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.

  8735 Henderson Rd Tampa, FL 33634-1143

• 

  WellCare Health Plans, Inc.

  PO Box 25735 Tampa, FL 33622-5735

• 

  WellCare Health Plans, Inc.

  PO Box 31401 Tampa, FL 33631-3401

• 

  WellCare Health Plans, Inc.

  PO Box 31370 Tampa, FL 33631-3370

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:04/20/2023

  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.

  greetings I am new to ******** and was provided false misleading information and or important information was left out which would have influenced my decision to buy this product was quoted one set of prices and I am being charged another more costly price and they want me to use a pharmacy not within 50 miles of my home or use their online pharmacy if I had been aware of these facts I may not have bought this product I was mislead and they need to do something about it period

  Business Response

  Date: 05/04/2023

  Good afternoon,

   I am sorry for your dissatisfaction and any inconvenience with the plan we have conducted a review with the details provided as we were unable to contact the member after numerous attempts via phone call. After review the member is not going to a preferred pharmacy and is paying the non-preferred price for transactions. Complainant has rejected mail order and other preferred pharmacies offered per calls that have been reviewed. 

• Initial Complaint

  Date:04/17/2023

  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.

  A letter dated on April 1 stated I had been disenrolled & this is my first notification I received.I spoke to ******, *****, ******, ***************** I did not receive payment booklet, did not received a warning letter only the ***************** did not receive any calls or messages (****** verified that Wellcare did not speak to a ************* never left a message). I have talked on the phone about 7 hours in 3 days to get this cleared up. Still not cleared up.***** stated that this happens to Wellcare all the ********* is Wellcare's fault.I wanted to make it right but they want to Penalize a Senior Citizen by taking away my prescription help but why does Wellcare want all the blame to rest solely on me and not take any responsibility??The only answer I get from some of the *********************** does not accept missing mail as an excuse for reenrollment. The last convo was w/******* she stated that I was reenrolled the night before & after giving me all the information I needed to make a payment she put me on hold and when she came back her demeanor had change &she stated I was not enrolled and I could not be enrolled. ******* gave no answers and I wanted to know what happened & could she do anything. ******* then stated she would put in a request but did not state what she put into the statement. I asked did Wellcare take any accountability but ******* did not answer only stated that i would be mailed the decision.I noticed as I spoke to each Rep. the information change in how they contacted me & the number of times they tried to contact me.The first two was consistent, ******'s changed 3 different times in one conversation, *******'s account did not match anyones. Also, the April 1 letter only speaks of one letter. I am not sure about Wellcare's accuracy in their notes. Again, why am I being held accountable when their own people are saying different things. I also noticed the more people I spoke to the numbers went up. Why??

  Business Response

  Date: 05/16/2023

  Good morning 

  I hope all is well the plan has reviewed complaint plan final resolution: The member was disenrolled *** (Failure to Pay) on 03/31/2023 because the beneficiary had not paid the total premium by the end date *Per exhibit 19 member was required to pay $71.40 to avoid termination.  *Per exhibit 19A member was required to pay $71.40 to avoid termination *The Plan mailed Payment book on 12/16/2022 *The Plan mailed Exhibit 19 (*** notice) on 02/02/2023 * The Plan mailed Exhibit 19A (*** notice) on 03/14/2023 *Failure to Pay Notices mailed to ***************************************************************** *Failure to Pay Confirmation of Disenrollment mailed on 04/07/2023 * Was Member previously at risk for ***? Yes in 2021 * **************** done: 02/13/2023, 03/13/2023     AGENT FINDINGS: *** review complete. No plan error found. The member is not eligible for reinstatement. According to *** letter (Exhibit 19) the member was required to make a payment of $71.40 by 03/31/2023 to avoid ***. Per review of the members account in Oracle the members payment of $71.40 was not received by the *** date therefore the members plan termed on 03/31/2023. Payments made after the *** grace ****** are considered late, and not a plan error.  *** letters were mailed to the members address on file and ***** calls were made timely. Therefore the member is not eligible for reinstatement. Here is a full reconciliation of the members account.  Plan Invoices 2020- $880.80 2021- $950.40 2022 - $826.80 2023- $214.20 Member payments 2020- ($880.80) 2021- ($950.40) 2022 ($826.80) 2023 ($0.00) (Total Plan Invoices ) $2,872.20- (Member payments) $2,658.00 = $214.20   The member making a payment of $214.20 will not reinstate the member's account as there was no plan error found.

• Initial Complaint

  Date:04/07/2023

  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 over charge me for a value script plan in ****************************************** 2023.We resolved the issue that SS took out $627.90 overcharged because WellCare made a mistake as to what plan i was on. They told me and my insurance broker that as of 1/6/23 they would send the overpayment to SS.And that it would take up to 90 days. On the 91st day my broker and i called and they said they have no record of a credit being issued. They procrastinate on the phone and run you around with no results. We have called numerous times and talked to them for hours at a time. The last time the CS agent went silent after asking to speak to a manager and did not say anything and did not hang up for ************************************************************* Member id ******** ************************* 09/16/1948 Agent *********************** Summit Ins. *********** ********** ** They can supply better documentation with ticket numbers and names/dates if needed.

  Business Response

  Date: 04/26/2023

  The plan is still review with Enrollment regarding member's issue. Once an update is provided the plan will provide to member and the BBB.  

• Initial Complaint

  Date:04/07/2023

  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.

  Hard to get approved plan benefits started. I've been struggling for weeks to get wellcare to fix my mom's meal authorization. Very thankful for the services when I am able to receive them.

  Business Response

  Date: 04/28/2023

  Good afternoon, the plan has made out reach and left message for complainant on 4/21/23 at 11:45 am, 4/24/23 at 11:46 am and 4/25/23 at 3:42 pm a letter has been sent to member on 4/25/23 advising the Presidential/CEO team is trying to reach out to recent BBB complaint ********. Please reach out to ************ reference to ********* so we can assist with meal authorization issue you have encountered. 

• Initial Complaint

  Date:04/06/2023

  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.

  Entered by BBB Staff - lj Consumer filing complaint for his elderly mother. She is 93. Account number ********. Monthly payments are $30. She is on ******** and ********* She missed her January and February 2023 payments. They cancelled her coverage on February 28, 2023. Consumer made the March payment of $30. Company accepted his payment by check. He was not aware that she had missed two payments. She is unable to receive her medicine. Consumer would like to make her payments and reinstate her coverage. Company will not renew her coverage

  Business Response

  Date: 04/17/2023

  On 4/17/23 @1:52 pm resolution was provided to complainant final resolution.  According to Billing -Eligible for Reinstatement (if member meets GCR criteria):Y  Amount Due for reinstatement:65.2  Amount Due By:5/31/2023-per enrollment member did not meet  GCR criteria. Last payment was made in 12/2022, no pmt posted for FEB, March, then payment was made 3/6/2023 which would cover Feb's balance therefore no refund will be due to the member as payment posted was owed for prior month. Member has a current balance of $65.20. Member stated today there was a payment of $96 advise this bring the account current. 

  Customer Answer

  Date: 05/10/2023

   
  Better Business Bureau:
  
  I spoke to the business in reference my complaint. This has been resolved. 
  
  Sincerely,
  
  ***** & *************************

• Initial Complaint

  Date:04/05/2023

  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.

  I am actually doing this on behalf of my mom she was ***************************************** October November and she passed away on February 28 due to congestive heart failure and this wellcare plan she had she should have just not any insurance because wellcare denied her rehabilitation and home health care and now she owes ***** plus hospital bills I would recommend wellcare to be shut down *********************** Member id ******** Birthday 02/12/1934 I am her daughter and the only person related to her

  Business Response

  Date: 04/19/2023

  Good afternoon,

       We apologize for your dissatisfaction with WellCare, outreach has been made to the complainant who expressed her displeasure with the plan. Complainant declined to provide any details to have reviewed and was uncooperative during the call. Review was conducted with the information that was provided in the original complaint findings were inconclusive due to the lack of information. 

• Initial Complaint

  Date:03/28/2023

  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.

  On August 22,2021 my Father passed away. His name is ***************************. He had a ******** prescription drug plan with Wellcare and had paid the insurance annual premium of $211.20 for the entire 2021 year coverage on December 11, 2020. On September 7, 2021 I called Wellcare to inform them of my father passing away and the Wellcare representative told me that they will cancel the policy and any money that was over paid will be sent back. On October 25, 2021 I called Wellcare regarding the status of the refund. I was told that they were having technical issues. On December 9, 2021, I mailed Wellcare a letter regarding the insurance premium refund along with ****************************** death certificate and document from his trust for proof that I am authorized to handle his estate. On January 20, 2022, I received a letter from Wellcare regarding my issue. They wanted a Letter of Appointment of executor. Because my Father had set up a trust before he passed away, I did not need to go through probate to settle his other affairs. To obtain the Letter of Appointment of Executor, I would need to go through probate court and spend more money for the probate process than what the refund is for. On February 1, 2022, I called Wellcare and I was told that a deposit was done on October 28,2021 for $70.40 made to ****************************** checking account. I have a joint checking account with my Father and this deposit was never done. I tried to speak to a manager at Wellcare, and I was transferred to several people. The last person I spoke to gave me a ticket number and said I would get a call from them on February 2, 2022. They never called me back or sent out a refund check. I just want the $70.40 for the Insurance premium refund for his account number # ********. I don't think that they should keep this money since my Father passed away before the Insurance premium expired. Wellcare has all the documents they need to send me the refund.

  Business Response

  Date: 03/28/2023

  Hello and Good Afternoon, We sincerely apologize for the dissatisfaction and delay in receiving your fathers premium refund. We will be in touch to help resolve matter. Thank you.

  Customer Answer

  Date: 03/29/2023

   
  Complaint: 19860697
  
  I am rejecting this response because: I received a voice mail message from WellCare and I called them back at 3:30 pm EST.  Received a recording that theyre closed and that their normal business hours are Monday through Friday 8 am to 5 pm EST.  I called before 5 pm EST.  The office should still be open.  WellCare has canceled the policy and they just need to mail out a refund check.  
  
  Sincerely,
  
  ***********************

  Business Response

  Date: 04/17/2023

  Hello and Good Morning, We apologize for the inconvenience. A refund check has been issued and I have been in contact with *****************. This case will remain open until I receive confirmation the check was received. Thank you.

  Customer Answer

  Date: 04/24/2023

   
  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:03/27/2023

  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.

  my pcp on many occasions have requested physical therapy for my lower back pain because of arthritis it keeps being denied because of an excuse it is being faxed to the wrong number on many occasions after the number was given to my provider by wellcare

  Business Response

  Date: 04/05/2023

  Hello ****************,

  We have tried contacting you to provide the information we received from our Clinical Department however, we've been unable to make contact.

  This is the information we received-We have spoken with both the primary care physician and rehab center. The primary care has never sent any referral to the network physical therapy center (TEAM REHABILITATION CHESTERFIELD). Our nurse requested the *** send the members prescription to the center. The network therapy facility then schedules an evaluation and requests authorization for treatment.
  TEAM REHABILITATION ************ will be happy to schedule the member, but has never received any request to do so. Physical therapy evaluations with PAR provider do not require authorization. ****** in the primary care office was asked to fax the members information to Team Rehabilitation Chesterfield. The representative at Team Rehab (**************) states they will be able to schedule the member with no concern but have never received any request. The member or *** must make contact with the therapy provider to initiate services. 

  I would be more than happy to assist you in scheduling your appointment for therapy if needed. Please contact Wellcare at ************ reference your case number PRC-*****. Thank you.

  Customer Answer

  Date: 04/19/2023

   
  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:03/24/2023

  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.

  My PCP representative authorized physical therapy for me through WellCare. My initial doctor visit was January 25. My first PT session was two weeks later on February 9. I had 4 sessions of 12 authorized but had a conflict so I did not have PT for two weeks. During that time I was mailed a denial of claim on March 9; I did not receive the denial until March 16. This denial is at least 6 weeks after authorization by my PCP representative and after I had received 4 treatments.When I contacted Wellcare (a time consuming, phone maze trip to ***** and back) I was told my previous treatment had not been "closed out". When I asked the WellCare representative what that meant, she said she didn't know, and that PT is handled by **** a third party vendor.I maintain my health care provider followed normal procedures, and that this requirement of closing out a previous treatment, well over a year old, is just a gimmick used to deny the request. My PCP knew nothing of this procedure, and this is obviously not standard practice.Upload documents? There is no electronic trail, only a letter. There is nothing documenting any of these proceedings on the WellCare website because the letter comes from **** That WellCare uses a third party vendor should not be my problem and all correspondence should be available on the website. All I can do is send photos, sorry for the poor quality.

  Business Response

  Date: 03/30/2023

  good morning, the appeal for Physical Therapy was approved and member confirmed she has been advised the same. 

  Customer Answer

  Date: 03/31/2023

  
  Complaint: ********
  
  While I acknowledge my complaint was "resolved" by the company, my real complaint is that I even had to resort to the BBB and social media to get my physical therapy treatment reinstated. I wonder how many other WellCare customers just accepted the initial rejection of authorization for treatment. I should not have to fight for what should be a transparent and straight forward process. 
  
  Sincerely,
  
  *****************************

• Initial Complaint

  Date:03/20/2023

  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.

  member ID #******** I am so upset i have been on the phone now for about 2 hrs. this is the worse medical plan I have every had I am taking to people who I can't understand who connect me to departments that have nothing to do with my issue. And on top that that I am asked over and over the same question's. I think I am going to be connected to some after a 30 mins hold and it tell s me hangup or call back. I want a call from some in executive with answers to my question and that the issue is being work or I can not stay with you, you have no C.S. ix the issue with teladocc. This one of benifits that I have not been able to access and some other issue with C.S and lies

  Business Response

  Date: 04/04/2023

  The plan has reached out to member and was able to set up a few conference calls with Ms. ********** and Teladoc to resolve the issue. Several request for Teladoc IT to follow back up with member.  Per Teladoc best search engine to use is ****** Chrome member does not want to use the requested search engine, at this point member needs to speak with IT. The plan is going to assist in last try to referrer to Case Managment to assist. If not,member will need to attempt to use the requested search engine to set up schedule appointment with a provider. Members current search engine is not compatible.