WellCare Value, a Forsyth County, Georgia Medicare Advantage plan from WellCare, is a Health Maintenance Organization (HMO) option for people with Medicare. It gives you all of the same health insurance benefits as original Medicare and offers extras that Medicare does not cover.
The insurance premium is $0.00 per month. You also have co-payments and/or co-insurances with each healthcare service that you use. You can learn more about the basic coverage costs on the co-payments page.
The real benefit of an HMO plan like WellCare Value is lower, predictable out-of-pocket expenses. Although more restrictive than original Medicare, a Medicare Advantage HMO plan limits your annual out-of-pocket costs. With Medicare Parts A and B, there's no cap, leaving you vulnerable to excessive medical bills.
With an HMO you are required to use healthcare providers in the plan's network. If you don't you will incur additional costs. Also, be aware that your primary care physician must make refer you before you see a specialist.
To help seniors compare plans, Medicare rates the relative quality of all plans. After a full year on the market, each plan receives a one to five-star over-all mark, with one star being the lowest quality and five stars the highest quality.
The CMS has awarded WellCare Value Average as compared to all others (as of 15 October, 2014).out of 5 stars. That means Medicare deems this plan
By law, Medicare Advantage plans have an out-of-pocket limit of $6,700 per year. That said, plans can offer an out-of-pocket maximum as low as $3,400 per year. This plan's out-of-pocket spending limit is $6,700 per year. This amount is not inclusive of your monthly premium or the cost of your prescriptions. It's only what you pay when you receive heathcare services.
What this means to you is that you will no longer make co-payments or co-insurance payments when your out-of-pocket spending reaches $6,700. This is your safety net in the event of a critical illness or a serious accident. It protects you from serious financial liability and it should be carefully considered along with the premium and the co-payments.When comparing WellCare Value with original Medicare benefits, don't forget that you pay about twenty percent of all healthcare expenses covered by Part A and Part B, but there is no out-of-pocket limit. In other words, you have a lot of risk unless you get a Medigap policy to cover the gaps.
Be a smart shopper. Compare WellCare Value with these plans:
- Kaiser Permanente Senior Advantage Enhanced
- HumanaChoice H6609-122
- Aetna Medicare Essential Plan
- Aetna Medicare Select Plus Plan
- Humana Gold Choice H8145-069
WellCare Value vs. Medigap Plan K
If you're looking at WellCare Value because of it premium, we suggest looking a Medigap Plan K, as well. The out-of-pocket limit on Plan K is $4,940 vs. $6,700 on this plan. You also have complete freedom to see the physician you choose. Visit Medigap Plan K vs. Medicare Advantage to see other important differences.
Who Can Join?
You can join WellCare Value if you are entitled to Medicare Part A and enrolled in Medicare Part B and live in the service area. You must continue to pay your Medicare Part B premium. The service area includes: Cumming, and all other areas of Forsyth County, Georgia.
CMS File Date: October 15, 2014.
This Medicare Advantage Plan catalog is maintained by 9/14/2015. For more information, download the Summary of Benefits , visit the WellCare website, or call WellCare at N/A.and was last updated on