Skip to main content

Provider Notice: Model of Care

The Centers for Medicare & Medicaid Services (CMS) regulations require that health plans provide their Special Needs Plan provider network with information on their basic Model of Care. This applies to our Dual-Eligible Special Needs Plan (D-SNP) members who are eligible for both Medicare and Medicaid.

Please review WellCare's self-study program This PDF document will open in a new window. that outlines the basic Model of Care requirements for our providers. Frequently asked questions outline other information you may find helpful.

Once you have reviewed the self-study program, please fill out the evaluation and fax it back to the number provided so we can track that you received the information.

Medicare Provider Expectations - Model of Care

WellCare asks that you partner with us to ensure we are giving the highest quality of care possible to our D-SNP members by performing the following steps:

1. Review the member Care Plans faxed to you by a WellCare Case Manager.

2. If necessary, update the Care Plan with any required changes and fax the revised plan back to WellCare at 1-866-287-3286.

  • Call 1-866-635-7045 for questions or to further discuss the Care Plan; or you can call the Case Manager directly at the phone number listed on the fax cover sheet of the Care Plan.
  • Please keep a copy of the updated Care Plan to review with the D-SNP member during their next office visit.

3.  Participate in Interdisciplinary Care Team (ICT) for all D-SNP members and give feedback as appropriate.

We appreciate the quality care you provide our members and your support in our efforts to meet the CMS regulations regarding the Special Needs Plan Model of Care.


Need help? We're here for you.

Contact Us
Last Updated On: 4/24/2017
The Governor has declared a State of Emergency in Los Angeles County, due to the ongoing wild fires. If you are an affected member and need access to medical or pharmacy services, please call Member Services at 1-866-999-3945 for assistance. ×