Wellcare, a company offering a comprehensive range of Medicare products and the Medicare brand of Centene Corporation, has officially confirmed the news of offering Medicare Advantage (MA) to over 51 million beneficiaries in 32 states, as well as Prescription Drug Plan (PDP) products to more than 8 million members across all 50 states.
According to certain reports, the stated footprint spans 51 new counties across eight markets, with a focus on Duals, enhancements to the Wellcare Spendables® card, and improving member experience.
For better understanding, Medicare provides coverage primarily based on a member being 65 and older or eligible through disability, whereas on the other hand, Medicaid typically offers coverage to individuals and families who meet specific income and financial eligibility requirements. Members eligible for both programs are referred to as Dual Eligibles or Duals. In that regard, Wellcare establishes a clear focus on creating seamless integrated experiences for dual-eligible members, caregivers and their providers.
Mors on the same would reveal how, as a part of its evolving support and product offerings for dual-eligible members, Wellcare will launch the first phase of its enhanced integrated Duals model across Arizona, Delaware, Illinois, Iowa, Michigan, Ohio, South Carolina, and Texas.
Markedly enough, the development in question also builds upon the conclusion of the Medicare-Medicaid Financial Alignment Initiative (FAI), which phases out MMPs nationwide. You see, Wellcare offers, at launch, MMPs in five of the eight launch states (Illinois, Michigan, Ohio, South Carolina and Texas), and moving forward, it will seamlessly transition members in those markets to new integrated D-SNPs that administer both Medicare and Medicaid benefits.
Talk about the company’s 2026 plan offerings on a slightly deeper level, we begin from the Wellcare Spendables® card, which is designed to offer eligible members a single card with preloaded funds available at more than 66,000 nationwide retailers across Wellcare’s 32-state footprint.
Eligible members may use their Wellcare Spendables® card on multiple benefits. In fact, depending on the plan, benefits may include an allowance for over-the-counter health items and covered out-of-pocket dental, vision and hearing costs. In case that wasn’t enough, members who are eligible may also use the allowance for other benefits to support their overall wellbeing.
Next up, Wellcare offers $0 or low copay for primary care physician visits on all plans. This it does alongside Dario’s digital mental health and social support resources that, on their part, provide online behavioral health support and are available 24/7 across all Medicare Advantage plans.
These resources are understood to include peer-to-peer support, self-guided behavioral health programs, and access to Centene health plan resources.
Another detail worth a mention is rooted in how monthly cost for insulin under Medicare plans will be capped at either $35 or 25% of the drug’s negotiated or maximum fair price, whichever is lower. Alongside that, there is also the prospect of $0 cost-sharing for Part D vaccinations recommended for adults by the Advisory Committee on Immunization Practices (ACIP).
Staying on Part D benefit, it will also continue to include three phases with members’ out-of-pocket costs capped at no more than $2,100 for the plan year.
Beyond that; we must also expand upon how preferred retail pharmacy networks will include Walgreens*, CVS* and select grocers. All in all, the given network is likely to include more than 60,000 total pharmacies.
From that lot, Express Scripts® Pharmacy home delivery will continue to be the preferred mail order (Home Delivery) pharmacy, with its focus on providing convenient and efficient service for prescriptions that are filled for more than 35 days.
Among other benefits, we have $0 plans for routine physical exams to support annual preventive visits; kidney evaluation and A1c labs; preventive and diagnostic mammograms; preventive and diagnostic colonoscopies; routine/medical eye exams for diabetics; and Tier 6 adherence meds at preferred pharmacies.
“We are deeply committed to offering a diverse range of plans that support our members’ health and wellbeing,” said Michael Carson, Chief Executive Officer at Walgreens. “We’re especially excited about the continued growth and integration of our dual-eligible plans, in collaboration with our federal and state partners, which help us better serve individuals who are eligible for both Medicare and Medicaid. Supporting the health of our aging population isn’t just a priority – it’s a responsibility. These offerings reflect our dedication to delivering quality care.”
