Complaints

This profile includes complaints for WellCare Health Plans, Inc.'s headquarters and its corporate-owned locations. To view all corporate locations, see Find Local Branches.

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  WellCare Health Plans, Inc.

  PO Box 31370 Tampa, FL 33631-3370

• 

  WellCare Health Plans, Inc.

  PO Box 22348 Tampa, FL 33622-2348

• 

  WellCare Health Plans, Inc.

  PO Box 31389 Tampa, FL 33631-3389

• 

  WellCare Health Plans, Inc.

  PO Box 31503 Tampa, FL 33631-3503

• 

  WellCare Health Plans, Inc.

  PO Box 31397 Tampa, FL 33631-3397

The complaint text that is displayed might not represent all complaints filed with BBB. Some consumers may elect to not publish the details of their complaints, some complaints may not meet BBB's standards for publication, or BBB may display a portion of complaints when a high volume is received for a particular business.

• Initial Complaint

  Date:09/16/2024

  Type:Billing Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  WellCare terminated my WellCare value script plan on July 1st, 2024, for allegedly failing to pay my monthly premiums (See WellCares termination of coverage letter). Immediately after WellCare terminated my coverage in error, I notified WellCare several times that they made a mistake, and that I did in fact pay my monthly premiums. WellCare refused to correct the mistake and reinstate my coverage, so on July 31st, 2024, I filed a grievance through WellCares operational grievance department and provided a premium payment history PDF document downloaded from my WellCare member portal as proof that I made my monthly premium payments (See WellCare grievance). On August 27th, 2024, WellCares operational grievance department determined that WellCare errored in terminating my prescription insurance and that I am eligible for a good cause reinstatement of my WellCare value script prescription insurance (See WellCare good cause reinstatement letter). On September 9th, 2024, I spoke with ****** who is a WellCare member services supervisor who said she "doesnt care about WellCare's good cause reinstatement letter and shes not reinstating my insurance. On September 11th, 2024, ***** who is a ******** senior specialist called WellCare with me on a three-way recorded phone call, at which time WellCare refused to reinstate my prescription coverage because more than sixty days had gone by from the date WellCare terminated my prescription coverage in error". I made several requests on file with ******** and WellCare to have my value script plan reinstated immediately after WellCare terminated my coverage in error on July 1st, 2024. Additionally, it's not my fault that WellCares grievance department issued my good cause reinstatement letter on August 27th, 2024, in response to my grievance filed on July 31st, 2024 and when I received WellCare's reinstatement letter that they sent out in the mail on August 27th, 2024, I called WellCare once again requesting reinstatement.

  Business Response

  Date: 09/18/2024

  Dear *****************************,
  Thank you for bringing this matter to our attention. We are sorry for any inconvenience that you have experienced. After our Billing/Failure to Pay Department reviewed your account your request for reinstatement has been denied. I have provided you with a resolution via email and if you have any further questions or concerns, please do not hesitate to contact us.
  Sincerely,
  **** D

  Customer Answer

  Date: 09/18/2024

   
  Complaint: 22283584
  
  I am rejecting this response because:

  Dear **** D
  
  You have not provided me with a resolution via email and WellCare has not reinstated my prescription insurance coverage terminated in bad faith on 07/01/2024 based on misrepresentation. After the Better Business Bureau reached out to WellCare regarding my complaint you gaslighted me with additional false allegations in recent email communication while failing to address key issues in response to my Better Business Bureau complaint such as:
  
  Why WellCare listed my address incorrectly on a notice of upcoming changes letter dated 12/13/2024,which contained important information regarding significant increases in cost to my old WellCare classic plan that went into effect on January 1st,2024, without my knowledge or consent.
  
  Why WellCare has listed my address in a different way in multiple letters containing important information related to my coverage sent from 12/13/2024 to present.
  
  Why WellCare initially at the end of February 2024, fixed the mistake by enrolling me into the WellCare Value script plan for $0.50 per month effective 03/01/2024 and later required that I pay the old WellCare classic premiums for January 2024 and February 2024 for the old plan for a price that I could not afford and didnt use as a contingency to keep the WellCare value script plan that I did want.
  
  Why WellCare lied to me and ******** in a notice of termination letter dated 07/05/2024, by claiming that I failed to pay my WellCare value script plan for $0.50 cents per month as the reasoning for terminating my coverage, which my premium history downloaded directly off WellCares member portal confirms that I did in fact pay.
  
  Why WellCare in response to my grievance filed through WellCares operation grievance department issued a determination letter dated 08/27/2027 stating that I can call and request a good cause reinstatement that now you claim, does not actually grant me good cause reinstatement.
  
  Why you are lying attempting to blame your billing/failure to pay department as being the reasoning why WellCare has not reinstated my coverage, when I clearly provided confirmation that I did not fail to pay my premiums.
  
  Why WellCare treated me so horribly, which from my perspective based on phone conversations with WellCare employees and there being no other logical explanation for WellCares malicious actions that I am being discriminated against due to my disability and race. I hope that if WellCare doesnt reinstate my WellCare Value script plan that this publicly viewable complaint saves others from getting treated so horribly by WellCare. 

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

  Business Response

  Date: 09/19/2024

  Dear *****************************, 

  A resolution was provided to you via email. Grievance Department did not approve a good cause reinstatement, the Grievance Department acknowledged your address issues and informed you to contact customer service for a good cause reinstatement. Those type of reinstatements are only approved by your Billing/Failure to Pay Department, the request was sent over to that department and it was denied. 

  The denial was based on several telephone contacts that you made to WellCare on 3/27/24, 4/10/24, 5/10/24, and 6/20/24 in which you were informed that you had a past due on your account that need to be paid by 6/30/24 or you were in danger of termination. You also have access to your member portal since 2/2024 that shows what your current and past due amount is, I do apologize that you do not agree with the resolution but after your account it was determined that you were informed several times verbally about your past due balance. 

   

  Thank you, 

  Customer Answer

  Date: 09/19/2024

   
  Complaint: 22283584
  
  I am rejecting this response because:

  Dear ***********************,

  
  The better business bureau has our recent email correspondence, which demonstrates WellCare ignored the grievance departments August 27th, 2024, good cause reinstatement letter of my WellCare value script plan, which you admit and proceed to make nonsensical arguments as to why you are not following through with (See emails with ***********************). You also admit WellCare did not provide an acceptable resolution, by admitting WellCare denied the reinstate of my WellCare value script plan terminated on July 1st, 2024, which in this case is the only acceptable resolution (See WellCares termination letter dated 07/05/2024).  Additionally, you admit WellCares administrative error with my address resulting in the improper not mutually agreed upon increase in cost with my old WellCare classic plan for January 2024 and February 2024, which you no longer appear to be denying is the real cause of the outstanding balance.

  
  Surprisingly,even after these crucial admissions, all which WellCare has previously denied you stand by WellCares malicious decision to falsify company records by writing in the July 5th, 2024, termination of coverage letter that I failed to pay my WellCare value script plans premiums specifically. You lied again within our recent email correspondence from September 18th,2024, by claiming during a 2/20/2024 phone call if I wanted to opt out of the old Well Care classic plan that the agent could have sent me a disenrollment form. It was in fact during this time that WellCare disenrolled me from the WellCare classic plan and enrolled me in the WellCare value script plan to solve the outstanding balance issue, which occurred due to WellCares previously mentioned administration address mishap that you now admit (See WellCare value script enrollment letter dated 02/26/2024). This value script plan enrollment letter proves that WellCare enrolled me into the WellCare value script plan effective May 1st, 2024, and indicates the monthly premium for the value script plan is $0.50 cents per month. My WellCares transaction history report proves that I paid my $0.50 payment for March 2024 on 03/01/2024, my $0.50 payment for April 2024 on 04/10/2024, my $0.50 payment for May 2024 on 05/10/2024 and my $0.50 payment for June 2024 on 05/28/2024 (See my WellCares transaction history report).

  
  Therefore,WellCares value script enrolment letter dated 02/26/2024 combined with my WellCare transaction history report clearly proves that WellCare changed my prescription plan to WellCare value script on May 1st 2024, that the premium cost of my WellCare value script was $0.50 per month and that I did pay my value script plans monthly premium every month that it was in effect for March 2024, April 2024, May 2024 and June 2024. Despite me explaining this to WellCare on March 27th, 2024, April 10th, 2024, May 10th, 2024,and on June 20th, 2024, during recorded phone calls that you admitted took place, WellCare still maliciously falsified the July 5th,2024, termination of coverage letter to make it appear, that I did not pay my WellCare value script insurance premiums. WellCare falsified the July 5th,2024, coverage termination letter because its the only way WellCare could trick ******** into confirming the termination of my value script plan.

  
  The $52.00 balance listed in WellCares transaction history report in connection with the old WellCare classic plan exists due to WellCares acknowledged administrative error with listing my address incorrectly resulted in me not having proper opportunity to opt of the old classic plans premium increase timely. WellCare did not have the right to make me pay the $52.00 WellCare classic plans balance that exists due to WellCares mistake as a contingency to keep my WellCare value script plan. ******** has confirmed that WellCare member services can reinstate my WellCare value script plan using the above referenced documentation and WellCares refusal to reinstate my value script plan has nothing to do with WellCares billing department, which is simply a false narrative designed to cover up WellCares malicious and discriminatory actions.

  
  Despite your admissions in your last response as it relates to key issues you still havent provided explanations on any of the following issues mentioned in my prior response:

  
  Why WellCare listed my address incorrectly on a notice of upcoming changes letter dated 12/13/2023,which contained important information regarding significant increases in cost to my old WellCare classic plan that went into effect on January 1st,2024, without my knowledge or consent.
  
  Why WellCare has listed my address in a different way in multiple letters containing important information related to my coverage sent from 12/13/2023 to present.
  
  Why WellCare initially at the end of February 2024, fixed the mistake by enrolling me into the WellCare Value script plan for $0.50 per month effective 03/01/2024 and later required that I pay the old WellCare classic premiums for January 2024 and February 2024 for the old plan for a price that I didnt want and didnt use as a contingency to keep the WellCare value script plan that I did want.
  
  Why WellCare lied to me and ******** in a notice of termination letter dated 07/05/2024, by claiming that I failed to pay my WellCare value script plan for $0.50 cents per month as the reasoning for terminating my coverage, which my premium history downloaded directly off WellCares member portal confirms that I did in fact pay.
  
  Why WellCare in response to my grievance filed through WellCares operation grievance department issued a determination letter dated 08/27/2027 stating that I can call and request a good cause reinstatement that now claim, does not actually grant me good cause reinstatement.
  
  Why you are lying attempting to blame your billing/failure to pay department as being the reasoning why WellCare has not reinstated my coverage, when I clearly provided confirmation that I did not fail to pay my premiums.
  
  Why WellCare treated me so horribly, which from my perspective based on phone conversations with WellCare employees and there being no other logical explanation for WellCares malicious actions that I am being discriminated against due to my disability and race. I hope that if WellCare doesnt reinstate my WellCare Value script plan that this publicly viewable complaint saves others from getting treated so horribly by WellCare. 
  
  

• Initial Complaint

  Date:09/16/2024

  Type:Billing Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  My name is ***** ******* a WellCare Mutual of Omaha No Premium open PPO member id ******** and on or about July 25, 2024 I had a physical with blood work being done. Upon the findings of the blood work I found my PSA high as well as high marker for cancer and was referred to a Urology firm in ***********, Mo. Urology sought to have an *** done for further determination of possible cancer. Well upon trying to find someone in Network I found out there was not a single provider in Network with WellCare leaving me with trying to find out why. The approval by Wellcare was given on August 23, 2024 then approval was withdrawn on August ******* number one reason provider was not in network, (2) not enough information given to warrant the *** as stated in the letter on the withdrawal of approval by a consulting firm Namely *******. In my case file filed by my case management Nurse had in her filing that a *** was needed to determine possible cancer. Many workers searched for an in network provider and failed because there isn't any available in the big town of **. the closest in network provider is 163 miles from me. Upon complaining about the issue I filed a Complaint with the *************** basis being that WellCare could not meet the basic standards of ******** Part B which is required per contractual reasoning between ******** and WellCare. I gave WellCare almost 2 weeks to resolve the issue at hand and they failed to do so. I had a scheduled appt with Diagnostic Imaging on SEPT 10, 2024 and fought to get approval to use the firm for my ***. I gave them until 5 pm 09/09/2024 and at 1:30 pm that day approval was once again given by the Evolent. Upon my approaching time of my appointment I was notified by phone that the approval was made but because the provider was not in Network I would be held responsible for 40% of the cost. I again see that WellCare failed to meet the basics of ******** PartB as in it I be only charged $240 for the service.

  Business Response

  Date: 09/24/2024

  Dear Mr. ***** *******,

  I spoke to the complainant ***** ******* on 09.17.2024. The complainant was advised prior to the appointment on 09.05.2024 that if he goes to an out-of-network provider he will be responsible for 40% of the out of network cost. The complainant was aware that WellCare was working to find an in-network provider. The complainant was adamant to go to his appointment on 09.10.2024. I spoke to ****** on 09.09.2024 from ************************* and she stated she spoke to *** at ******* on the 29th of August 2024 and she stated the case was withdrawn for Diagnostic Imaging by the providers office because the member wanted to go to ********************** Elmont reached out to the patient, and he stated he is going to ********************************* and a new case for the member was started by ******************** on 08.06.2024 the complainant was made aware of that on 09.09.2024 during our follow-up call. The urgency of the complainant's needs to have the *** done was understood, I offered to work with our internal case management to locate an in-network provider, outreach was made to the complainant on 09.09.2024 but was unsuccessful.On 09.05.2024 the complainant and I spoke about the coverage and discussed his specific plan which I located on ************ website for both in and out of network cost. I stated the in-network cost would range from $0-$300 for an advance *** and out -of -network would be 40% of the total cost of service rendered. The complainant requested that I respond to the BBB complaint, and he will in turn respond through the BBB.

  Customer Answer

  Date: 09/28/2024

   
  Complaint: 22281623
  
  I am rejecting this response because:
  
  Sincerely,
  
  ***** *******

• Initial Complaint

  Date:08/27/2024

  Type:Billing Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  I had x-rays at hospital ******* and they haven't filed my insurance. And they keep sending me a bill.What can you do about it for me. I did call you about this once and you were supposed to check on it for me Account #for me at the hospital is 495009A14254 ******* Oklahoma .************************** x-ray of lower and sacral spkne,2 or 3 views

  Business Response

  Date: 09/10/2024

  Hello and Good Afternoon, We have successfully made contact with Ms. ****** and are diligently  working with our Claims team in efforts of resolving this matter. Thank you.

• Initial Complaint

  Date:08/27/2024

  Type:Customer Service 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.

  You always call my cell phone about my moms perscription, and health benfits. When questioned about this you don't find the ************ on my moms account. Please fix this asap.

  Business Response

  Date: 08/28/2024

  Dear ********************** ,
  Thank you for bringing this matter to our attention. We are sorry for any inconvenience that you have experienced. We will do everything we can to resolve the issue as quickly as possible. If you have any further questions or concerns, please do not hesitate to contact us. 
  Sincerely,
  **** D

  Customer Answer

  Date: 08/28/2024

   
  Complaint: 22197881
  
  I am rejecting this response because:

   

  the complaint is still ongoing at this time.

  also I got another call from a company called, ComplexCare for *****************************

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

  Business Response

  Date: 09/05/2024

  Fidelis is in receipt of your letter dated August 27, 2024 regarding a complaint filed by consumer *********************************.  Due to federal and state privacy and confidentiality regulations, we are unable to disclose any protected health information, including, but not limited to eligibility, claims, and billing information. Fidelis appreciates that the Better Business Bureau has brought this matter to the attention of the Plan however, the Plan has addressed the concerns directly with the complainant.

  Customer Answer

  Date: 09/05/2024

   
  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me.
  
  Sincerely,
  
  *********************************

• Initial Complaint

  Date:08/26/2024

  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 a ******** Part D prescription drug plan from Wellcare. I filled a prescription on 7/30/24, and paid cash. I then needed to submit a claim to Wellcare for this RX, so I printed the 3-page form, filled it out, and mailed to Wellcare on 8/3/2024. I called customer service on 8/20/24 and spoke to ***** (an account supervisor in the ***). She could not find any record of my claim being received by Wellcare. She told me to mail another copy. I can only conclude that the claim has been misplaced by Wellcare.I do not think printing a form and mailing is acceptable. I have limited access to printing. Even if it was easy to print, Wellcare has shown they cannot properly manage paper claims. I need to be able to submit this online, by email, or at least by fax. And I need this claim processed in the next week.

  Business Response

  Date: 08/26/2024

  Good afternoon, the plan contacted ************ on 8/26/24 and is reviewing and researching her concerns. A follow up update call will be made once the research is complete. 

  Customer Answer

  Date: 09/04/2024

   
  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. Thanks for your help.
  
  Sincerely,
  
  ***********************

• Initial Complaint

  Date:08/22/2024

  Type:Customer Service 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 canceled my coverage with WellCare and was somehow put back on it. I recently sent them a letter. I am now on ******** where my prescriptions are free or even lower than ********* I should never have even been using WellCare and dont know how I received it. WellCare needs to terminate my service with them ASAP and never reinstate it.

  Business Response

  Date: 08/27/2024

  Dear ************************* ,
  Thank you for bringing this matter to our attention. We are sorry for any inconvenience that you have experienced and it was determined that you were on auto-enrollment with CMS ********* We have terminated your coverage with WellCare effective 8/31/24  and based on our conversation the resolution has been accepted.
  If you have any further questions or concerns, please do not hesitate to contact us.
  Sincerely,

  **** D

  Customer Answer

  Date: 08/27/2024

   
  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me.
  
  Sincerely,
  
  *************************

• Initial Complaint

  Date:08/15/2024

  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.

  Unsupported claims reversal resulting in outstanding balance with no explanation or reason for the reversal. Member #********

  Business Response

  Date: 08/26/2024

  Good morning,  
  On 8/20/24 *********************** was educated about the worldwide impact of Ozempic being out-of-stock and members/ patients in constant need while some want it, it may be processed on the account but not received until later due to the outage. He was further explained to share the similarities of the example and his scenario, due to this outage and processing prior to the actual dispensing of the medication, there are/ could be adjustments. He understood and had no further inquiries or concerns. 

   

  Thank you,  

  *******

• Initial Complaint

  Date:08/07/2024

  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.

  I received WellCare as part ( D ) PDP prescription Supplemental G plans in February 2024 at 65.Since then WellCare in March of 2024 changed my PDP plan to an Advantage Plan because one of their employees along with a third-party vendor decided to make some money by doing this to me an unsuspecting client without my knowledge, I had to make calls to ******** and WellCare where upon WellCare explained that this was done by one of their employees and a Third Party Vendor for this thievery. I had to wait 30 days for them to switch it back and I filed a complaint with ********.Now in August of this year 2024, WellCare received a prescription from my Doctor for Ozempic but an incorrect code was put in for Hypertension instead of Diabetes. Now they are saying I have to wait 60 Days before they can accept another script from my Doctor, a simple correction of the code is all that is needed, they said they would call my Doctor but they never did, and then I was told to contact the third-party vendor C2C Vendor Solutions to handle it, in other words to their job. WellCare is a DISASTER and having incompetent people in their employment is not what anyone would sign up for when you need help or understanding in their day-to-day operations with the elderly clients!

  Business Response

  Date: 08/21/2024

  Hello, 

  We have contacted the member and informed them that the rejected transaction in question was valid. The rejection occurred because the plan requires updated lab results to support the member's medical condition. This case remains open, and the member has been advised on what documentation is needed from their provider for the transaction to be validated. We will provide further feedback once a final determination has been made.

  
  Thank you for your attention to this matter.

  Customer Answer

  Date: 08/21/2024

   
  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me.
  
  Sincerely,
  
  *************************

• Initial Complaint

  Date:08/06/2024

  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 am a Wellcare customer. I have been getting phone calls from a number I do not recognize ***************, most recently today, 5-Aug-2024), purporting to be from Wellcare. When I answer or return the call, the first thing they want is my member id number, which I refuse to give out to a number I don't recognize, and end the call. When I call Wellcare using the phone number on my card, I have to waste my time on hold and jumping through their hoops, and finally get told "Yeah, that's us, you can return the call", but they don't transfer me to that department or give me the message.My complaint is that Wellcare customers are going to get tired of verifying the phone number (it's only human nature), and will simply get into the habit of giving out personal information to unsolicited callers, which is precisely the wrong thing to do. Yet, it is Wellcare's policy to encourage their customers to do exactly that, or they will be punished by wasting their time in a phone maze.Furthermore, the last time I called Wellcare about this, they said they would remove me from their call list, yet I am still getting these calls.When people get scammed by unwisely giving out information, the victims lose money, property, or their identities, and feel utterly foolish. The scammers are delighted and enriched. Yet the companies that habituate this behavior get away *****-free. This has to be stopped!

  Business Response

  Date: 08/14/2024

  An outbound call was placed to ****************** on 08.07.2024 at 4:38pm Est. I advised ****************** I was calling regarding his complaint received by the BBB.  ****************** expressed his concerns about receiving unfamiliar calls on his landline. I then explained to the complainant, he was added to the *** (Do not contact list), per the *** guidelines there are some calls from WellCare that he will need to take. The complainant understood and was satisfied with the outcome of our conversation.

  Customer Answer

  Date: 08/15/2024

   
  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is no less satisfactory than I expected.  I do hope, however, that this complaint triggers a change in Wellcare's contact policy and procedures.
  
  Sincerely,
  
  *************************

• Initial Complaint

  Date:08/06/2024

  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.

  On May 20th 2024 I contacted my insurance company WellCare because I was unable to find anyone that would strike my tooth for a list of dentists that carried WellCare I called over 10 dental services in ******* either they would take WellCare and was not taking new patients and the other dentists was not taken well care an assistant in the WellCare office even try to help also at no results I had insurance through WellCare at that time it was well care no premium HMO ********. While talking with the representative she realized that I could get WellCare assist open PPO ******** which went into effect 5.23.24 when she canceled the old insurance and the new one went into effect I did find a dentist by the name of urgent dental of Buffalo but I had to pay out of my pocket $635 an urgent dental told me that they would submit a claim to my insurance company because they did not take the insurance but I could get in on the 22nd of 2024 and that's what I end up doing ever since I have been trying to submit a claim to receive my money back on my own and now I just received a grievance statement from WellCare stating that I did not have insurance on May ***** which I did. I sent in a copy of the bill with the statement and I filled out also a reimbursement claim and I have called them so many times and I get the runaround each time. The person that looked into this name is *****.R Grievance Resolution Team. I even spoke with one of the representatives at one point of time claim that she tried to call urgent dental of ******* to speak with them after I had given her the phone number and the fax number and the email address she placed a call she said and she could not get through to them as soon as I got off the phone with one of the WellCare Representatives a place to call myself to urgent dental or Buffalo they picked up the phone right away and I asked them did anyone call from WellCare and the assistant that I spoke with said no one called from WellCare.

  Business Response

  Date: 08/15/2024

  Contact was made with complainant: ********************* on 08.12.2024 at 12:56pm EST. She was educated, provider: ********************* was out-of-network (OON) with WellCare insurance; therefore, we are unable to reimburse her the money paid, $635. Due to her explaining via her complaint and confirming during our call, she chose to see ********************* with the understanding they were out of network, she would be responsible for the services rendered. She made mention she doesnt understand why the plan was cancelled in one day and she didnt have coverage. She was educated, she spoke with someone to change and terminate coverage on 05.20.2024, but terminations of plans happen on the last day of the month if approved while enrollments take place the first of the month. This means the termination would not have taken place on 05.23.2024 leaving her without coverage. She was further educated; the previous plans termination was 05.31.2024 with a new plans effective date 06.01.2024. She shared, she had been speaking with someone to locate providers, but they were unsuccessful; therefore, she located this provider through her own research and decided to go there because she was in pain. While I empathized with her experience of being in pain, she was educated that the provider was OON, and she didnt have permission which caused her to be denied reimbursement. 

  Customer Answer

  Date: 08/15/2024

   
  Complaint: 22097010
  
  I am rejecting this response because:
  
  Sincerely,
  
  *********************