Doctor ordered a medication for microscopic colitis and the only medication that is prescribed is budesonide. They will not cover it. Asked about another drug. There isn't one they told me.
This is insane and unconscionable.
Have to pay out
of pocket for at least 8 weeks. Total cost in the thousands .
How can they not cover the only drug for this condition?????
Second appeal with doctors filling out there required forms. Image they what to denie you and play doctor.
SL
Susan Lynne Deketeleare M.
No more coverage for prescription drugs
I’ve been a member of WellCare since 2019. Much of that time premiums were taken out of SS til January 2026. I tried getting a thyroid medication filled and was told I had no coverage, which I finally paid out of pocket. This was learned on May 13, 2026. I immediately called Medicare which told me that my coverage was cancelled due to lack of payment. This was new news to me. Called WellCare and was told they sent out memos stating the change where individuals were to pay for premiums as of January 2026. I never received the memos or did I speak to anyone stating such. The premium for December 2025 was $0 premium then jumped up to $4.80 per month. I asked to being reinstated for “Good Cause”, but was told that wasn’t a good reason, and couldn’t be reinstated. I continued that I wasn’t aware of change. I received no memos or calls stating such. I spoke to various people and they repeat the same exact words, “ it doesn’t include the guidelines for my reasoning for my being reinstated. Many calls I was hung up on, no compromising, no understating, or actually listening. It appears this is a way to let a lot of the Medicare members go, and they do. I ended up receiving a call from Escalation Department them saying the same, can’t reinstate. I indicated and said “why would anyone risk losing their prescription coverage for $4.80 ?” These people have scripts that they read from, it’s apparent. One lady from WellCare totally agreed with me, that I should be reinstated, but her hands were tied. Even Medicare thought it was unfair. I understand there are many of us that claim they didn’t get the memos or got it late to do anything about it. Now many are going to have to wait til enrollment to get the coverage, and also pay a 10% increase due to it being over 63 days. I did not I repeat I did not intentionally not pay the premiums, I was just unaware that I had too. Thought all along the premiums were taken out of SS as they have been since 2019. Very poor customer service, and puts a lot of hardship on people with limited incomes, shame on them. Horrible company.
GG
Greg G.
Worst drug coverage of any Part D…
Worst drug coverage of any Part D Medicare Plan I've ever had (all drugs covered are generics, no brand names) and absolutely WORST customer service experience EVER!! Use another plan!! I'm changing as soon as I'm eligible. WORST EVER!!!
DL
Donald L.
As a Provider
As a Provider, Wellcare Customer Service, Billing, Authorization is a run around. They transfer you so many times in hope you get frustrated and hang up. I even asked for a supervisor and she could not answer my questions and wanted to transfer me. If coverage is a 1 star for patients, the Star rating for Providers is worse.
JM
Jeff M.
They denied my Nurtec coverage bc doc…
They denied my Nurtec coverage bc doc didn’t respond to fax within a few hours. Doc promptly responded but WellCare won’t process the response bc claim already denied. Why does Medicare allow these cheats to offer plans?
SC
Scott
The worst Medicare advantage plan ever
The worst Medicare advantage plan ever. Need pre authorizations for the most basic cheap generic drugs that say they are covered when you sign up. Their list of dentists is incorrect and I can no longer see my dentist. I really regret using this wretched company and can’t wait to switch back to FloridaBlue.
CA
catherineb
2 medications that were covered for $2…
2 medications that were covered for $2 my first year went up to $90 the next-- outrageous
LI
Linda
Medicare drug plans are a joke and…
Medicare drug plans are a joke and Wellcare is no exception. You can't check between pharmacies for prices. Every pharmacy has a different agreement and sometimes it's actually cheaper to pay out of pocket but you have to call around. They have an online tool but it doesn't work. They have the information, they just don't want YOU to have the information. If you chat or call, the only thing they will tell you is which pharmacy is closest to you. You need an advanced degree and a lot of time to not get cheated. Luckily, I got the $0 premium plan which is exactly what it's worth. I had cigna and they weren't any better. Good luck, Seniors. You're going to need it.