". If it was corrected why am still receiving calls and text from WellCare, when I am clearly not a member; and at this point, WellCare isn't even a consideration for me. I've gone as far as filing a complaint with ******** for them violating HIPPA laws by refusing to correct the mistake they made. All I want if for my phone number to be removed from my mothers account, even as the emergency contact number, because of what WellCare stated that the system is automatically pulling the emergency contact number instead of the customer phone number and the customer service representative is in error calling the emergency contact number. Why did this error occur in the first place? Why can't it be fix, since it is a simple contact number change?

  Business Response

  Date: 05/15/2023

  The complainants phone number, and information has been added to the Suppression list and her contact number deleted from the members account.   

  Customer Answer

  Date: 05/15/2023

   
  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:04/25/2023

  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.

  ID ******** On April 21st I was supposed to get a ride from MODIVE (Wellcare's transportation service) and they did not arrive. After waiting half an hour I called and was told they could not make it. Then I was told they could reroute and I should expect a wait of at least an hour. I waited, no van arrived. I called again and was told they could NOT reroute and it was cancelled. Not even a call to advise me. My complaint with Wellcare is that they know this is a bad service and do nothing about it. They can see the complaints on the BBB. People are missing important appointments . It is taking months to get appointments these days. Apparently if they notify Modive they still do not improve their service. So, because this is free, we are expected to accept it! They say they CARE about us , but don't fight to get ** good transportation.

  Business Response

  Date: 05/10/2023

  Good morning, 

  
   We apologize for your dissatisfaction and inconvenience this issue has caused you. We are currently reviewing the case and have reached out to the member and vendor involved, we will be making outreach again once we receive findings and a conclusion based upon the review. 

   

  Thank you