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Overview 

Effective 1/1/17, WellCare of New York will no longer be offering individual Qualified Health Plans in New York. WellCare will continue to have a strong presence in New York’s Essential Plan, Medicaid, Medicare Advantage and Medicare Part D markets.

Some of your patients will be experiencing plan transitions at the end of calendar year 2016, as follows:

Qualified Health Plan members — WellCare will no longer be issuing Qualified Health Plans (QHP) in New York’s individual commercial exchange market and existing WellCare individual QHP policies will terminate as of Dec. 31, 2016. WellCare of New York will continue to offer the Essential Plan. Members must obtain coverage effective Jan. 1, 2017 through another health plan or the Marketplace during the 2016 open enrollment period which runs from Nov. 1, 2016 through Jan. 31, 2017.

What do I need to do?

You do not need to take any action at this time. WellCare does not plan to terminate any of our existing provider contracts and claims for services will be paid in accordance with existing contract terms and in conformance with current State and federal laws and regulations. As always, we encourage providers to submit claims in a timely manner for prompt processing.

You should be aware that some of your patients may be entitled to an extension of benefits or access to transitional care.

We thank you for your service to our members. WellCare looks forward to continuing its relationship with you as we undergo these transitions. Please contact WellCare of New York at 1-855-582-6172 with any questions or if you require any assistance.

Helpful Resources

Detailed health plan information on important topics such as coverage procedures and policies.

Detailed health plan information on important topics such as coverage procedures and policies.

Contains key phone numbers, authorization requirements and more.

Explains various services WellCare offers to assist providers with day-to-day administrative tasks.

Explains various services WellCare offers to assist providers with day-to-day administrative tasks.

Learn how to submit claims with WellCare to ensure efficient handling and payment.

Learn about all the tools available in WellCare's secure provider portal.

Other Helpful Information

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Authorizations

The authorization process is identical to that used for Medicaid.


Consumer Enrollment

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Last Updated On: 1/3/2017