frequently asked questions

Table of Contents

Introduction

In this article, we will address some common questions and concerns regarding Medicare Prescription Drug Plans. We will provide information on enrollment periods, formulary lists, preferred pharmacies, Extra Help subsidy, premium payment options, and Late Enrollment Penalties. Read on to find answers to your questions.

Enrollment

There are five easy ways to enroll in a Medicare Prescription Drug Plan. You can choose the method that works best for you. The options include:

  1. Online Enrollment: Visit our website and follow the enrollment instructions.
  2. Phone Enrollment: Call our Member Services at 1-888-550-5252 (TTY: 711) to enroll over the phone.
  3. Mailed Enrollment: Request a mailed copy of the enrollment form by chatting live with a representative on our member portal or by calling Member Services.
  4. Initial Coverage Election Period: Enroll as early as three months before your 65th birthday month or as late as three months after.
  5. Annual Enrollment Period (AEP): Enroll from October 15 to December 7 each year.

Formulary

To search for your medications, you can view our online formulary. This list contains the drugs covered by your plan. You can also request a mailed copy of the formulary by chatting with a representative on our member portal or by calling Member Services. The formulary can be found online at our website or by calling the number on the back of your ID card.

Enrollment Periods

There are specific times when you can join, switch, or leave a prescription drug plan. These enrollment periods include:

  1. Initial Coverage Election Period: Based on the month of your 65th birthday, you can enroll as early as three months before or as late as three months after your birthday month.
  2. Annual Enrollment Period (AEP): From October 15 to December 7, you can enroll, switch, or leave Medicare Part D or Medicare Advantage plans.
  3. Medicare Advantage Open Enrollment Period (MA OEP): From January 1 to March 31, members enrolled in Medicare Advantage plans can switch to another Medicare Advantage plan or return to Original Medicare.
  4. Special Enrollment Periods (SEP): You may qualify for a Special Enrollment Period if certain events happen in your life, such as changing your permanent residence or moving to a new service area.

Plan Comparison

To compare Wellcare plan options and choose the one that’s right for you, use our helpful Plan Comparison tool. This tool allows you to review plan details, compare prescription drug costs, and more. It can assist you in making an informed decision about your Medicare Prescription Drug Plan.

Preferred and Standard Pharmacies

To see the preferred and standard pharmacies for your plan, please visit our Find a Provider Tool. This tool will provide you with a list of pharmacies that accept your plan, making it convenient for you to get your medications.

Extra Help Subsidy

The Extra Help subsidy is available to individuals with limited income and resources to help pay for Medicare prescription drug program costs. These costs include premiums, deductibles, and co-payments/co-insurance. Depending on your income and resources, you may qualify for Extra Help. To find out if you qualify, call 1-800-MEDICARE (1-800-633-4227) or apply online. You can also contact Social Security or your state Medicaid Office for more information.

Premium Payment Options

There are several ways you can make your premium payment with us. These options include:

  1. AutoPay: Set up AutoPay or make a one-time payment through our secure online member portal.
  2. Deduction from Monthly Social Security or Railroad Retirement Board Check: Call Member Services to set up these deductions.
  3. Phone Payment: Call our billing option line at 1-888-550-5252 to make a payment over the phone.
  4. Online Guest Pay: Enter your member ID and email address to make a payment online. A confirmation email can be requested.
  5. Check or Money Order: Make your check or money order payable to Wellcare and send it to the provided address. Ensure you include your member ID on the payment.
  6. Cash Payment: Use your member ID or payment coupon to pay with cash at CheckFreePay locations. Find a location near you by calling 1-800-877-8021 or visiting their website.

Late Enrollment Penalties

A Late Enrollment Penalty (LEP) is an additional amount added to your Medicare Part D monthly premium. The cost of the penalty depends on how long you went without Part D or creditable prescription drug coverage. You may owe a Late Enrollment Penalty if you go without prescription drug coverage for a continuous period of 63 days or more after your Initial Enrollment Period is over.

It is important to provide information about prior coverage when enrolling in a Part D plan. This helps determine if you owe a Late Enrollment Penalty. To learn more about Late Enrollment Penalties, visit our website or contact our Member Services.

In conclusion, we hope this article has provided you with helpful answers to your frequently asked questions about Medicare Prescription Drug Plans. If you have further questions or need assistance, please reach out to our Member Services. We are here to help you make informed decisions about your healthcare coverage.