WellCare Value, a Dallas County, Texas 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.
The Centers for Medicare and Medicaid Services (CMS) reviews and rates the quality of all plans. The 1 (worst) to 5 (best) star ratings assist people considering plans and offer an unbiased measure of 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
Medicare Advantage plans are limited to a maximum out-of-pocket limit of $6,700 (annually). This out-of-pocket limit does not include your prescriptions or your monthly premiums. It only applies to your costs for healthcare services.
Although the mandatory limit is $6,700, the CMS allows plans to offer a lower limit that can be as low as $3,400. The out-of-pocket limit on this plan is $6,700. Be sure to take into consideration, along with the premium and the co-payments, when making your enrollment decision.
If you are comparing WellCare Value with your original Medicare benefits, it's important to remember that there are no limits to your out-of-pocket expenses with Medicare Part A or Medicare Part B. If you keep your original Medicare benefits, the only way to avoid high medical bills is to purchase Medicare Supplement insurance to supplement your coverage.
Be a smart shopper. Compare WellCare Value with these plans:
- Aetna Medicare Value Plan
- HumanaChoice R5826-026
- Humana Gold Choice H8145-084
- Care N' Care Health Plan I MA-Only
- Care N' Care Health Plan III
WellCare Value vs. Medigap Plan K
You might also consider comparing WellCare Value with Medigap Plan K. That's because the out-of-pocket limit on Plan K is only $4,940 (vs. $6,700 on this plan) and you can see any doctor you choose. Read Medigap Plan K vs. Medicare Advantage to learn more.
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: Addison, Carrollton, Irving, Coppell, Rowlett, Garland, Sachse, Grand Prairie, Richardson, Cedar Hill, Desoto, Duncanville, Lancaster, Hutchins, Mesquite, Seagoville, Wilmer, Balch Springs, Sunnyvale, Dallas, and all other areas of Dallas County, Texas.
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