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.

close

Find a Location

WellCare Health Plans, Inc. has 26 locations, listed below.

*This company may be headquartered in or have additional locations in another country. Please click on the country abbreviation in the search box below to change to a different country location.

BBB accredited

Near

Country

USUnited States

Please enter a valid location.

Filter

• 

  WellCare Health Plans, Inc.

  PO Box 31370 Tampa, FL 33631-3370

• 

  WellCare Health Plans, Inc.

  PO Box 31372 Tampa, FL 33631-3372

• 

  WellCare Health Plans, Inc.

  PO Box 31368 Tampa, FL 33631-3368

• 

  WellCare Health Plans, Inc.

  PO Box 31367 Tampa, FL 33631-3367

• 

  WellCare Health Plans, Inc.

  PO Box 31384 Tampa, FL 33631-3384

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:01/31/2023

  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 are con artist! I have both ******** and ********* I have two chronic health issues that are not curable. Wellcare enrolled me in their open access program with the promise of extra benefits. Which I got for 3 months. ******** 2023 rolls around and I'm being denied the extra benefits I was promised. My Dr. *** Social worker filled out the necessary paperwork. I need to have my medical equipment and testing strips. I also was promised $50.00 in monthly utility payments. Wellcare will **** you in and then start denying the benefits promise.

  Business Response

  Date: 02/09/2023

  Upon benefit review there were changes made for the 2023 benefits which excluded some benefits that were previously provided. On September 30, 2022, the Annual Notice of Change was mailed providing the benefit changes and what benefits are included for the year 2023.if you qualify for those benefits your provider would need to submit the attestation for the benefit in question.  We have requested for our Case Management team to reach out to you and assist with your medical needs to include your diabetic supplies needed. Your case Manager will be reaching out to assist as needed. 

  Customer Answer

  Date: 02/09/2023

   
  Complaint: 18953886
  
  I am rejecting this response because: I have come to question the ethical issues of this situation. I have had to beg for diabetic supplies although I'm classified **************** open access. I still feel that unethical practices are in place concerning my entitlement to utility monthly payments. The company changed the rules within 3 months of my entitlement to utility payments which makes it very convenient for the company to take away what I initially qualified for.  Good for Wellcare they can now keep that money.  Because I believe that this is more of a ethical issue I would like to point out that this company has been sued repeatedly for that very reason. All that is required is to ****** Wellcare/lawsuits. Had I known before joining this company I would have joined to begin with. I will be leaving this company in Oct of 2023. I sincerely thank the BBB for its efforts at resolving this issue.
  
  Sincerely,
  
  *************************

• Initial Complaint

  Date:01/30/2023

  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.

  Good morning,I am under the care of a out-of-network trauma counselor. I was told by Wellcare (multiple representatives) that I do not need prior authorization. Once I submitted my claims they denied coverage do to the fact that i didn't get preauthorization. I sent an appeal letter in and i still waiting.I would like to continue seeing a out of network trauma counslor and so I asked how do i get preauthorization. The response from 2 more agents and 2 superviors totaling 3 hours of conversation over two day was YOU DO NOT NEED PRIOR AUTHORIZATION! They cannot figure out why my claims are denied

  Business Response

  Date: 02/15/2023

  We are still working hard to resolve your concerns and will be providing updates as we go along. Thank you for your patience.

  Customer Answer

  Date: 02/22/2023

   
  Complaint: 18946645
  
  I am rejecting this response because:  I cannot see what wellcare is offering.
  
  Sincerely,
  
  *********************

  Business Response

  Date: 03/15/2023

  Member was advised the following-We captured the previous services that were denied and submitted a reimbursement for all eligible dates of service to make the member whole.  Procedure code ***** per the auth tool no longer requires auth. Initially it was due to the services being rendered via Telehealth. The members total reimbursement is $2,550.00 for Teladoc visits, Member has no cost share. Reimbursement has been mailed to the member and receipt was confirmed.

  Customer Answer

  Date: 03/15/2023

   
  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,
  
  *********************

  Customer Answer

  Date: 04/20/2023

   
  Complaint: 18946645
  
  I am rejecting this response because:   Things with Wellcare have started up again.  After BBB intervening all of last years Trauma therapy bills were paid in full.  I had my therapist call them directly to see if we need to do anything different this year and they said we were good to go. Unfortunately, the first bill I sent in was rejected because the therapist is out of network.  I have a PPO plan with them and all of last years were out of network. I am frustrated more than I can express.  I spoke to someone in the Executive Response Team and she said someone will look at it.  Last year when the *** said this nothing happened until you guys got involved. Can you help me again?
   
  Wellcare member id  ******** 

   

  Sincerely,
  

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

  Business Response

  Date: 05/11/2023

  Good afternoon, 

   

    We are sorry for your dissatisfaction with WellCare and apologize for any inconvenience this issue has caused you. After review a determination has been made no error was found by customer service agents prior to the *** given. The member must use an in-network provider for the services to be covered. Appeal Overturn for this denial before, and a range of dates was processed and paid to the member incorrectly via the overturn. Multiple letters have gone out to the member, Prior to the Overturn, indicating an in-network provider must be used.

   

   

  Thank you 

  Customer Answer

  Date: 05/17/2023

   
  Complaint: 18946645
  
  I am rejecting this response because:  firstly, according to WellCare I can use an out of network provider. Just not through Telemed.   The correspondence they are saying they sent me was received by me after the fact.  My trauma Counselor called them to verify they would pay before I started seeing her.   They never told her in must be in office. 

  This is actually not true becasuse my husband ********************* Member ID ******** has his trauma therapy appointments this way and Wellcare pays 60% for them.
  
  My main gripe with Wellcare is the rules change depending on who you get.  I am not letting go of this because it is just wrong!   

  What do I do now?  Do I go to my local congressman or senator?

   

  Thanks

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

  Business Response

  Date: 05/19/2023

  Good morning, 

   

     We apologize for your dissatisfaction with the plan, a review has been conducted and the conclusion of the review determined the services are not approved. The provider was not told that telehealth services were covered, the provider is a non par and telehealth services are not covered under an ONN provider. Documents have been sent advising member services are not covered. 

   

  Thank you

• Initial Complaint

  Date:01/30/2023

  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 received the week of 01/25 a letter dated 01/13/2023 from Wellcare. In the letter they state I owed them $377.52. In the letter they gave me an address to mail my check BUT the letter told me nothing about the detail of the $377.52 owed. Nothing about when the debt was originally due; nothing about the medication it was for; nothing about how they calculated the $377.52.During business hours of 01/26 and 01/27 I called Wellcare, spoke with: **************************, ****************************, ****. ****** and ********. Not one of them could find records for this 01/13 letter or the amount due of $377.52, or anything else in their 'systems' that could explain this letter. They could not confirm they even sent this. Even dropping the 'fraud' word, did not raise a red flag with them.

  Business Response

  Date: 02/23/2023

  We looked into the concerns raised and determined the following:
  When the different drugs were prescribed by her doctor and filled it impacted her deductible by lowering it resulting in her payment of a lower cost share for the medication that she received from the pharmacy
  After the other two drugs, that she did not obtain from the pharmacy, were reversed, her deductible increased which resulted in the recoupment letter requesting that she pay the difference between her original cost share and the adjusted cost share
  Because of the confusion related to the reversal of the prescriptions that were prescribed, but not picked up by her, and the information on the portal, we are NOT the request for repayment.
  
  

  Customer Answer

  Date: 02/25/2023

   
  Complaint: 18940918
  
  I am rejecting this response because:   It makes no sense.  It is not a well structured or grammatically correct letter.  They will need to edit it an write it in proper english. 

  Additionally, In a 02/17/2023 email from ************************* (Wellcare/Centene escalation), she told me that the $377.52 is not due.  I am going to assume this is accurate.   

  Wellcare/Centene needs to figure out what they are saying to their customers and stop speaking out of both side of their mouth.

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

  Business Response

  Date: 02/27/2023

  We looked into the concerns raised and determined the following:

  
  When the different drugs were prescribed by her doctor and filled it impacted her deductible by lowering it resulting in her payment of a lower cost share for the medication that she received from the pharmacy. After the other two drugs that she did not obtain from the pharmacy were reversed, her deductible increased which resulted in the recoupment letter requesting that she pay the difference between her original cost share and the adjusted cost share.
  

  Because of the confusion related to the reversal of the prescriptions that were prescribed, but not picked up by her, and the information on the portal, we retracted the request for repayment related to this prescription.

  Customer Answer

  Date: 03/14/2023

   
  Better Business Bureau:
  
  I have reviewed the response made by the business (received 03/14/2023) through the BBB in reference to complaint ID ********, and find that this response FINALLY matches the response I received from ******* and ****** earlier this month.   

  Just because I am accepting their response, DOES NOT mean that Wellcare is an ethical company or a company that cares about it's customer.  **********************'s actions towards me since Jan 25, 2023 have been appalling, unprofessional and  inaccurate.  It's because of Wellcare's behavior that I had to go to the BBB and other regulatory bodies.

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

• Initial Complaint

  Date:01/27/2023

  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 wont pay one of my claims concerning mental health. I had a PPO PLAN. I was on the phone with WellCare For 4 hours today. 1/27/23 This has happened many times. This claim is from 2021.Billing finally told me it was WellCares insurance company mistake. It took me at least 6 months to ************ this. What scares me is they said they would call me back. Never have.My provider wont speak with me over this. It is ruining my credit!. Will you help me.*************************************

  Business Response

  Date: 09/03/2024

  Good afternoon, all, 

   

  According to my research, the claim was denied as (DENIED: not a covered benefit or exceeded the benefit limit) this is a telehealth visit and could have been paid for, but the provider did not include a Waiver of Liability (WOL) and was dismissed after we submitted 3 letters to the provider requesting the waiver. 

   

  Thank you, 

• Initial Complaint

  Date:01/20/2023

  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.

  Powerchair was under warranty when it malfunctioned but the company didnt come out until after it was not covered. WellCare is replacing powerchair because they cant find anyone to repair so thats fine because the do have a lemon law on durable medical equipment which mine is covered by has been repaired 9 times and lemon law says 4 times. But WellCare is telling me I have to pay my 20% insurance premium even thou I already paid it two years ago already for the chair that is defective and the item that is messed up was installed incorrectly by the powerchair repair technician and repair company that is trying to ripe me off. But I have been calling WellCare for several weeks and days and leaving messages and they say some one will call you back but dont. The president ****** even does it name ******** for the president ****** operator that promises someone will call you back but they never do.Tonight I even had a customer service supervisor on phone with 3 way with Medicare supervisor and they treat me like c*** and said someone get back with you but they will not call back. Had one customer service supervisor tried to send me to grievce department to speak with them but only was answering machine and couldnt leave a message because it was broken like normal and plus they dont respond to messages left anyway because I had left many messages in past and never got response back from them.

  Business Response

  Date: 02/03/2023

  ****************** is aware and update to date with the status of a new Power Wheelchair order on his behalf.  As of 1/30/2023, I was advised by *********************** an order was placed with the manufacturer and it will take 3-4 weeks for arrival. In addition, Case Management will be working with ****************** and assist with medical needs as needed.

  Customer Answer

  Date: 02/03/2023

   
  Complaint: 18856741
  
  I am rejecting this response because:
  Because ****** in case management supervisor said they was covering powerchair 100% . And now you cant get her to answer phone calls she gets the messages and types to her employees in chat/ email saying she will call back and never does. Yes *********************** has ordered new powerchair but Im having to pay $5000 almost out of my pocket. Even though she ****** told me and doctor ****** manager they was covering 100%. I just spoke with **** from the president escalate team and nothing changed but they said that case management will get in touch but this is going on for a month and said they will call me all the time and no no one does.  I have made arrangements with *********************** to make monthly payments for new chair and it will leave me completely broke not able to afford food gas are medication and not able to pay for repairs at home until chair is paid off and also will not be able to afford specialist doctors appointments for my medical care until paid off. 
  Sincerely,
  
  ***********************

  Business Response

  Date: 02/06/2023

           According to your plan's benefits as advised, you would be responsible for your co-insurance amount. The rate provided is calculated according to your plan's benefits.

• Initial Complaint

  Date:01/19/2023

  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.

  I am ********* authorized representative and filing this complaint for her. She received communications from Wellcare stating that she has joined the Wellcare program and it included a number of forms to be filled out specifically related to the "Authorized Representative". According to ******* she has never talked to a WellCare person nor applied for their services. I called WellCare to find out who initiated their services for ******* and was told they cannot provide this information. The fact that they have her information makes this a fraudulent issue I believe. If they wish not to have a complaint field with State and Federal agencies I want them to tell me who initiated this service so I can take action against that party.

  Business Response

  Date: 01/20/2023

  We spoke with Mr. ****** (member's brother) today, and he confirmed that his concerns were resolved to his satisfaction and did require further assistance at this time. Member is currently not enrolled with Wellcare.

• Initial Complaint

  Date:01/09/2023

  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 keeps changing benefits. Was enrolled in concierge program was un enrolled without notification. They told me I had to have my doctor fill out a form. *************** could never get wellcare to send the form. Everytime I call I get the run around. Very difficult for people who are disabled and rely on their services.

  Business Response

  Date: 01/25/2023

  As per our conversation today, Ms. Gordon advised that assistance was no longer required as information was given to her regarding plan benefits, and she will determine if a plan change is needed or to remain with the current plan. 

• Initial Complaint

  Date:01/06/2023

  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.

  Well fail to advise their clients that they were changing transportation services. I was on the phone January 5, 2023 early this morning with a supervisor by the name ******* for 3 hours trying to get a understanding of what was going on with the medical coverage for transportation for which she had not been informed neither. The grievance number for this incident is ********** through Wellcare. I finally was scheduled for transportation through Lift transportation by the new company that's supposed to be the contractor for Wellcare Access transportation but they only scheduled me for a one way trip not a round trip or should I say two way trip. When I get ready to return home from Podiatrist appointment in ********* ****** call for pick return home and I have no ride the new transportation say they have no record of me I call Wellcare back another supervisor gets the call by the name of ***************** explained the whole scenario again to him a d the whole situation is played all over I'm on hold for 2 hours the supervisor for Access hangs up and the supervisor for Wellcare never gets me a ride. I'm stranded in ********* **** live in ********* almost 10 miles from home surgery has been done on my toe diabetic no money. My doctor pays out of pocket for me a Uber to go home because my medical insurance wouldn't cover me getting home and the doctors office is getting ready to closed. My doctor needs refunded her money I need compensated for be stressed out all day from morning until the time I return home safely. I missed important business calls from being on hold with medical insurance my doctor had to give me peanut butter for my sugars went low from being stressed. Wellcare is has inconveniences many other clients. And then the supervisor ******* didn't even bother to call to see if it had Transportation if I was safe when we got disconnected. Terrible customer service.

  Business Response

  Date: 01/19/2023

  Hello, we have forwarded your concerns to our vendor manager, and we are awaiting response. We will get back to you asap with resolution. We apologize for the delay.

• Initial Complaint

  Date:01/03/2023

  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 signed up for WellCare. January 2022. I am on the give back program and suppose to have ***** taken off my part B . A year later and still nothing but run around. I have called so many times . Weekly, daily. And still nothing. If they arent gonna get it straightened out then they shouldnt have it as a option. I lost over a ******* because they cant fix the problem. Why should I be the one always making the calls.

  Business Response

  Date: 01/17/2023

  My apologies, the consumer has been advised of the resolution via email on 01/13/2023, after review, SSA denial of giveback amount due to spousal benefits.  thank you 

  Customer Answer

  Date: 01/18/2023

   
  Complaint: 18676886
  
  I am rejecting this response because: I have not seen anything saying it was denied . Dont think they did anything at all. Have read reviews from others who say they didnt get the give back either 
  
  Sincerely,
  
  ***********************

  Business Response

  Date: 01/30/2023

  Good afternoon, this issue is currently in review, the member has been advised of the denial fo the giveback, due to her receiving spousal benefits, 

  Customer Answer

  Date: 01/31/2023

   
  Complaint: 18676886
  
  I am rejecting this response because:
  I still have not received anything from social security or ******** that it was denied 
  Sincerely,
  
  ***********************

  Business Response

  Date: 02/02/2023

  Issue is closed, please contact SSA. Denied due to receiving spousal benefits. 

• Initial Complaint

  Date:01/03/2023

  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.

  For some reason anthem has been added once again to my insurance. Its under a different last name as usual. I had my wife call early last week and this issue was supposed to be resolved. It was not. It is still showing anthem. I had to report them the last time this happened because it was not fixed. This happens over and over. My doctor will not see me until this is fixed and I have an appointment any day now. I need my blood pressure medicine and other medication. It is detrimental to my health and well being. I could have a stroke without my medicine. It would be a shame if anything happened to me and me with a young son under two years old and a wife. I dont understand why this keeps happening. Its happened numerous times in the last few years. It needs to be resolved immediately. Please help me. Anthem needs to be removed permanently. They have it in their records to not add it yet they still do. If wellcare doesnt resolve this I am going to seek further actions. My health seems unimportant to them otherwise why do they allow this to keep happening and for years. Like i stated my wife who is my authorized representative called earlier last week and it was supposed to be fixed within 2-3 days. I am including the name its showing which is not my name. I do not have anthem.

  Business Response

  Date: 01/06/2023

  We have attempted to reach you for clarification of your concerns and to provide assistance. Please contact Wellcare at ************ and reference PRC-*****. Thank you.