Disclaimer and Help
Disclaimer of Warranties and Liabilities
‘Ohana Health Plan, a plan offered by WellCare Health Insurance of Arizona, Inc.
Wellcare is the Medicare brand for Centene Corporation, an HMO, PPO, PFFS, PDP plan with a Medicare contract and is an approved Part D Sponsor. Our D-SNP plans have a contract with the state Medicaid program. Enrollment in our plans depends on contract renewal.
For Wellcare CalViva Health Dual Align members: CalViva Health is a Medi-Cal Managed Care Plan (MCP) and is the Local Initiative Health Plan for Medi-Cal managed care in Fresno, Kings, and Madera Counties. CalViva Health is a full-service health plan contracting with the Department of Health Care Services (DHCS) to provide Medi-Cal Covered Services to Medi-Cal managed care enrollees under the Two-Plan model in all zip codes in Fresno, Kings, and Madera Counties. CalViva Health contracts with Health Net Community Solutions, Inc. on a capitated basis to provide and arrange for Medi-Cal Covered Services in all zip codes in Fresno, Kings, and Madera Counties. Health Net Community Solutions, Inc. is a subsidiary of Health Net, LLC and Centene Corporation, and is the CalViva Health MCP’s Contracted Administrator in all zip codes in Fresno, Kings, and Madera Counties.
Washington residents: “Wellcare” is issued by Coordinated Care of Washington, Inc.
Washington residents: Health Net Life Insurance Company is contracted with Medicare for PPO plans. “Wellcare by Health Net” is issued by Health Net Life Insurance Company.
Washington residents: “Wellcare” is issued by WellCare Health Insurance Company of Washington, Inc.
“Wellcare” is issued by WellCare Prescription Insurance, Inc.
Health Net is contracted with Medicare for HMO plans. Enrollment in Health Net depends on contract renewal.
Every year, Medicare evaluates plans based on a 5-star rating system.
Out-of-network/non-contracted providers are under no obligation to treat Plan members, except in emergency situations. Please call our customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services.
Medicare approved Wellcare to provide these benefits and/or lower copayments/co-insurance as part of the Value-Based Insurance Design program. This program lets Medicare try new ways to improve Medicare Advantage plans.
Wellcare’s pharmacy network includes limited lower-cost, preferred pharmacies in rural areas of Nebraska. The lower costs advertised in our plan materials for these pharmacies may not be available at the pharmacy you use. For up-to-date information about our network pharmacies, including whether there are any lower-cost preferred pharmacies in your area, please call 1-800-977-7522 (TTY: 711) for Wellcare Assist Open (PPO), Wellcare Giveback (HMO-POS), and Wellcare Simple Open (PPO) in NE or consult the online pharmacy directory at
www.wellcare.com/NE.
Arizona D-SNP plans: Contract services are funded in part under contract with the State of Arizona.
Louisiana D-SNP members: As a Wellcare HMO D-SNP member, you have coverage from both Medicare and Medicaid. You receive your Medicare health care and prescription drug coverage through Wellcare and are also eligible to receive additional health care services and coverage through Louisiana Medicaid. Learn more about providers who participate in Louisiana Medicaid by visiting
www.myplan.healthy.la.gov/en/find-provider or
www.louisianahealthconnect.com. For detailed information about Louisiana Medicaid benefits, please visit the Medicaid website at
ldh.la.gov/medicaid" and select the “Learn about Medicaid Services” link. To request a written copy of our Medicaid Provider Directory, please contact us.
Notice: TennCare is not responsible for payment for these benefits, except for appropriate cost sharing amounts. TennCare is not responsible for guaranteeing the availability or quality of these benefits. Any benefits above and beyond traditional Medicare benefits are applicable to Wellcare Medicare Advantage only and do not indicate increased Medicaid benefits.
Wellcare By Allwell (HMO and HMO SNP) includes products that are underwritten by Superior HealthPlan, Inc.
Wellcare (HMO and HMO SNP) includes products that are underwritten by WellCare of Texas, Inc., WellCare National Health Insurance Company, and SelectCare of Texas, Inc.
Wellcare Dual Liberty (HMO D-SNP) is a Fully Integrated Dual Eligible Special Needs Plan with a Medicare contract and a contract with the New Jersey Medicaid program. Enrollment in Wellcare Dual Liberty depends on contract renewal. This information is not a complete description of benefits. Contact the plan for more information. Limitations and restrictions may apply. Benefits may change on January 1 of each year. Your Part B premium is covered by Medicaid. This plan is available to those who have both Medicare and full Medicaid benefits. Wellcare uses a formulary. There is no obligation to enroll. Please contact Wellcare for details.
