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Medicare Basics

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Medicare is a federal health insurance program. It is available to people 65 and older, people under 65 with certain disabilities and people with end-stage renal disease. When you are ready to decide on a plan, take the time to understand how the plans work. That way, you can make an informed decision and choose the plan that is right for you.

Different Parts of Medicare Cover Different Services

The parts of Medicare are:

Part A - Hospital Coverage

  • Helps cover inpatient hospital care.
  • Helps cover care in a skilled nursing facility or hospice.
  • Also helps cover home health care.

Part B - Medical Coverage

  • Helps cover doctor and outpatient services.
  • Helps cover preventive services to maintain health or keep illnesses from getting worse.
  • Those who have Part B coverage pay a monthly premium directly to the government unless Medicaid or a third party pays it.

Part C - Medicare Advantage

  • An alternative to the Original Medicare insurance program and administered by the federal government, Part C gives you the option to enroll in a Medicare Advantage plan offered by companies such as WellCare.
  • Part C plans cover the same services as Part A and Part B, but may also offer additional benefits not covered by Original Medicare.   
  • Members of Medicare Advantage plans must continue to pay their Part B premium.

Part D - Prescription Drug Coverage

  • Helps cover the cost of prescription drugs.
  • Offered by companies like WellCare (may require a monthly premium).
  • May be a stand-alone Prescription Drug plan, or may be included with a Medicare Advantage plan (Part C).

When It Comes to Coverage, You Have Options:

  • You can get health services through Original Medicare and select a Prescription Drug plan, like one of WellCare's Prescription Drug Plans.
  • You can get your health services and prescription drug coverage through a Medicare Advantage plan that offers both, such as the WellCare Medicare Advantage plan.
  • You can purchase a Medicare Supplement plan from an insurance company to cover the gaps in Original Medicare. If your Medicare Supplement plan does not cover prescription drugs, you can also enroll in a Prescription Drug plan.

For definitions of the variety of medical terms used, view our glossary.

Important Information

For important information about WellCare’s Medicare Advantage coverage including eligibility, benefits and more, please see our Conditions and Limitations page.

You have the right to file a grievance or provide feedback directly to Medicare about our plan. Complete and submit the Medicare Feedback and Complaint Form. 

Medicare has an Office of the Medicare Ombudsman (OMO) that can help you with complaints, grievances and information requests. Visit Medicare.gov for more information about Medicare and/or assistance with complaints and grievances.  

WellCare (HMO) is a Medicare Advantage organization with a Medicare contract. Enrollment in WellCare (HMO) depends on contract renewal.  

You must continue to pay your Medicare Part B premium.  

How to access coverage in the event of a disaster or local emergency.

In the event of an emergency or natural disaster, WellCare is committed to helping you continue to access care easily. In a time of crisis, we will:

  • Allow Part A and Part B and supplemental Part C plan benefits to be furnished at specified non-contracted facilities (note that Part A and Part B benefits must, per 42 CFR §422.204(b)(3), be furnished at Medicare certified facilities)
  • Waive in full, requirements for gatekeeper referrals where applicable
  • Temporarily reduce plan-approved out-of-network cost-sharing to in-network cost sharing amounts
  • Waive the 30-day notification requirement to enrollees as long as all the changes (such as reduction of cost-sharing and waiving authorization) benefit the enrollee
  • Allow you to fill medications sooner than usual to ensure you have what you need during the emergency 

These actions will be in effect through the emergency declaration period. Disasters/Emergencies may be declared by the U.S. Government, the Federal Emergency Management Agency (FEMA), or the Governor of any state.

Typically, the source which declares the disaster will clarify when the disaster or emergency is over. If however, the disaster or emergency timeframe has not been closed 30 days from the initial declaration, and if the Centers for Medicare & Medicaid Services (CMS) has not indicated an end date to the disaster or emergency, we will resume normal operations 30 days from the initial declaration.

WellCare also offers Special Needs Plans (SNP) to qualifying individuals. To enroll in a Special Needs Plan, please contact us for more information.

  • Disclaimers

    For important information about WellCare’s Medicare Advantage coverage including eligibility, benefits and more, please see our Conditions and Limitations page.

    You have the right to file a grievance or provide feedback directly to Medicare about our plan. Complete and submit the Medicare Feedback and Complaint Form. 

    Medicare has an Office of the Medicare Ombudsman (OMO) that can help you with complaints, grievances and information requests. Visit Medicare.gov for more information about Medicare and/or assistance with complaints and grievances.  

    WellCare (HMO) is a Medicare Advantage organization with a Medicare contract. Enrollment in WellCare (HMO) depends on contract renewal.  

    You must continue to pay your Medicare Part B premium.  

  • How to access coverage in the event of a disaster or local emergency.

    How to access coverage in the event of a disaster or local emergency.

    In the event of an emergency or natural disaster, WellCare is committed to helping you continue to access care easily. In a time of crisis, we will:

    • Allow Part A and Part B and supplemental Part C plan benefits to be furnished at specified non-contracted facilities (note that Part A and Part B benefits must, per 42 CFR §422.204(b)(3), be furnished at Medicare certified facilities)
    • Waive in full, requirements for gatekeeper referrals where applicable
    • Temporarily reduce plan-approved out-of-network cost-sharing to in-network cost sharing amounts
    • Waive the 30-day notification requirement to enrollees as long as all the changes (such as reduction of cost-sharing and waiving authorization) benefit the enrollee
    • Allow you to fill medications sooner than usual to ensure you have what you need during the emergency 

    These actions will be in effect through the emergency declaration period. Disasters/Emergencies may be declared by the U.S. Government, the Federal Emergency Management Agency (FEMA), or the Governor of any state.

    Typically, the source which declares the disaster will clarify when the disaster or emergency is over. If however, the disaster or emergency timeframe has not been closed 30 days from the initial declaration, and if the Centers for Medicare & Medicaid Services (CMS) has not indicated an end date to the disaster or emergency, we will resume normal operations 30 days from the initial declaration.

  • Special Needs

    WellCare also offers Special Needs Plans (SNP) to qualifying individuals. To enroll in a Special Needs Plan, please contact us for more information.

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Y0070_WCM_42183E Last Updated On: 10/1/2019