A Medicare Advantage Private Fee-for-Service plan works differently than a Medicare supplement plan. Your doctor or hospital is not required to agree to accept the plan’s terms and conditions, and thus may choose not to treat you, with the exception of emergencies. If your doctor or hospital does not agree to accept our payment terms and conditions, they may choose not to provide health care services to you, except in emergencies. Providers can find the plan’s terms and conditions on our website.

WellCare is a Health Plan that is approved by Medicare and contracts with the Federal Government.

WellCare's contract with Medicare is reviewed annually. Availability of coverage beyond the end of the current year is not guaranteed.

Enrollment periods into a WellCare Healthplan occur during specific times of the year. You may view the application to Learn more about enrollment periods.

If you enroll into more than one plan at a time, you will be enrolled into the last plan you applied for.

To be eligible for a PFFS plan you must have Medicare Part A and B, and you must live in the plan's service area.

You must continue to pay your Part B premium, if it's not otherwise paid for under Medicaid or by another third party.

Members must use network pharmacies to access their prescription drug benefits. There are some occasions, under emergency circumstances, where access to a non-network pharmacy for prescription benefits is allowed. Please call customer service for more information.

For additional information on WellCare's PFFS Plans' benefits, call our customer service department at 1-866-207-6301 (TTY/TDD users, 1-866-239-6265). Our office hours are Monday - Sunday, 8:00 a.m. - 2:00 a.m., Eastern.

You may be enrolled into only one Part D plan at a time. Benefits and limitations may vary by plan and by county or parish. Please contact WellCare for details. As a member of WellCare PFFS plan, you may go to any Medicare provider who accepts WellCare's terms and conditions.

If enrolled in a MA plan, a beneficiary may not enroll in a PDP, unless the enrollee is a member of a Private Fee-for-Service MA plan (PFFS) that does not provide Medicare prescription drug coverage, a Medical Savings Account MA plan (MSA), or a 1876 cost plan.

You may be able to get extra help to pay for your prescription drug premiums and costs. To check if you qualify for extra help, call:

• 1-800 MEDICARE (1-800-633-4227), 24 hours a day/7 days a week (TTY/TDD users call 1-877-486-2048)
• The Social Security Administration at 1-800-772-1213, 7:00 a.m. - 7:00 p.m., Monday - Friday (TTY/TDD users call 1-800-225-0778)
• Your state Medicaid office

Rights and responsibilities upon disenrollment

If a you disenroll, be sure to remember the following during the disenrollment process:

• Use your WellCare prescription drug coverage and our network pharmacies to fill your Rx until your coverage ends.
• If you leave WellCare, you may join another Medicare PDP or a Medicare Advantage plan, as long as the following applies:
  1) This type of plan is available in your area.
  2) The providers are accepting new members.
  3) You meet the eligibility requirements of the plan.
• You may only disenroll or switch plans during certain periods.

WellCare can disenroll you in the following circumstances:

• You are no longer eligible for Medicare prescription drug coverage.
• If WellCare is no longer contracting with Medicare or leaves your service area.
• When you move out of WellCare’s service area.
• You materially misrepresent a third party reimbursement.
• You fail to pay premium.
• You engage in disruptive behavior, provided fraudulent information when you enrolled, or abuse your enrollment card.

Please refer to Section 3 of the Evidence of Coverage for more information on "Your Rights and Responsibilities as a member of Our Plan" and Section 6 of the Evidence of Coverage has information on "Ending your Membership".