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:09/26/2022

  Type:Product Issues
  Status:

  UnresolvedMore 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 not received my prescription for Eliquis. I contacted Wellcare Prescription Plan. They informed me that someone called on May 27,2022 and cancelled the prescription. This is not true. This is my second incident this year that I have filed about with this company. You, the BBB, were effective at that time. This is not a good company. I have had ongoing problems and have had no resolution from Wellcare. I was informed that I needed to contact my doctor and have the doctor ***** the prescription. I am concerned that again, I am not receiving a prescription that is critical to my health. I spoke to **** and she referred to supervisor ******** at number: **************. She was not able to help me. Please,please investigate this company so that no one else will not have to go through this.

  Business Response

  Date: 09/28/2022

  good afternoon, after review, Pharmacy advised there are no active prescription on file for Eliquis.   RX # ********* was discontinued by prescriber on 6/8/2022. Order request # ********** from 9/28/22 is in discontinued prescription status as the prescription was discontinued by doctor. Doctor will be contacted for approval to refill since the current RX is not valid and a new prescriptions is needed. Member also called on 5/27/2022 per call notes RX# ********* was discontinued due to being only a 30 day supply with member approval. We contacted the member, she advised she was canceling the plan, stopping payments on her account, advised her disenrollment also needs to be approved by ********* she advised she will call them, and she gets her medications from ******, i advised of pharmacy findings, member advised she will document and will seek legal counsel. We apologize for any convenience this may have caused. ty   

  Customer Answer

  Date: 10/03/2022

   
  Complaint: 18124523
  
  I am rejecting this response because:

    Spoke to Iris at Wellcare on Sept 26,2022. She informed me that someone from my household contacted Wellcare May 27,2022 and cancelled my Rx for Eliquis. This is not true. A supervisor named ******* was then put on the phone call. She indicated that there were no refills left for Eliquis . She stated that the doctors were contacted twice and refused to refill. This is not true. I have attached refill information from ************** that indicates that there are two more refills until 01/31/23. I hope the attachment I included show up. If not, I can resend a picture of that refill information. I have not received my refill for Venlafaxine as well. Again, I was told that Wellcare did contact the doctor and they refused to refill. This is not true. I contacted Doctor ******* **************. They state that no one has contacted them regarding this refill. Please note that I also had issues with Wellcare back in January. Wellcare took my payment that was hundreds of dollars and did not send my Eliquis to me for almost two weeks. I called daily and Wellcare stated it was arriving the next day. This was not true. 

   I have a health issue with clots and need this medication so that I will not get another clot. I have been hospitalized for a week and almost died. It is very important that I receive this Rx. Due to my previous experience with Wellcare, I do not want to rely on this company any longer. There is currently a complaint filed with ******** as well. I was able to secure free samples from my doctor since Wellcare has been negligent ( see attached photo).

  My purpose in writing to you is to help prevent this happening to others. I think about my elderly mom and have concerns. If Wellcare can deliver such poor service and also lie to the customer, what would happen to others? This company is not ethical. I have tried to work with this company. Wellcare continues to not deliver services and prescriptions to me. Please,please help me. Please hold Wellcare accountable. I have documented every phone call and can substantiate what I am saying.

  Thank you for assisting me. Please let me know if I can provide you with ny other information.

   

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

  Business Response

  Date: 10/12/2022

  Hello and Good Afternoon, We sincerely apologize for the inconvenience and dissatisfaction you've experienced. Per review by our Pharmacy team, medication Venlafaxine has no refills we are still awaiting ** to send over new RX for that medication.  Eliquis was shipped Urgent next day. Thank you.

  Customer Answer

  Date: 10/12/2022

   
  Complaint: 18124523
  
  I am rejecting this response because: It is imperative that you review this new information regarding Well Care. The situation has escalated and is far worse.
  Events:
  WellCare has responded with false statements that can be proved-
  1. WellCare replied :that there were no active prescriptions for Eliquis/blood thinner
                                  WellCare states that someone in my household called and cancelled the Rx
                                  WellCare states via letter to me and statements to BBB that the doctor discontinued the RX
  2. I am attaching documents that verify these statement and proof that refutes WellCare claims:
    - See attached Prescription refills for Eliquis that current and extend to *** 2023
    - The doctor has provided me with Eliquis since my health condition is life threatening. I can have another
      blood clot and die without the medication. It is taking weeks to resolve issues with WellCare putting my health at 
      risk.
   
  3. Updated issues with WellCare. WellCare has sent me both e-mails and texts messages. I have taken a screen shot  
      And attached. WellCare was billing me $444.and would send my Rx/******** when I replied.Note that when WellCar
      replied to BBB ,WellCare acknowledges that I stated I am no longer doing business with WellCare.
      WellCare advised me to inform ******** that I was dropping WellCare.
   
  4. ******** was contacted and formal charges and a complaint was filed against WellCare with ******** 9/25.
   
  5. My credit card was billed $444. on October 7,2022 WITHOUT my authorization and confirmation.
   
  6. Eliquis medication was delivered Oct 10,2022.
   
  7. Medication from WellCare received on October 10,2022 was not opened, refused and sent back to 
      WellCare. Note that I have attached proof of this action which costs me $13.28.
   
  8. Note that I also paid $25. To my bank to stop payment automatic payment to WellCare at a cost of $25.
   
  Summary: WellCare failed to deliver more that one Rx. This occurred in *** 2022 as well. Charges filed with BBB at that time and case opened. My health has been jeopardized since WellCare did not provide me my Eliquis RX. 
  I have now been billed and have charges of $444. After I dropped WellCare. I also did NOT confirm payment.
  I have incurred fees of $38.28 to stop WellCare since I communicated weeks ago that I am no longer doing business with WellCare because of their unethical business practices. I would like the BBB to have WellCare compensate this money to me. I also would like $444. Credited back to my credit card  because this is an unauthorized charge and the Rx /Eliquis was returned unopened ( see attachment ).
  
     
  

  
  

  Customer Answer

  Date: 10/17/2022

   
  Complaint: 18124523
  
  I am rejecting this response because: It is imperative that you review this new information regarding Well Care. The situation has escalated and is far worse.
  Events:
  WellCare has responded with false statements that can be proved-
  1. WellCare replied :that there were no active prescriptions for Eliquis/blood thinner
                                  WellCare states that someone in my household called and cancelled the Rx
                                  WellCare states via letter to me and statements to BBB that the doctor discontinued the RX
  2. I am attaching documents that verify these statement and proof that refutes WellCare claims:
    - See attached Prescription refills for Eliquis that current and extend to *** 2023
    - The doctor has provided me with Eliquis since my health condition is life threatening. I can have another
      blood clot and die without the medication. It is taking weeks to resolve issues with WellCare putting my health at 
      risk.
   
  3. Updated issues with WellCare. WellCare has sent me both e-mails and texts messages. I have taken a screen shot  
      And attached. WellCare was billing me $444.and would send my Rx/******** when I replied.Note that when WellCar
      replied to BBB ,WellCare acknowledges that I stated I am no longer doing business with WellCare.
      WellCare advised me to inform ******** that I was dropping WellCare.
   
  4. ******** was contacted and formal charges and a complaint was filed against WellCare with ******** 9/25.
   
  5. My credit card was billed $444. on October 7,2022 WITHOUT my authorization and confirmation.
   
  6. Eliquis medication was delivered Oct 10,2022.
   
  7. Medication from WellCare received on October 10,2022 was not opened, refused and sent back to 
      WellCare. Note that I have attached proof of this action which costs me $13.28.
   
  8. Note that I also paid $25. To my bank to stop payment automatic payment to WellCare at a cost of $25.
   
  Summary: WellCare failed to deliver more that one Rx. This occurred in *** 2022 as well. Charges filed with BBB at that time and case opened. My health has been jeopardized since WellCare did not provide me my Eliquis RX. 
  I have now been billed and have charges of $444. After I dropped WellCare. I also did NOT confirm payment.
  I have incurred fees of $38.28 to stop WellCare since I communicated weeks ago that I am no longer doing business with WellCare because of their unethical business practices. I would like the BBB to have WellCare compensate this money to me. I also would like $444. Credited back to my credit card  because this is an unauthorized charge and the Rx /Eliquis was returned unopened ( see attachment ).
  
     
  

  
  

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

  Business Response

  Date: 10/25/2022

  Hello and Good Afternoon, We sincerely apologize for the frustration and dissatisfaction experienced. We have been in coordination with our Pharmacy department and confirmed the Eliquis medication was in fact delivered not refused. At this time there will be no refund issued, however, if she would still like to return the medication we will approve a mail tag for return and refund. Please note, our Pharmacy shipped this medication in good faith since it was needed. We thank you for understanding.

  Customer Answer

  Date: 11/02/2022

   
  Complaint: 18124523
  
  I am rejecting this response because:

  !. I terminated my Well Care account on 9/24/22

  2. I was billed and Rx sent without my authorization. On October 7 ( billed ) and Rx returned 10/11/22. Proof-

  3. *** Tracking # 1Z5RF1110395179015 indicates Rx received  by WellCare on 10/17/22

  4. WellCare needs to contact my credit card company and have the charges removed.

  5. I would also like the amount of $13.28 for the  *** cost of returning the Rx that was unauthorized.

  6. Again, I have sent documentation to prove of the unethical business practices of WellCare. WellCare has stated that they did NOT send my Rx because: Someone in my household cancelled the Eliquis Rx, the doctor refuses to refill after numerous requests by WellCare and most recently, WellCare sent e a letter that states my doctor no longer wants me to take the medication ( I have the letter WellCare sent, screenshots of texts from WellCare and e-mails from WellCare and statements from my doctors that prove what I am stating ). These statements are false.

  7. It should be noted that I also filed with the BBB in 1/22 for the same reason. My medication was delayed for almost two weeks.This put me at risk for a blood clot again as I experienced in January. Again, I struggled with WellCare, months later. I reached out to BBB for help. The situation got worse after I contacted you,BBB.After  terminating business with WellCare and contacting BBB,WellCare sent me my Rx almost two weeks late  and illegally billed my credit card with NO authorization. I am still receiving e-mails and text messages regarding other Rx even though I have asked WellCare to discontinue communicating with me.

  8. WellCare is an unethical company. They put my life at risk by failing to provide a Rx needed to prevent clots. I have spent countless hours trying to resolve this matter. I was informed by ******** that I can file a formal complaint and I have done so. I will also follow up my concern with the Federal Trade Commission. 

  Thank you for assisting with this matter. My initial goal was to hold WellCare accountable for unethical business practices. I would not want this to happen to someone else. For example, receiving a letter from WellCare stating that, " my doctor no longer wants me to take this medication " could put an individual's life at risk. Please help me to be compensated by WellCare for the above charges. Please hold them accountable.

  Best Regards,

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

   

   

   

   

   

  
  
  
  
  
  
  
  
  
  
  

• Initial Complaint

  Date:09/23/2022

  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 have a ******** Drug Plan with Wellcare that I enrolled in as of Jan. 1, 2022. They have not credited my credit card premium payments to my account correctly since March 2022. My premiums are $12.90 per month and I have given them a total of $129.00 so far this year. That pays for 10 months of premiums through October 2022. However, online and on numerous phone calls with their reps to get this corrected, they say I still owe September and October premiums and that I am overdue. Today, I spoke with ****** at Wellcare and she said that she sees payments of $12.90; $25.80; $25.80;$25.80;$25.80 & $12.90 on my account. However, she would not commit to saying that covers payments through October 2022. She would not answer when my next premium is due based on my payments. Its simple math, but she could not give me an answer. The answer should be November 2022. I can not get them to correct their errors on my account. They have escalated this problem many times with no resolution thus far. I am hoping that you can get them to correct their records on my account.Thank you for your attention to this matter,***********************

  Business Response

  Date: 09/28/2022

  Today 9/28/2022 at 12:40pm we reached out to Ms. *********************** and advised that her account has been updated to reflect all payments posted. Her account currently reflects a zero balance with next payment due in November-2022. **************** did not express further concerns and we advised she may contact us back if she has further questions. 

  Customer Answer

  Date: 10/09/2022

   
  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:09/21/2022

  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 have been told I need prior authorization to see a doctor I always see. I see him monthly. They want me to go to my doctor every time before I got to see the other doctor. That is double dipping. I shouldn't need that.

  Business Response

  Date: 10/26/2022

  Good day,

  CMS runs a variety of programs that support efforts to safeguard beneficiaries access to medically necessary items and services while reducing improper ******** billing and payments. Through prior authorization and pre-claim review initiatives, CMS helps ensure compliance with ******** rules. Under prior authorization, the provider or supplier submits the prior authorization request and receives the decision before services are rendered.  https://www.cms.gov/research-statistics-data-systems/medicare-fee-service-compliance-programs/prior-authorization-and-pre-claim-review-initiatives

  On 9/21/22 Plan telephoned ********************* Resolution given- Authorization is required to see out of network pain management provider ********* whose office can submit request directly to health plan. Member is pre-established patient previous to being on WellCare.

  Thank you 

• Initial Complaint

  Date:09/15/2022

  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.

  Like to make a complaint against WellCare on false information they gave me a false information on my insurance and it was enrolled with them and November of last year and every time I went to my doctor ****** would take their insurance they told me that I would get $150 for groceries which I did not get they told me special benefits that I would get that I did not get I had to cancel all of my other doctors because they were not in their Network I am suffering from diverticulitis I have a neuropytosis I cannot see my specialist because they're not in wheelchair's network every time I call them they told me that that would be taken care of but it has not so I'd like to file a complaint against them if it's possible they for mental English and fiscal ability I have put me in a place where now I have to find the other doctors to take care of my diverticulitis my neurophytosis I was supposed to went go get an MRI last month but where my primary doctor sent me they would not take it my eye doctor was not in their Network when they told me that he was my gas colleges is not in their Network when they told me that he was my neurophytosis doctor they told me that he was in the my network and he was not he is not either in my network that's about it I like to file a complaint against them for false advertising and anything else I can file for they've been taking a money out of my check since November of last year.

  Business Response

  Date: 09/26/2022

  Hello,
  

  Please be advised that we have made several attempts to reach out to the member for additional information needed for investigations however, we were unable to make contact.

   

• Initial Complaint

  Date:09/15/2022

  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 have several grievances against WellCare. They were to issue me four checks to be reimbursed for medical trips that they failed to provide transportation as agreed in their contract. I spoke with several managers who haves to do their jobs. I want my checks now.

  Business Response

  Date: 10/05/2022

  Several attempts to reach the complainant have been made with no success and no response to voicemail requesting a return call.  Please be advised the reimbursement request must be processed by transportation vendor Modivcare. All requests must be submitted in writing. The reimbursement form can be printed from www.Modivcare .com and can be mailed or emailed per instructions on the form. The plan welcomes the opportunity to discuss this issue further if the complainant desires to do so.  Please contact us at ************ and provide reference number PRC-***** for any additional questions or concerns regarding this matter.

• Initial Complaint

  Date:09/14/2022

  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.

  Wellcare transportation driver denied me a ride to clinic for have a legal service animal. This is the second time. Would like reimbursement for having to make for other arrangements. Wellcare has already verified that he is legal service animal and he has been to every appointment. It's sad that I'm judged for having a service animal.

  Business Response

  Date: 09/23/2022

  Good Day,

  *********************************** concern with On Time Transit LLC refusal to transport her with a Service Dog was forwarded to our vendor Modivcare Transportation for thorough investigation.
  
  We apologize that Ms. ******* experience with On Time Transit LLC was unsatisfactory.  We work with our transportation provider to provide these services and we were advised On Time Transit LLC: Vehicle ID Number: ****** Driver is allergic to dogs. When he told the member to call Modivcare because he could not take her because of the dog but she refuses to call and said that he had to take her. The driver told member that another driver was on his way to take her. She said that that was fine.
  
  Dispatch was informed and we sent another driver and by the time our second driver arrived she refused to go so stating that it was too late and that we had to pay her $35 for her troubles, which was denied.
  
  Corrective action- The complaint that On Time Transit LLC refused transportation to member with service animal has been deemed substantiated. There were no documented calls regarding service issue and the Provider did not report this to Modivcare. The Provider could receive correction actions not limited to trip removal. On Time Transit has been permanently excluded from the members profile. Member Experience has added member to Care Coordination for 30 days 09/22/2022 ending 10/22/2022 should she schedule future appointments
  
  We regret any inconvenience member experienced because of not being transported to her appointment.

  Customer Answer

  Date: 10/17/2022

   
  Complaint: 18023625
  
  I am rejecting this response because:

  Wellcare transportation originally denied me transportation to my doctors appointment because of my service animal. I filed a bbb complaint which was closed. Now wellcare is denying me transportation service all together as retaliation. My health plan includes this service and now I'm being denied. Plus I was not reimbursed for paying out of my own pocket on a fixed income because I'm disabled. I will be filing a complaint with the **** attor of General, and any agency that has regulations over wellcare transportation services. It would be nice if the bbb Could atleast help me get reimbursed
  
  Sincerely,
  
  *******************************

  Business Response

  Date: 10/24/2022

  Per Sub-vendor Driver Name: *************************** Vehicle ID Number: ****** Driver is allergic to dogs. Plan trying to inform rest of resolution from transportation vendor, but member was disappointed provided HIPPA and ended call.  Final Resolution response received from On Time Transit LLc: Driver Name: *************************** Vehicle ID Number: ****** Driver is allergic to dogs. When he told the member to call Modivcare because he could not take her because of the dog but she refuses to call and said that he had to take her. The driver told member that another driver was on his way to take her. She said that that was fine. Dispatch was informed and we sent another driver and by the time our second driver arrived she refused to go so stating that it was too late and that we had to pay her $35 for her troubles. Of course, we said no and that she needed to contact Modivcare. Remediation: This issue has been escalated to Transportation Network for a review of the Providers Operations. The Provider could receive correction actions not limited to trip removal. On Time Transit has been permanently excluded from the member's profile. Member Experience has added member to Care Coordination for 30 days 09/22/2022 ending 10/22/2022 should she schedule future appointments.
  9/22/2022
  Closed Complaint
  
  

  Customer Answer

  Date: 10/26/2022

   
  Complaint: 18023625
  
  I am rejecting this response because: I was never offered an alternative. I have witnesses of a caregiver.  Driver has taken me to medical appointments before. ****** has done this before last time as I was reaching for the vehicle door he took off with my hand on door handle. I never said anything about $35 only that transportation service was guaranteed with my insurance program. I don't think it's legal to be disabled and have a service animal and refused services.  Please help I reached out to the *** and I have a advocate trying to help.
  
  Sincerely,
  
  *******************************

  Customer Answer

  Date: 12/02/2022

   
  Complaint: 18023625
  
  I am rejecting this response because: 

  Since I filed a bbb complaint last against company I was denied the transportation services. Apparently it's legal to deny people with legal service animal transportation offered in plan. I also go through *********** program for food. This month I was sent nothing. I reached out to well care and helper with no luck. Please how can you offer people these benefits to enroll if you never can receive. It really a hassle being disabled. I'm always grateful when it comes but it seems like I'm totally being disregarded.
  
  Sincerely,
  
  *******************************

  Business Response

  Date: 12/06/2022

  Final Response The complaint that On Time Transit LLc refused transportation to member with service animal has been deemed unsubstantiated. There was no indication that driver refused transport (no witnesses). ************** indicates, member had a 13:30 pick up LOS Ambulatory-1 Service Dog from her residence located at ******************************************* going to a 14:30 ***************** appointment (18 Miles) located at ************************************************ with a return set for 16:00 secured with On Time Transit LLc 03/30/2022. Member Experience confirmed with the treating facility member was transported successfully, in attendance and, seen by the doctor. The Provider responded stating there were no issues on this day. There are no future rides scheduled currently. Remediation: This issue has been escalated to Transportation Network for a review of the Providers Operations. ME will continue to partner with the Network to ensure a reliable Preferred Provider is assigned to future scheduled appointments to ensure delivery of service. No future appointments currently. On Time Transit has been permanently excluded from the members profile. Member Experience has added member to Care Coordination for 30 days 09/22/2022 ending 10/22/2022 should she schedule future appointments. 9/22/2022 Closed Complaint *********************** transportation vendor 3rd response and final to member this issue has been closed. 

• Initial Complaint

  Date:09/07/2022

  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 have a cervical fusion and cervical stenosis. My pain management doctor gives me 4 epidural shots a year and I get relief. WellCare keeps denying the procedure, doesnt give any reasons why and nothing in the mail. This has been going on for months. They say they will call back in 24 hours. Ive waited 3 months for a call back. They lie to you on the phone and do nothing. They have totally frustrated the doctors office by lying. This company needs to be kicked out of *********.

  Business Response

  Date: 09/21/2022

  Good afternoon,

  Additional medical information was provided on appeal-Our Medical Director has reviewed the request for Epidural Pain injection and the request is APPROVED. The record provided, medical judgment, and Local Coverage Determination (LCD): Epidural Steroid Injections for Pain Management (L38994) were used to make the decision

  Outbound calls were made successfully to member and Provider advising authorization now approved.

  Thank you **************;

• Initial Complaint

  Date:09/06/2022

  Type:Delivery 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.

  In April, I received from Wellcare ******** advantage plan that I do not have SSBCI for non-medical transportation. I mail my appeal June 2, 2022 and June 24, 2022 after being advised my advisors asking for fast appeal (72 hrs.). My 1st tracked appeal arrived in ***** on June 4, 2022 after it was mail June 2, 2022 was never was pickup by Wellcare. My 2nd track mailed appeal was mail June 24, 2022 and was pickup by Wellcare June 30, 2022.I call Wellcare customer service 3 times *************, ****** and ******; I was told my appeal decision is on the way to me.As of today, ******, I have not received my appeal decision.********************************

  Business Response

  Date: 09/06/2022

  On 9/06/22 made contact with member review and confirmed reason of complaint. Advised member will follow up once review and research is complete reference to the 2 appeals filed. 

• Initial Complaint

  Date:08/31/2022

  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 have had a WellCare Classic prescription drug plan since 2019. Twice recently I was mailed flyers that were only in Spanish. I do not read, write, or speak Spanish - and at no point did I select Spanish as my preferred language. In July, when the first occurrence happened, I mailed the flyer back explained my issue. I was never mailed the flyer in English. Again, today, August 31, 2022, I was mailed another flyer that is completely in Spanish. I don't appreciate being racially profiled by my last name. If I do not receive the flyers in English, I will contact an attorney.

  Business Response

  Date: 09/12/2022

  Good morning, we were unable to reach the complainant to obtain further information on the flyers, we have flagged his account as English, as well as reviewed documents sent , they were all in English. We apologize for any inconvenience this may have caused. 

• Initial Complaint

  Date:08/29/2022

  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 made an appointment to be pickup to go to see my doctor. The driver showed up. but the van was not made for wheelchair people. I missed my appointment. This is the third time this has happened. So I called WellCare and told them what had happened. I was put on hold. The problem was not addressed.

  Business Response

  Date: 09/19/2022

  The plan called  ACCESS 2CARE On 9/16/22@ 11:37 am to ************ spoke with ******** advised of call with Sub vendor I had on 8/29/22 trip its was 1st time pick up this member and all vans are the same size and ***** model and was not aware before pick that would not accommodate ride due of member needed larger van and they do not have larger van. Per ******** member last trip was 4/15/21. And that was a issue with ride of size of van. If member has not updated or plan of new details for new year it will not be added for future trips  for the member. She stated member does have listed for ******************************************************************************************************** start of 2023 year with preferred vendor request for accommodating vans for his scooter. The plan contact member to provide final resolution was not able to speak with member left detail message on 9/19/22 @2:00 pm.