Wellcare Medicare Plan Hearing Aid Benefits

876,923 Total Members

OTC Supplemental Benefits Prescription Hearing Aid Coverage
Company Plan name Plan type OTC Supplement OTC Rolls Over? Annual OTC Supplement Coverage? Covered Amount Covers OTC Aids? Coinsurance? Copay? Prior Authorization? Need Referral? Enrollees
Wellcare Wellcare Dual Access (HMO D-SNP)
H4868-014-0 		HMO $200 per Month Yes $0 Yes $1,500 No No Yes Yes No 42,977
Wellcare Wellcare No Premium Open (PPO)
H2775-106-0 		Local PPO $84 per Quarter No $336 Yes $1,500 No No Yes Yes No 32,316
Wellcare Wellcare Giveback Open (PPO)
H2775-111-0 		Local PPO No $0 Yes $700 No No Yes Yes No 32,008
Wellcare Wellcare Giveback (HMO)
H5087-029-2 		HMO No $0 Yes $2,000 No No Yes Yes Yes 31,737
Wellcare Wellcare TexanPlus Classic No Premium (HMO)
H4506-003-0 		HMO $33 per Month Yes $0 Yes $1,500 No No Yes Yes No 29,200
Wellcare Wellcare No Premium (HMO)
H0174-010-0 		HMO $55 per Month Yes $0 Yes $1,500 No No Yes Yes No 21,722
Wellcare Wellcare Dual Access Open (PPO D-SNP)
H2775-112-0 		Local PPO $84 per Month Yes $0 Yes $2,000 No No Yes Yes No 17,722
Wellcare Wellcare Dual Liberty (HMO D-SNP)
H1032-175-0 		HMO $180 per Month Yes $0 Yes $5,000 No No Yes Yes No 15,791
Wellcare Wellcare No Premium (HMO)
H9730-009-0 		HMO $49 per Month Yes $0 Yes $2,000 No No Yes Yes No 15,190
Wellcare Wellcare Dual Align 001 (HMO D-SNP)
H5087-001-0 		HMO $260 per Quarter No $1,040 Yes $2,000 No No Yes Yes Yes 14,254
Wellcare Wellcare No Premium (HMO-POS)
H1416-009-0 		HMOPOS $67 per Month Yes $0 Yes $3,000 No No Yes Yes No 12,999
Wellcare Wellcare Assist Open (PPO)
H2775-113-0 		Local PPO $45 per Month Yes $0 Yes $1,500 No No Yes Yes No 11,945
Wellcare Wellcare Dual Access (HMO D-SNP)
H1032-124-0 		HMO $170 per Month Yes $0 Yes $4,000 No No Yes Yes No 11,452
Wellcare Wellcare No Premium Best (HMO)
H5087-005-0 		HMO $113 per Quarter No $452 Yes $2,000 No No Yes Yes No 11,405
Wellcare Wellcare No Premium (HMO-POS)
H5475-026-0 		HMOPOS $86 per Quarter No $344 Yes $1,500 No No Yes Yes No 11,181
Wellcare Wellcare No Premium Open (PPO)
H2775-109-0 		Local PPO $112 per Quarter No $448 Yes $1,500 No No Yes Yes No 10,867
Wellcare Wellcare No Premium Open (PPO)
H6713-001-0 		Local PPO $22 per Month Yes $0 Yes $1,500 No No Yes Yes No 10,863
Wellcare Wellcare No Premium (HMO)
H4868-019-0 		HMO No $0 Yes $1,500 No No Yes Yes No 10,582
Wellcare Wellcare Giveback Open (PPO)
H7326-003-0 		Local PPO No $0 Yes $700 No No Yes Yes No 10,434
Wellcare Wellcare Dual Liberty (HMO D-SNP)
H9730-004-0 		HMO $175 per Month Yes $0 Yes $5,000 No No Yes Yes No 10,316
Wellcare Wellcare Dual Access (HMO-POS D-SNP)
H5475-001-0 		HMOPOS $134 per Month Yes $0 Yes $3,000 No No Yes Yes No 10,010
Wellcare Wellcare No Premium (HMO)
H1032-213-0 		HMO $78 per Month Yes $0 Yes $3,000 No No Yes Yes No 9,786
Wellcare Wellcare Dual Access (HMO D-SNP)
H0174-004-0 		HMO $119 per Month Yes $0 Yes $2,000 No No Yes Yes No 9,602
Wellcare Wellcare Giveback (HMO)
H1032-200-0 		HMO No $0 Yes $1,000 No No Yes Yes No 9,304
Wellcare Wellcare No Premium (HMO)
H1112-038-0 		HMO No $0 Yes $3,000 No No Yes Yes No 9,193
Wellcare Wellcare Giveback (HMO)
H1032-040-0 		HMO $359 per Quarter No $1,436 Yes $3,000 No No Yes Yes Yes 8,616
Wellcare Wellcare Giveback (HMO)
H0174-019-0 		HMO No $0 Yes $700 No No Yes Yes No 8,598
Wellcare Wellcare Assist (HMO)
H0174-009-0 		HMO $66 per Month Yes $0 Yes $2,000 No No Yes Yes No 8,047
Wellcare Wellcare No Premium Open (PPO)
H0111-001-0 		Local PPO $75 per Quarter No $300 Yes $1,000 Yes No Yes Yes No 7,812
Wellcare Wellcare Dual Liberty (HMO D-SNP)
H0174-006-0 		HMO $144 per Month Yes $0 Yes $3,000 No No Yes Yes No 7,799
Wellcare Wellcare Dual Access (HMO D-SNP)
H1112-006-0 		HMO $84 per Month Yes $0 Yes $4,000 No No Yes Yes No 7,742
Wellcare Wellcare Dual Liberty (HMO D-SNP)
H0913-013-0 		HMO $198 per Month Yes $0 No 7,497
Wellcare Wellcare No Premium Open (PPO)
H7326-001-0 		Local PPO $29 per Month Yes $0 Yes $1,500 No No Yes Yes No 7,369
Wellcare Wellcare TexanPlus No Premium (HMO)
H0174-014-0 		HMO $50 per Month Yes $0 Yes $2,000 No No Yes Yes No 7,104
Wellcare Wellcare No Premium (HMO)
H1416-071-0 		HMO $27 per Month Yes $0 Yes $1,000 No No Yes Yes No 7,100
Wellcare Wellcare Giveback (HMO)
H9730-007-0 		HMO $40 per Quarter No $160 Yes $1,000 No No Yes Yes No 6,598
Wellcare Wellcare Giveback (HMO)
H1032-212-0 		HMO No $0 Yes $1,000 No No Yes Yes No 6,393
Wellcare Wellcare No Premium (HMO)
H1032-201-0 		HMO $67 per Month Yes $0 Yes $2,000 No No Yes Yes No 6,176
Wellcare Wellcare Assist (HMO)
H1112-043-0 		HMO $25 per Month Yes $0 Yes $2,000 No No Yes Yes No 5,680
Wellcare Wellcare Giveback (HMO)
H0174-018-0 		HMO No $0 No 5,537
Wellcare Wellcare Giveback (HMO)
H1416-065-0 		HMO $40 per Quarter No $160 Yes $700 No No Yes Yes No 5,515
Wellcare Wellcare Giveback (HMO)
H1112-042-0 		HMO No $0 Yes $700 No No Yes Yes No 5,408
Wellcare Wellcare No Premium Exclusive (HMO)
H5779-007-0 		HMO $55 per Month Yes $0 Yes $3,000 No No Yes Yes No 5,379
Wellcare Wellcare No Premium Open (PPO)
H2117-001-0 		Local PPO $35 per Month Yes $0 Yes $1,000 No No Yes Yes No 5,265
Wellcare Wellcare Dual Access (HMO D-SNP)
H9730-003-0 		HMO $126 per Month Yes $0 Yes $3,000 No No Yes Yes No 5,233
Wellcare Wellcare No Premium (HMO)
H1112-039-0 		HMO No $0 Yes $3,000 No No Yes Yes No 5,101
Wellcare Wellcare Dual Liberty (HMO D-SNP)
H1112-033-0 		HMO $140 per Month Yes $0 Yes $5,000 No No Yes Yes No 5,094
Wellcare Wellcare Giveback (HMO)
H1032-193-0 		HMO No $0 Yes $2,000 No No Yes Yes No 5,027
Wellcare Wellcare No Premium (HMO)
H1032-205-0 		HMO $38 per Month Yes $0 Yes $2,000 No No Yes Yes No 4,732
Wellcare Wellcare No Premium Open (PPO)
H9761-001-0 		Local PPO $28 per Month Yes $0 Yes $2,000 No No Yes Yes No 4,583
Wellcare Wellcare Dual Access (HMO D-SNP)
H1416-034-0 		HMO $180 per Month Yes $0 Yes $2,000 No No Yes Yes No 4,577
Wellcare Wellcare No Premium (HMO)
H1353-005-0 		HMO $41 per Month Yes $0 Yes $2,000 No No Yes Yes No 4,386
Wellcare Wellcare No Premium (HMO)
H5087-026-0 		HMO $168 per Quarter No $672 Yes $1,500 No No Yes Yes Yes 4,363
Wellcare Wellcare No Premium (HMO)
H4073-001-0 		HMO $107 per Quarter No $428 Yes $1,500 No No Yes Yes No 4,175
Wellcare Wellcare Giveback Open (PPO)
H6713-002-0 		Local PPO No $0 Yes $700 No No Yes Yes No 4,029
Wellcare Wellcare No Premium Best (HMO)
H5087-016-0 		HMO $115 per Quarter No $460 Yes $2,000 No No Yes Yes No 3,969
Wellcare Wellcare Dual Access (HMO D-SNP)
H4868-004-0 		HMO $100 per Month Yes $0 Yes $2,000 No No Yes Yes No 3,901
Wellcare Wellcare 'Ohana Dual Liberty (HMO D-SNP)
H2491-004-0 		HMO $90 per Month Yes $0 Yes $1,000 No No Yes Yes No 3,820
Wellcare Wellcare No Premium (HMO)
H4847-001-0 		HMO No $0 Yes $1,500 No No Yes Yes No 3,763
Wellcare Wellcare No Premium Open (PPO)
H5199-012-0 		Local PPO $53 per Month Yes $0 Yes $2,000 No No Yes Yes No 3,707
Wellcare Wellcare No Premium (HMO-POS)
H1416-077-0 		HMOPOS $59 per Month Yes $0 Yes $2,000 No No Yes Yes No 3,694
Wellcare Wellcare Dual Access (HMO D-SNP)
H0712-005-0 		HMO $80 per Month Yes $0 Yes $2,000 No No Yes Yes No 3,657
Wellcare Wellcare Dual Access (HMO D-SNP)
H1416-035-0 		HMO $141 per Month Yes $0 Yes $3,000 No No Yes Yes No 3,564
Wellcare Wellcare Assist (HMO)
H1416-068-0 		HMO $35 per Month Yes $0 Yes $2,000 No No Yes Yes No 3,550
Wellcare Wellcare No Premium Essential (HMO)
H5779-002-0 		HMO $75 per Quarter No $300 Yes $2,000 No No Yes Yes No 3,516
Wellcare Wellcare Assist (HMO)
H5475-038-0 		HMO $37 per Month Yes $0 Yes $3,000 No No Yes Yes No 3,448
Wellcare Wellcare No Premium (HMO)
H2491-007-0 		HMO $91 per Quarter No $364 Yes $1,000 No No Yes Yes Yes 3,388
Wellcare Wellcare Dual Access Open (PPO D-SNP)
H2117-002-0 		Local PPO $155 per Month Yes $0 Yes $4,000 No No Yes Yes No 3,352
Wellcare Wellcare Giveback (HMO)
H1032-195-0 		HMO No $0 Yes $1,500 No No Yes Yes No 3,296
Wellcare Wellcare Dual Liberty (HMO D-SNP)
H1416-044-0 		HMO $210 per Month Yes $0 Yes $4,000 No No Yes Yes No 3,286
Wellcare Wellcare Assist (HMO)
H1416-042-0 		HMO $50 per Month Yes $0 Yes $3,000 No No Yes Yes No 3,269
Wellcare Wellcare Dual Pinnacle Liberty (HMO D-SNP)
H2491-012-0 		HMO $240 per Month Yes $0 Yes $2,000 No No Yes Yes No 3,267
Wellcare Wellcare No Premium Open (PPO)
H1914-001-0 		Local PPO $32 per Month Yes $0 Yes $2,000 No No Yes Yes No 3,267
Wellcare Wellcare Assist (HMO)
H9730-010-0 		HMO $52 per Month Yes $0 Yes $1,500 No No Yes Yes No 3,214
Wellcare Wellcare Assist Compass (HMO)
H1416-023-0 		HMO $60 per Month Yes $0 Yes $4,000 No No Yes Yes No 3,212
Wellcare Wellcare 'Ohana No Premium (HMO)
H2491-015-0 		HMO $91 per Quarter No $364 Yes $700 No No Yes Yes No 3,170
Wellcare Wellcare Giveback Open (PPO)
H7175-004-0 		Local PPO No $0 Yes $1,500 No No Yes Yes No 3,108
Wellcare Wellcare Dual Access (HMO D-SNP)
H9364-002-0 		HMO $100 per Month Yes $0 Yes $2,000 No No Yes Yes No 2,997
Wellcare Wellcare No Premium (HMO)
H1032-192-0 		HMO $71 per Quarter No $284 Yes $2,000 No No Yes Yes No 2,991
Wellcare Wellcare Dual Access Open (PPO D-SNP)
H0111-004-0 		Local PPO $84 per Month Yes $0 Yes $3,000 No No Yes Yes No 2,979
Wellcare Wellcare No Premium (HMO)
H1032-194-0 		HMO $45 per Month Yes $0 Yes $2,000 No No Yes Yes No 2,833
Wellcare Wellcare No Premium Preferred (HMO)
H1416-055-0 		HMO $45 per Month Yes $0 Yes $1,000 No No Yes Yes No 2,814
Wellcare Wellcare No Premium Open (PPO)
H5199-008-0 		Local PPO $77 per Quarter No $308 Yes $2,000 No No Yes Yes No 2,781
Wellcare Wellcare Dual Liberty (HMO D-SNP)
H4847-004-0 		HMO $150 per Month Yes $0 Yes $3,000 No No Yes Yes No 2,768
Wellcare Wellcare No Premium (HMO-POS)
H0913-002-0 		HMOPOS No $0 Yes $700 No No Yes Yes No 2,758
Wellcare Wellcare Giveback (HMO)
H1032-198-0 		HMO No $0 Yes $2,000 No No Yes Yes No 2,750
Wellcare Wellcare No Premium Essential (HMO-POS)
H9730-005-0 		HMOPOS $27 per Month Yes $0 Yes $2,000 No No Yes Yes No 2,708
Wellcare Wellcare 'Ohana No Premium (HMO)
H2491-009-0 		HMO $97 per Quarter No $388 Yes $1,000 No No Yes Yes No 2,563
Wellcare Wellcare Dual Freedom Access (HMO D-SNP)
H2491-011-0 		HMO $200 per Month Yes $0 Yes $2,000 No No Yes Yes No 2,554
Wellcare Wellcare No Premium Open (PPO)
H3975-001-0 		Local PPO No $0 Yes $3,000 No No Yes Yes No 2,527
Wellcare Wellcare No Premium Open (PPO)
H7175-001-0 		Local PPO $93 per Quarter No $372 Yes $1,000 No No Yes Yes No 2,402
Wellcare Wellcare No Premium (HMO)
H6193-001-0 		HMO $32 per Month Yes $0 Yes $2,000 No No Yes Yes No 2,368
Wellcare Wellcare Giveback (HMO)
H1353-006-0 		HMO No $0 Yes $1,000 No No Yes Yes No 2,360
Wellcare Wellcare Assist (HMO)
H5779-008-0 		HMO $100 per Quarter No $400 Yes $4,000 No No Yes Yes Yes 2,346
Wellcare Wellcare No Premium Focus (HMO)
H1112-040-0 		HMO $65 per Quarter No $260 Yes $2,000 No No Yes Yes Yes 2,222
Wellcare Wellcare Dual Liberty (HMO D-SNP)
H9364-003-0 		HMO $110 per Month Yes $0 Yes $3,000 No No Yes Yes No 2,204
Wellcare Wellcare Assist (HMO)
H2491-010-0 		HMO $40 per Month Yes $0 Yes $1,000 No No Yes Yes No 2,172
Wellcare Wellcare Dual Liberty Open (PPO D-SNP)
H7175-002-0 		Local PPO $144 per Month Yes $0 Yes $3,000 No No Yes Yes No 2,145
Wellcare Wellcare Premium Ultra Open (PPO)
H2775-105-0 		Local PPO $131 per Quarter No $524 Yes $1,500 No No Yes Yes No 2,138
Wellcare Wellcare Giveback (HMO)
H5475-031-0 		HMO No $0 No 2,062
Wellcare Wellcare No Premium Open (PPO)
H0969-001-0 		Local PPO $35 per Month Yes $0 Yes $1,000 No No Yes Yes No 2,058
Wellcare Wellcare Assist (HMO)
H4847-005-0 		HMO $30 per Month Yes $0 Yes $1,500 No No Yes Yes No 2,030
Wellcare Wellcare Assist (HMO)
H4868-016-0 		HMO $47 per Quarter No $188 Yes $2,000 No No Yes Yes No 2,028
Wellcare Wellcare Giveback (HMO)
H1416-080-0 		HMO $57 per Quarter No $228 Yes $1,000 No No Yes Yes Yes 1,981
Wellcare Wellcare No Premium Focus (HMO)
H0913-017-0 		HMO $75 per Quarter No $300 Yes $2,000 No No Yes Yes No 1,981
Wellcare Wellcare Giveback Open (PPO)
H1914-002-0 		Local PPO No $0 Yes $700 No No Yes Yes No 1,956
Wellcare Wellcare No Premium (HMO)
H1032-199-0 		HMO $48 per Month Yes $0 Yes $2,000 No No Yes Yes No 1,933
Wellcare Wellcare Dual Access Open (PPO D-SNP)
H2775-115-0 		Local PPO $83 per Month Yes $0 Yes $2,000 No No Yes Yes No 1,895
Wellcare Wellcare Assist Compass (HMO)
H1416-041-0 		HMO $50 per Month Yes $0 Yes $1,000 No No Yes Yes No 1,876
Wellcare Wellcare Dual Access Open (PPO D-SNP)
H7323-005-0 		Local PPO $71 per Month Yes $0 Yes $2,000 No No Yes Yes No 1,847
Wellcare Wellcare Dual Select (HMO D-SNP)
H1032-182-0 		HMO $207 per Quarter No $828 Yes $2,000 No No Yes Yes Yes 1,846
Wellcare Wellcare Assist (HMO)
H0913-015-0 		HMO $40 per Quarter No $160 No 1,801
Wellcare Wellcare Giveback (HMO)
H1032-191-0 		HMO No $0 Yes $1,500 No No Yes Yes No 1,792
Wellcare Wellcare Giveback Dividend (HMO)
H1416-064-0 		HMO No $0 Yes $700 No No Yes Yes No 1,784
Wellcare Wellcare No Premium (HMO)
H1215-002-0 		HMO $55 per Month Yes $0 Yes $1,500 No No Yes Yes No 1,784
Wellcare Wellcare Patriot No Premium (HMO-POS)
H1112-034-0 		HMOPOS $28 per Month Yes $0 Yes $2,000 No No Yes Yes No 1,783
Wellcare Wellcare Dual Reserve (HMO D-SNP)
H1032-214-0 		HMO $409 per Quarter No $1,636 Yes $2,000 No No Yes Yes Yes 1,780
Wellcare Wellcare Giveback (HMO)
H1032-204-0 		HMO No $0 Yes $1,000 No No Yes Yes No 1,771
Wellcare Wellcare Assist Open (PPO)
H2775-114-0 		Local PPO $50 per Month Yes $0 Yes $2,000 No No Yes Yes No 1,751
Wellcare Wellcare Dual Access Open (PPO D-SNP)
H5199-016-0 		Local PPO $89 per Month Yes $0 Yes $3,000 No No Yes Yes No 1,733
Wellcare Wellcare No Premium (HMO)
H5087-024-0 		HMO $101 per Quarter No $404 Yes $1,000 No No Yes Yes No 1,732
Wellcare Wellcare Low Premium (HMO-POS)
H5475-024-0 		HMOPOS $40 per Quarter No $160 Yes $1,000 No No Yes Yes No 1,727
Wellcare Wellcare Giveback Open (PPO)
H9761-002-0 		Local PPO No $0 Yes $700 No No Yes Yes No 1,716
Wellcare Wellcare No Premium (HMO)
H0174-015-0 		HMO $40 per Month Yes $0 Yes $1,500 No No Yes Yes No 1,674
Wellcare Wellcare Plus Open (PPO)
H0969-005-0 		Local PPO $90 per Month Yes $0 Yes $1,500 No No Yes Yes No 1,665
Wellcare Wellcare No Premium (HMO)
H9364-001-0 		HMO $31 per Month Yes $0 Yes $1,500 No No Yes Yes No 1,646
Wellcare Wellcare TexanPlus No Premium (HMO)
H0174-002-0 		HMO $40 per Month Yes $0 Yes $2,000 No No Yes Yes No 1,614
Wellcare Wellcare Giveback Open (PPO)
H3047-002-0 		Local PPO $50 per Quarter No $200 Yes $700 No No Yes Yes No 1,607
Wellcare Wellcare Advantage No Premium (PFFS)
H2816-038-0 		PFFS No $0 No 1,603
Wellcare Wellcare No Premium Essential (HMO-POS)
H5475-022-0 		HMOPOS $41 per Month Yes $0 Yes $3,000 No No Yes Yes No 1,554
Wellcare Wellcare Giveback (HMO)
H1032-210-0 		HMO No $0 Yes $2,000 No No Yes Yes No 1,480
Wellcare Wellcare Low Premium (HMO-POS)
H1416-026-0 		HMOPOS $76 per Quarter No $304 Yes $1,000 No No Yes Yes No 1,460
Wellcare Wellcare No Premium (HMO)
H1032-211-0 		HMO $53 per Month Yes $0 Yes $2,000 No No Yes Yes No 1,438
Wellcare Wellcare No Premium Open (PPO)
H7518-001-0 		Local PPO $125 per Quarter No $500 Yes $2,000 No No Yes Yes No 1,433
Wellcare Wellcare Dual Liberty (HMO D-SNP)
H0712-029-0 		HMO $100 per Month Yes $0 Yes $2,000 No No Yes Yes No 1,432
Wellcare Wellcare No Premium Open (PPO)
H1395-002-0 		Local PPO $33 per Month Yes $0 Yes $1,000 No No Yes Yes No 1,330
Wellcare Wellcare No Premium (HMO)
H1032-218-0 		HMO $40 per Month Yes $0 Yes $2,000 No No Yes Yes No 1,280
Wellcare Wellcare No Premium (HMO)
H1032-196-0 		HMO $78 per Month Yes $0 Yes $2,000 No No Yes Yes No 1,278
Wellcare Wellcare No Premium Open (PPO)
H7169-001-0 		Local PPO $32 per Month Yes $0 Yes $1,500 No No Yes Yes No 1,277
Wellcare Wellcare No Premium Open (PPO)
H7323-003-0 		Local PPO $90 per Quarter No $360 Yes $1,000 No No Yes Yes No 1,258
Wellcare Wellcare Dual Reserve (HMO D-SNP)
H1032-202-0 		HMO $81 per Month Yes $0 Yes $2,000 No No Yes Yes No 1,242
Wellcare Wellcare Giveback (HMO)
H0174-020-0 		HMO No $0 Yes $700 No No Yes Yes No 1,235
Wellcare Wellcare No Premium (HMO)
H0712-019-0 		HMO No $0 Yes $2,000 No No Yes Yes No 1,224
Wellcare Wellcare Dual Access (HMO D-SNP)
H1416-036-0 		HMO $100 per Month Yes $0 Yes $5,000 No No Yes Yes No 1,213
Wellcare Wellcare No Premium Open (PPO)
H0074-001-0 		Local PPO $22 per Month Yes $0 Yes $1,000 No No Yes Yes No 1,205
Wellcare Wellcare Dual Liberty (HMO D-SNP)
H1353-004-0 		HMO $90 per Month Yes $0 Yes $2,000 No No Yes Yes No 1,185
Wellcare Wellcare No Premium Open (PPO)
H8553-001-0 		Local PPO $84 per Quarter No $336 Yes $2,000 No No Yes Yes No 1,166
Wellcare Wellcare Dual Access Open (PPO D-SNP)
H2128-005-0 		Local PPO $66 per Month Yes $0 Yes $2,000 No No Yes Yes No 1,155
Wellcare Wellcare No Premium (HMO)
H2162-001-0 		HMO $30 per Month Yes $0 Yes $1,500 No No Yes Yes No 1,154
Wellcare Wellcare Giveback Open (PPO)
H0088-002-0 		Local PPO No $0 Yes $700 No No Yes Yes No 1,139
Wellcare Wellcare Giveback (HMO)
H0174-017-0 		HMO No $0 No 1,136
Wellcare Wellcare No Premium Open (PPO)
H6594-001-0 		Local PPO $36 per Month Yes $0 Yes $1,500 No No Yes Yes No 1,114
Wellcare Wellcare No Premium Essential (HMO-POS)
H5475-011-0 		HMOPOS No $0 Yes $2,000 No No Yes Yes No 1,096
Wellcare Wellcare No Premium (HMO)
H1112-044-0 		HMO $70 per Quarter No $280 Yes $2,000 No No Yes Yes No 1,080
Wellcare Wellcare Dual Access (HMO D-SNP)
H4073-002-0 		HMO $170 per Month Yes $0 Yes $5,000 No No Yes Yes No 1,079
Wellcare Wellcare Dual Access (HMO-POS D-SNP)
H1416-033-0 		HMOPOS $110 per Month Yes $0 Yes $2,000 No No Yes Yes No 1,062
Wellcare Wellcare Dual Liberty (HMO D-SNP)
H5087-027-0 		HMO $220 per Quarter No $880 Yes $2,000 No No Yes Yes Yes 1,042
Wellcare Wellcare Assist (HMO)
H0712-020-0 		HMO $30 per Month Yes $0 Yes $2,000 No No Yes Yes No 1,030
Wellcare Wellcare No Premium (HMO-POS)
H1416-076-0 		HMOPOS $175 per Quarter No $700 Yes $3,000 No No Yes Yes Yes 1,021
Wellcare Wellcare No Premium (HMO)
H0174-016-0 		HMO $35 per Month Yes $0 Yes $1,500 No No Yes Yes No 1,013
Wellcare Wellcare Giveback (HMO)
H1032-209-0 		HMO No $0 Yes $2,000 No No Yes Yes No 1,000
Wellcare Wellcare No Premium Open (PPO)
H9428-001-0 		Local PPO $43 per Month Yes $0 Yes $1,000 No No Yes Yes No 954
Wellcare Wellcare Giveback (HMO)
H0174-021-0 		HMO No $0 Yes $700 No No Yes Yes No 953
Wellcare Wellcare No Premium Open (PPO)
H5199-014-0 		Local PPO $63 per Quarter No $252 Yes $2,000 No No Yes Yes No 916
Wellcare Wellcare No Premium (HMO)
H1862-001-0 		HMO $36 per Month Yes $0 Yes $1,500 No No Yes Yes No 907
Wellcare Wellcare Assist Open (PPO)
H7175-003-0 		Local PPO $125 per Quarter No $500 Yes $2,000 No No Yes Yes No 896
Wellcare Wellcare TexanPlus Patriot Giveback (HMO)
H4506-010-0 		HMO No $0 Yes $1,500 No No Yes Yes No 882
Wellcare Wellcare Plus Open (PPO)
H6594-003-0 		Local PPO $100 per Month Yes $0 Yes $1,500 No No Yes Yes No 880
Wellcare Wellcare Dual Liberty (HMO D-SNP)
H1215-001-0 		HMO $169 per Month Yes $0 Yes $3,000 No No Yes Yes No 880
Wellcare Wellcare Giveback (HMO)
H9364-004-0 		HMO No $0 Yes $1,000 No No Yes Yes No 879
Wellcare Wellcare Dual Access Open (PPO D-SNP)
H7169-003-0 		Local PPO $145 per Month Yes $0 Yes $2,000 No No Yes Yes No 876
Wellcare Wellcare Dual Access Open (PPO D-SNP)
H1914-006-0 		Local PPO $60 per Month Yes $0 Yes $2,000 No No Yes Yes No 876
Wellcare Wellcare Giveback (HMO)
H0913-021-0 		HMO No $0 No 854
Wellcare Wellcare Dual Liberty (HMO-POS D-SNP)
H1416-043-0 		HMOPOS $160 per Month Yes $0 Yes $3,000 No No Yes Yes No 842
Wellcare Wellcare Giveback (HMO)
H1416-079-0 		HMO No $0 Yes $1,000 No No Yes Yes No 836
Wellcare Wellcare Patriot Giveback Open (PPO)
H2117-003-0 		Local PPO $86 per Quarter No $344 Yes $2,000 No No Yes Yes No 817
Wellcare Wellcare Assist Open (PPO)
H2128-001-0 		Local PPO $120 per Quarter No $480 Yes $1,500 No No Yes Yes No 807
Wellcare Wellcare Assist Open (PPO)
H7326-007-0 		Local PPO $55 per Month Yes $0 Yes $700 No No Yes Yes No 795
Wellcare Wellcare No Premium Open (PPO)
H0088-003-0 		Local PPO No $0 Yes $1,500 No No Yes Yes No 790
Wellcare Wellcare No Premium (HMO)
H1032-190-0 		HMO $65 per Quarter No $260 Yes $2,000 No No Yes Yes No 790
Wellcare Wellcare Giveback Open (PPO)
H2128-004-0 		Local PPO No $0 Yes $700 No No Yes Yes No 788
Wellcare Wellcare Giveback Open (PPO)
H1848-001-0 		Local PPO No $0 Yes $700 No No Yes Yes No 784
Wellcare Wellcare No Premium Open (PPO)
H3047-001-0 		Local PPO $40 per Month Yes $0 Yes $700 No No Yes Yes No 751
Wellcare Wellcare Dual Liberty (HMO D-SNP)
H1032-176-0 		HMO $205 per Month Yes $0 Yes $5,000 No No Yes Yes No 721
Wellcare Wellcare No Premium Open (PPO)
H2128-002-0 		Local PPO $84 per Quarter No $336 Yes $1,500 No No Yes Yes No 714
Wellcare Wellcare No Premium Open (PPO)
H0270-001-0 		Local PPO $46 per Month Yes $0 Yes $1,000 No No Yes Yes No 701
Wellcare Wellcare Giveback (HMO)
H1032-189-0 		HMO No $0 Yes $1,000 No No Yes Yes No 693
Wellcare Wellcare Dual Access Extra (HMO-POS D-SNP)
H5475-021-0 		HMOPOS $117 per Month Yes $0 Yes $3,000 No No Yes Yes No 692
Wellcare Wellcare No Premium Open (PPO)
H7323-002-0 		Local PPO $103 per Quarter No $412 Yes $1,000 No No Yes Yes No 682
Wellcare Wellcare Patriot Giveback Open (PPO)
H7518-002-0 		Local PPO $150 per Quarter No $600 Yes $2,000 No No Yes Yes No 681
Wellcare Wellcare Dividend Giveback (HMO)
H5475-032-0 		HMO $40 per Quarter No $160 No 681
Wellcare Wellcare Specialty No Premium (HMO C-SNP)
H0174-008-0 		HMO $65 per Quarter No $260 Yes $1,500 No No Yes Yes Yes 680
Wellcare Wellcare Endurance (HMO)
H2491-016-0 		HMO $72 per Quarter No $288 Yes $700 No No Yes Yes No 673
Wellcare Wellcare No Premium Value (HMO)
H1416-056-0 		HMO $69 per Quarter No $276 Yes $700 No No Yes Yes No 643
Wellcare Wellcare No Premium (HMO)
H6975-005-0 		HMO $109 per Month Yes $0 Yes $2,000 No No Yes Yes No 641
Wellcare Wellcare Dual Access Open (PPO D-SNP)
H5965-004-0 		Local PPO $70 per Month Yes $0 Yes $2,000 No No Yes Yes No 629
Wellcare Wellcare TexanPlus No Premium (HMO-POS)
H4506-029-0 		HMOPOS $71 per Quarter No $284 No 612
Wellcare Wellcare Specialty No Premium (HMO C-SNP)
H1032-224-0 		HMO $177 per Quarter No $708 Yes $2,000 No No Yes Yes Yes 598
Wellcare Wellcare Giveback Open (PPO)
H6594-002-0 		Local PPO No $0 Yes $700 No No Yes Yes No 585
Wellcare Wellcare No Premium Open (PPO)
H1848-002-0 		Local PPO $85 per Month Yes $0 Yes $2,000 No No Yes Yes No 581
Wellcare Wellcare Dual Access Open (PPO D-SNP)
H3975-004-0 		Local PPO $101 per Month Yes $0 Yes $2,000 No No Yes Yes No 577
Wellcare Wellcare Dual Access Open (PPO D-SNP)
H1395-001-0 		Local PPO $127 per Month Yes $0 Yes $2,000 No No Yes Yes No 569
Wellcare Wellcare Assist Open (PPO)
H6594-004-0 		Local PPO $30 per Month Yes $0 Yes $1,500 No No Yes Yes No 565
Wellcare Wellcare Assist (HMO)
H6975-003-0 		HMO $105 per Month Yes $0 Yes $2,000 No No Yes Yes No 565
Wellcare Wellcare Dual Liberty Open (PPO D-SNP)
H7326-006-0 		Local PPO $150 per Month Yes $0 Yes $3,000 No No Yes Yes No 562
Wellcare Wellcare Patriot Giveback (HMO-POS)
H1416-058-0 		HMOPOS $35 per Month Yes $0 Yes $1,000 No No Yes Yes No 550
Wellcare Wellcare Specialty Giveback (HMO C-SNP)
H1032-227-0 		HMO $181 per Quarter No $724 Yes $1,000 No No Yes Yes Yes 549
Wellcare Wellcare Patriot Giveback (HMO-POS)
H4847-006-0 		HMOPOS No $0 Yes $2,000 No No Yes Yes No 537
Wellcare Wellcare Assist Open (PPO)
H1395-003-0 		Local PPO $20 per Month Yes $0 Yes $2,000 No No Yes Yes No 536
Wellcare Wellcare Dual Access Open (PPO D-SNP)
H0074-004-0 		Local PPO $100 per Month Yes $0 Yes $2,000 No No Yes Yes No 526
Wellcare Wellcare Dual Access Open (PPO D-SNP)
H1848-003-0 		Local PPO $150 per Month Yes $0 Yes $3,000 No No Yes Yes No 525
Wellcare Wellcare Giveback (HMO)
H9900-001-0 		HMO $50 per Quarter No $200 Yes $1,000 No No Yes Yes No 514
Wellcare Wellcare Giveback Open (PPO)
H9428-002-0 		Local PPO No $0 Yes $700 No No Yes Yes No 510
Wellcare Wellcare Patriot Giveback Open (PPO)
H3975-002-0 		Local PPO $40 per Quarter No $160 Yes $2,000 No No Yes Yes No 510
Wellcare Wellcare Patriot Giveback (HMO-POS)
H1416-060-0 		HMOPOS $82 per Quarter No $328 Yes $1,500 No No Yes Yes No 480
Wellcare Wellcare Patriot Giveback Open (PPO)
H8553-002-0 		Local PPO $90 per Quarter No $360 Yes $700 No No Yes Yes No 471
Wellcare Wellcare No Premium Open (PPO)
H5965-002-0 		Local PPO $114 per Quarter No $456 Yes $1,000 No No Yes Yes No 468
Wellcare Wellcare No Premium (HMO)
H9900-005-0 		HMO $60 per Month Yes $0 Yes $1,500 No No Yes Yes No 458
Wellcare Wellcare Specialty Giveback (HMO C-SNP)
H1032-203-0 		HMO $181 per Quarter No $724 Yes $2,000 No No Yes Yes Yes 453
Wellcare Wellcare Premium Enhanced Open (PPO)
H5199-010-0 		Local PPO $40 per Month Yes $0 Yes $2,000 No No Yes Yes No 446
Wellcare Wellcare Giveback Open (PPO)
H0969-003-0 		Local PPO No $0 No 436
Wellcare Wellcare Low Premium Open (PPO)
H7518-004-0 		Local PPO $84 per Month Yes $0 Yes $2,000 No No Yes Yes No 436
Wellcare Wellcare No Premium Open (PPO)
H4699-001-0 		Local PPO $47 per Month Yes $0 Yes $1,000 No No Yes Yes No 419
Wellcare Wellcare Assist Open (PPO)
H1914-004-0 		Local PPO $100 per Quarter No $400 Yes $1,500 No No Yes Yes No 400
Wellcare Wellcare No Premium (HMO)
H9335-001-0 		HMO $68 per Month Yes $0 Yes $2,000 No No Yes Yes No 399
Wellcare Wellcare Specialty Giveback (HMO C-SNP)
H1032-186-0 		HMO $372 per Quarter No $1,488 Yes $3,000 No No Yes Yes Yes 395
Wellcare Wellcare No Premium (HMO)
H1416-070-0 		HMO $29 per Month Yes $0 Yes $1,000 No No Yes Yes No 393
Wellcare Wellcare No Premium Rx Plus Open (PPO)
H7323-006-0 		Local PPO No $0 Yes $2,000 No No Yes Yes No 388
Wellcare Wellcare Dual Access Open (PPO D-SNP)
H7518-003-0 		Local PPO $205 per Month Yes $0 Yes $2,000 No No Yes Yes No 378
Wellcare Wellcare No Premium (HMO)
H9900-004-0 		HMO $62 per Month Yes $0 Yes $1,500 No No Yes Yes No 373
Wellcare Wellcare Premium Enhanced (PFFS)
H2816-019-0 		PFFS No $0 No 369
Wellcare Wellcare No Premium (HMO-POS)
H1416-075-0 		HMOPOS $174 per Quarter No $696 Yes $2,000 No No Yes Yes Yes 365
Wellcare Wellcare Dual Liberty (HMO D-SNP)
H9900-003-0 		HMO $210 per Month Yes $0 Yes $2,000 No No Yes Yes No 360
Wellcare Wellcare Advantage Premium Enhanced (PFFS)
H2816-037-0 		PFFS No $0 No 353
Wellcare Wellcare Premium Enhanced Open (PPO)
H9761-004-0 		Local PPO $51 per Month Yes $0 Yes $4,000 No No Yes Yes No 340
Wellcare Wellcare Assist (HMO)
H1353-007-0 		HMO $28 per Month Yes $0 Yes $1,500 No No Yes Yes No 336
Wellcare Wellcare Dual Liberty Open (PPO D-SNP)
H4699-005-0 		Local PPO $158 per Month Yes $0 Yes $3,000 No No Yes Yes No 323
Wellcare Wellcare Dual Access (HMO D-SNP)
H1353-002-0 		HMO $80 per Month Yes $0 Yes $2,000 No No Yes Yes No 321
Wellcare Wellcare Advantage No Premium (PFFS)
H2816-040-0 		PFFS No $0 No 320
Wellcare Wellcare Giveback (HMO)
H9335-005-0 		HMO No $0 Yes $700 No No Yes Yes No 311
Wellcare Wellcare Giveback Open (PPO)
H4699-002-0 		Local PPO $55 per Quarter No $220 Yes $1,000 No No Yes Yes No 304
Wellcare Wellcare No Premium Open (PPO)
H7323-010-0 		Local PPO $68 per Quarter No $272 Yes $700 No No Yes Yes No 301
Wellcare Wellcare Giveback Focus (HMO)
H5087-028-0 		HMO $56 per Quarter No $224 Yes $2,000 No No Yes Yes Yes 301
Wellcare Wellcare Dual Access (HMO D-SNP)
H1032-170-0 		HMO $157 per Month Yes $0 Yes $4,000 No No Yes Yes No 293
Wellcare Wellcare Premium Ultra (PFFS)
H2816-013-0 		PFFS $50 per Quarter No $200 No 281
Wellcare Wellcare No Premium (HMO)
H9258-001-0 		HMO $112 per Month Yes $0 Yes $2,000 No No Yes Yes No 281
Wellcare Wellcare Giveback (HMO)
H1215-003-0 		HMO No $0 Yes $1,000 No No Yes Yes No 276
Wellcare Wellcare Dual Liberty (HMO D-SNP)
H6975-002-0 		HMO $187 per Month Yes $0 Yes $4,000 No No Yes Yes No 269
Wellcare Wellcare No Premium Open (PPO)
H7323-009-0 		Local PPO $72 per Quarter No $288 Yes $700 No No Yes Yes No 264
Wellcare Wellcare Patriot Giveback (HMO-POS)
H1416-061-0 		HMOPOS No $0 Yes $3,000 No No Yes Yes No 264
Wellcare Wellcare Assist (HMO)
H9900-007-0 		HMO $55 per Month Yes $0 Yes $1,500 No No Yes Yes No 258
Wellcare Wellcare No Premium (HMO)
H1416-072-0 		HMO $29 per Month Yes $0 Yes $1,000 No No Yes Yes No 255
Wellcare Wellcare Dual Access Open (PPO D-SNP)
H0270-002-0 		Local PPO $160 per Month Yes $0 Yes $2,000 No No Yes Yes No 253
Wellcare Wellcare Giveback (HMO)
H1416-078-0 		HMO $60 per Quarter No $240 Yes $1,000 No No Yes Yes Yes 252
Wellcare Wellcare Assist Open (PPO)
H4699-004-0 		Local PPO $100 per Quarter No $400 Yes $2,000 No No Yes Yes No 248
Wellcare Wellcare Patriot No Premium Open (PPO)
H7175-005-0 		Local PPO No $0 No 244
Wellcare Wellcare Low Premium Open (PPO)
H0111-002-0 		Local PPO $60 per Quarter No $240 Yes $2,000 No No Yes Yes No 236
Wellcare Wellcare Patriot Giveback Open (PPO)
H5965-003-0 		Local PPO No $0 Yes $700 No No Yes Yes No 228
Wellcare Wellcare Dual Access (HMO D-SNP)
H6975-004-0 		HMO $150 per Month Yes $0 Yes $4,000 No No Yes Yes No 228
Wellcare Wellcare Low Premium Open (PPO)
H2128-003-0 		Local PPO $126 per Quarter No $504 Yes $1,500 No No Yes Yes No 226
Wellcare Wellcare Community Assist (PPO)
H2117-004-0 		Local PPO $103 per Quarter No $412 Yes $1,500 No No Yes Yes No 224
Wellcare Wellcare No Premium Open (PPO)
H4537-001-0 		Local PPO $43 per Month Yes $0 Yes $1,500 No No Yes Yes No 210
Wellcare Wellcare Dual Reserve (HMO D-SNP)
H1032-236-0 		HMO $240 per Quarter No $960 Yes $2,000 No No Yes Yes Yes 210
Wellcare Wellcare Patriot No Premium (HMO)
H4868-003-0 		HMO $100 per Quarter No $400 Yes $1,500 No No Yes Yes No 197
Wellcare Wellcare Assist (HMO)
H9900-006-0 		HMO $40 per Month Yes $0 Yes $1,500 No No Yes Yes No 190
Wellcare Wellcare No Premium (HMO)
H2491-017-0 		HMO $39 per Month Yes $0 Yes $1,000 No No Yes Yes No 189
Wellcare Wellcare Premium Enhanced Open (PPO)
H0111-003-0 		Local PPO $60 per Quarter No $240 Yes $2,000 No No Yes Yes No 183
Wellcare Wellcare Dual Access Medicare (HMO D-SNP)
H0712-025-0 		HMO $100 per Month Yes $0 Yes $4,000 No No Yes Yes No 180
Wellcare Wellcare Patriot No Premium (HMO)
H0913-020-0 		HMO $63 per Quarter No $252 Yes $2,000 No No Yes Yes No 175
Wellcare Wellcare No Premium Open (PPO)
H4537-002-0 		Local PPO $43 per Month Yes $0 Yes $1,500 No No Yes Yes No 164
Wellcare Wellcare Dual Access Open (PPO D-SNP)
H4699-003-0 		Local PPO $66 per Month Yes $0 Yes $2,000 No No Yes Yes No 163
Wellcare Wellcare Dual Reserve (HMO D-SNP)
H1032-217-0 		HMO $400 per Quarter No $1,600 Yes $2,000 No No Yes Yes Yes 162
Wellcare Wellcare No Premium Value (HMO)
H0712-023-0 		HMO $83 per Quarter No $332 Yes $1,000 No No Yes Yes No 159
Wellcare Wellcare No Premium Value (HMO)
H1416-057-0 		HMO $92 per Quarter No $368 Yes $700 No No Yes Yes No 147
Wellcare Wellcare Dual Access Open (PPO D-SNP)
H4537-004-0 		Local PPO $100 per Month Yes $0 Yes $2,000 No No Yes Yes No 129
Wellcare Wellcare Assist (HMO)
H9335-006-0 		HMO $70 per Month Yes $0 Yes $3,000 No No Yes Yes No 118
Wellcare Wellcare Patriot No Premium (HMO-POS)
H1416-059-0 		HMOPOS $75 per Month Yes $0 Yes $2,000 No No Yes Yes No 112
Wellcare Wellcare No Premium Open (PPO)
H7323-007-0 		Local PPO $35 per Month Yes $0 Yes $1,000 No No Yes Yes No 101
Wellcare Wellcare Premium Enhanced Open (PPO)
H8711-004-0 		Local PPO No $0 No 98
Wellcare Wellcare Specialty No Premium (HMO C-SNP)
H1032-184-0 		HMO $214 per Quarter No $856 Yes $2,000 No No Yes Yes Yes 97
Wellcare Wellcare Dual Reserve (HMO D-SNP)
H1032-206-0 		HMO $99 per Month Yes $0 Yes $2,000 No No Yes Yes No 96
Wellcare Wellcare Community Assist (PPO)
H0074-003-0 		Local PPO $50 per Quarter No $200 Yes $1,500 No No Yes Yes No 78
Wellcare Wellcare No Premium Open (PPO)
H5199-015-0 		Local PPO $101 per Quarter No $404 Yes $2,000 No No Yes Yes No 71
Wellcare Wellcare Patriot Giveback Open (PPO)
H0969-004-0 		Local PPO $45 per Quarter No $180 Yes $1,000 No No Yes Yes No 62
Wellcare Wellcare Community Assist (PPO)
H7518-005-0 		Local PPO $100 per Quarter No $400 Yes $1,500 No No Yes Yes No 61
Wellcare Wellcare Patriot No Premium (HMO)
H2491-018-0 		HMO $100 per Quarter No $400 Yes $1,500 No No Yes Yes Yes 56
Wellcare Wellcare Premium Enhanced Open (PPO)
H7175-006-0 		Local PPO $64 per Quarter No $256 Yes $1,000 No No Yes Yes No 56
Wellcare Wellcare Dual Access (HMO D-SNP)
H9900-002-0 		HMO $125 per Month Yes $0 Yes $2,000 No No Yes Yes No 53
Wellcare Wellcare Dual Access (HMO D-SNP)
H9335-003-0 		HMO $190 per Month Yes $0 Yes $2,000 No No Yes Yes No 44
Wellcare Wellcare Patriot No Premium Open (PPO)
H4699-006-0 		Local PPO $60 per Quarter No $240 Yes $2,000 No No Yes Yes No 44
Wellcare Wellcare Patriot Giveback Open (PPO)
H7169-004-0 		Local PPO No $0 No 42
Wellcare Wellcare Patriot No Premium (HMO)
H9900-008-0 		HMO $50 per Quarter No $200 Yes $1,000 No No Yes Yes No 39
Wellcare Wellcare Patriot No Premium (HMO)
H6975-006-0 		HMO $150 per Quarter No $600 Yes $2,000 No No Yes Yes Yes 37
Wellcare Wellcare Community Assist (PPO)
H3047-004-0 		Local PPO $60 per Quarter No $240 Yes $1,000 No No Yes Yes No 30
Wellcare Wellcare No Premium (HMO)
H2491-021-0 		HMO $80 per Quarter No $320 Yes $700 No No Yes Yes No 21
Wellcare Wellcare Low Premium Open (PPO)
H1848-004-0 		Local PPO $114 per Quarter No $456 Yes $2,000 No No Yes Yes No 18
Wellcare Wellcare Dual Access (HMO D-SNP)
H2491-022-0 		HMO $200 per Month Yes $0 Yes $1,500 No No Yes Yes No 17
Wellcare Wellcare Premium Hybrid Open (PPO)
H0074-002-0 		Local PPO $55 per Quarter No $220 Yes $2,000 No No Yes Yes No 15
Wellcare Wellcare Low Premium Open (PPO)
H4537-003-0 		Local PPO $50 per Quarter No $200 Yes $1,500 No No Yes Yes No 11

Plan Claims Contact Information

Organization Name: Wellcare
Contact Name: Curt Nelson
Title: Manager, Compliance
Phone: 1-715-563-5188
Email: jon.c.nelson@centene.com
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