Wellcare vs. UnitedHealthcare

After comparing Wellcare and UnitedHealthcare (UHC), we’ve determined that UHC was superior for its wider availability, greater selection of health care plans and larger network size. Wellcare sells only Medicare Advantage and prescription drug plans, yet UHC has issued more than five times more Medicare Advantage plans than Wellcare in 2022. UHC serves more consumers with employer group plans and individual and family plans, as well.

Find out how Wellcare and UHC compare in availability, cost, coverage and more.

Wellcare vs. UnitedHealthcare: A Quick Glance

	Wellcare	UnitedHealthcare
Plan Structures	Medicare Advantage, Medicaid	HMO, PPO, CDHP, EPO, FSA, HMO-POS, Indemnity, HSA, Medicaid, Medicare
Availability	36 states for Medicare Advantage; 50 states for prescription drug plans	48 states for Medicare Advantage; 50 states for individual and family plans and prescription drug plans
Coverage Limit	Varies	Varies
Deductible	Varies	Varies
Maximum Annual Benefit	Varies	Varies
Waiting Period	Varies	Varies
Providers In-Network	650 thousand	1.3+ million
Covers Telehealth	Yes	Yes
Policy Management	Mobile app, online account, phone	Mobile app, online account, phone

Wellcare Pros and Cons

Pros	Cons
Medicare Advantage plans available in 36 states	Individual and family plans not available
Prescription drug plans available in all 50 states	Smaller network than UnitedHealthcare

Click to read our full Wellcare review.

UnitedHealthcare Pros and Cons

Pros	Cons
Larger network than Wellcare	Medicare Advantage plans not available in two states
Commercial and individual and family plans available
Most popular Medicare Advantage provider in 2022

Click to read our full UnitedHealthcare review.

Wellcare vs. UnitedHealthcare: Plan Structures

UHC offers a greater selection of healthcare plans and serves a wider demographic than Wellcare.

Wellcare sells only Medicare Advantage (MA) plans and prescription drug plans (PDP), thereby only serving those who qualify for Medicare — consumers ages 65 years and older or those with certain diseases, like end-stage renal disease or amyotrophic lateral sclerosis. In contrast, UHC issues MA plans, plus group plans for businesses and individual/family plans.

Plan	Wellcare	UnitedHealthcare
Individual & Family	X	✓
Medicare Advantage	✓	✓
Dental	X*	✓
Vision	X*	✓
Small Business	X	✓

*Wellcare does not sell standalone dental or vision plans but these benefits may be included in a Medicare Advantage plan.

Wellcare vs. UnitedHealthcare: Plan Availability

UHC beats Wellcare in availability, offering MA plans in more states than Wellcare, plus issuing individual and family policies nationwide. PDPs by Wellcare are available in all 50 states but MA plans are available in only the following 36 states.

Alabama Arizona Arkansas California Connecticut Florida Georgia Hawaii Illinois Indiana Kansas Kentucky	Louisiana Maine Massachusetts Michigan Mississippi Missouri Nebraska Nevada New Hampshire New Jersey New Mexico New York	North Carolina Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina Tennessee Texas Vermont Washington Wisconsin

MA plans through UHC are available in select counties throughout 48 states. UHC individual and family health plans and PDPs are available in all 50 states.

According to the Kaiser Family Foundation, UnitedHealthcare is the most popular Medicare Advantage provider, issuing 28% (7.9 million) of all policies. Centene, the parent company of Wellcare, accounts for only 5% (1.4 million) of all policies.

Wellcare vs. UnitedHealthcare: In-Network Providers

UHC has more than twice as many healthcare providers in its network than Wellcare, providing their customers access to more than 1.3 million healthcare professionals and 6,500 hospitals nationwide. Wellcare customers have access to about 650,000 healthcare providers. This difference is likely partly due to UHC offering MA plans in 12 more states than Wellcare, giving its individual and family policies a nationwide presence.

Wellcare vs. UnitedHealthcare: Cost

When it comes to health insurance plans, average costs are difficult to pinpoint because coverage can vary significantly between each person. When calculating your costs, your health insurance provider will consider the following factors:

• Age
• Health habits (e.g., smoking, drinking)
• State
• Deductible

With Medicare Advantage plans, keep in mind that you will still be paying for Medicare Part B. In 2022, the monthly premium for Part B was $170.10 and will increase to $164.90 in 2023.

Wellcare vs. UnitedHealthcare: Coverage Limits

Coverage limits will vary per policy since different people have different health coverage needs. Whether you buy a Medicare Advantage plan through Wellcare or an individual health plan through UHC, your policy cost and coverage will be customized to your budget, health history and medical needs.

When researching Medicare Advantage plans, pay attention to the plan’s out-of-pocket maximum limits. Unlike Original Medicare plans, Medicare Advantage plans have an annual cap on how much you pay in copays, coinsurance and deductibles. The annual limit will vary by plan and can help you decide which plan is ideal for you.

For example, somebody who goes to the doctor frequently might want a lower out-of-pocket limit, but that means paying a higher premium because copays quickly add up.

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Wellcare vs. UnitedHealthcare: Policy Management

Wellcare and UHC users can manage their policies by speaking with an online agent or through their online portal. By logging into the portal, customers can access information about their plan and find an approved provider within their network.

Wellcare and UHC also have a mobile app that allows users to access their electronic insurance cards, find a provider or manage claims. The UHC mobile app, specifically, allows you to view estimates for treatments and specialty services, reference your out-of-pocket expenses and review your balance in your HRA, FSA or HSA.

Wellcare vs. UnitedHealthcare: Medical Loss Ratio

The medical loss ratio (MLR) was established under the 2020 Affordable Care Act and requires insurance companies to spend at least 80% to 85% of premium dollars on medical care improvements. If a health insurance company’s MLR falls below 80%, they must refund the difference to their customers. Both Wellcare and UHC recently issued rebates due to a falling MLRs that was short of the threshold.

UHC issued rebates in 2022 for individual plans in six states: Arizona, Maryland, Michigan, New Jersey, Tennessee and West Virginia. Rebates were also issued for group plans in the following 26 states plus the District of Columbia:

Arizona Arkansas California Colorado Delaware Florida Hawaii Idaho Illinois	Indiana Iowa Kentucky Maryland Massachusetts Michigan Mississippi Nebraska New Jersey	New York Ohio Oklahoma Tennessee Texas Virginia Wisconsin Wyoming

Centene, the parent company of Wellcare, has already paid MLR rebates of $207 million during the 12-month period ending December 31, 2021. That same year, MLR rebates accrued to $196 million, which should be paid out this year.

It should be noted that Centene’s MLR accounts for the different health plans offered under the Centene umbrella and is not limited to just Medicare Advantage plans sold under the Wellcare brand.

Wellcare Vs UnitedHealthcare: Enrollment Process

Whether it’s through Wellcare or UHC, you will need to sign up for an MA plan either during the initial enrollment period or the annual enrollment period.

The initial enrollment spans from three months before and after your 65th birthday. Open enrollment occurs every year starting on October 15 and ending on December 7th. During open enrollment, consumers can enroll in an MA plan, switch from an Original Medicare to an MA plan or switch from one MA plan or Medicare prescription drug plan to another.

Open enrollment for UHC individual and family plans in most states runs from November 1 through January 15.

Purchasing a health insurance policy outside the enrollment period may be possible, but only for qualifying events, such as:

• Change in marital status
• Having or adopting a child
• Moving to a new address
• Losing health coverage
• Change in employment status
• Death of someone who shares your health plan
• Household income falls below the federal poverty level
• Becoming a U.S. citizen

Wellcare vs. UnitedHealthcare: Policyholder Experience

According to a 2022 study of the largest Medicare Advantage plans in the United States by J.D. Power, UHC ranked higher in overall customer satisfaction than Centene. This study ranked companies based on six categories: coverage and benefits; provider choice; cost; customer service; information and communication and; billing and payment. On a 1,000-point scale, UHC ranked fourth (808), while Centene ranked 10th or last (773).

How To File Claims With Wellcare and UnitedHealthcare

With Wellcare, your doctor or care provider should submit a claim to the insurer, and you should be covered except for any out-of-pocket costs, like copays or deductibles. If you see an out-of-network provider, your doctor may send you a bill for the portion you’re responsible to pay.

If you paid upfront for a service and need reimbursement, you will need to submit a claim to Wellcare for reimbursement, which typically requires you to complete a form specific to your state. Depending on the form, you can either send it to the listed address or email address.

With UnitedHealthcare, you typically will not need to file a claim when you visit a network provider. However, there are some exceptions, such as going to an out-of-network provider or if the provider collects payments upfront instead of billing the insurance company directly.

UHC members can file a claim by signing into their online health insurance account or mailing a medical claims submission form to the address on their health plan ID card.

Wellcare History

In 1985, Wellcare began as a Medicaid provider for the state of Florida, with operations in Tampa, Florida. After the Balanced Budget Act of 1997 was passed, WellCare began offering Medicare Part C, now called Medicare Advantage. In 2003, it offered Medicare Advantage plans with prescription drug coverage. In 2004, Wellcare went public.

Fast forward to January 2018 and Wellcare was recognized by Fortune magazine as One of the World’s Most Admired Companies in January 2018. In January 2020, Wellcare was acquired by Centene Corporation. Today, Wellcare has issued more than 1.2 million Medicare Advantage plans and 4.1 million prescription drug plans across the U.S.

UnitedHealthcare History

UnitedHealth Group was founded in 1977 by Richard Burke and went public in 1984. It was Dr. Paul Ellwood, who coined the term “health maintenance organization,” and who helped Burke start UnitedHealth. UnitedHealth grew in prominence in 1997, when the American Association for Retired Persons (AARP) selected UnitedHealth to provide coverage to its members. That same year UnitedHealth expanded its Evercare program, which is designed to cover long-term care in nursing homes, elderly people living at home and people with chronic illnesses. Today UnitedHealth care even offers short-term health insurance.

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Key Takeaways UHC sells a wider selection of healthcare plans, has a larger network size and serves more states than Wellcare. Wellcare sells only Medicare Advantage plans and prescription drug plans, while UHC sells these plans plus individual and family plans, commercial member plans and more. UHC is the most popular provider of Medicare Advantage plans, serving more than five times as many enrollees as Wellcare.

Find the best health plan for your needs. There are so many health insurance options to explore beyond Wellcare and UnitedHealthcare. SmartFinancial makes it easy to find the best health insurance plan within your budget. Just enter your zip code below or call 855.214.2291 to receive your free health insurance quotes in minutes.

SOURCES

• Medicare. “Get started with Medicare.” Accessed
• Kaiser Family Foundation. “Medicare Advantage in 2022: Enrollment Update and Key Trends.” Accessed Oct. 7, 2022.
• Medicare. “What's Medicare?”
• Centers for Medicare & Medicaid Services. “Medical Loss Ratio.”
• UnitedHealthcare. “2022 Medical Loss Ratio Final Payout Report Group,” Page 1-2.
• Centene Corporation. “SASB Index.” Accessed Oct. 7, 2022.
• JD Power. “2022 U.S. Medicare Advantage Study.”
• JD Power. “2022 U.S. Commercial Member Health Plan Study.”
• Centene. “Centene Completes Acquisition of WellCare, Creating a Leading Healthcare Enterprise Focused on Government-Sponsored Healthcare Programs.” Accessed Oct. 7. 2022.
• Wellcare. “About Us.”