Profile: WellCare Health Plans Inc (WCG.N)
21 Nov 2018
WellCare Health Plans, Inc., incorporated on February 5, 2004, is a managed care company. The Company focuses on government-sponsored managed care services, primarily through Medicaid, Medicare Advantage (MA) and Medicare Prescription Drug Plans (PDPs), to families, children, seniors and individuals with medical needs. The Company operates in three segments: Medicaid Health Plans, Medicare Health Plans and Medicare PDPs. As of December 31, 2016, it served approximately 3.9 million members in 50 states and the District of Columbia. As of December 31, 2016, it operated Medicaid health plans in Arizona, Florida, Georgia, Hawaii, Illinois, Kentucky, Missouri, New Jersey, New York and South Carolina. As of December 31, 2016, it offered MA coordinated care plans (CCPs) in certain counties in Arizona, Arkansas, California, Connecticut, Florida, Georgia, Hawaii, Illinois, Kentucky, Louisiana, Mississippi, New Jersey, New York, South Carolina, Tennessee and Texas. As of December 31, 2016, it also offered standalone Medicare PDPs in 50 states and the District of Columbia.
Medicaid Health Plans
The Company's Medicaid Health Plans segment includes plans for beneficiaries of Temporary Assistance for Needy Families (TANF), Supplemental Security Income (SSI) and Aged, Blind and Disabled (ABD) programs and other state-based programs that are not part of the Medicaid program, such as Children's Health Insurance Program (CHIP) and Managed Long-Term Care (MLTC). The Medicaid programs and services it offers to its members vary by state and county, and are designed to serve its constituencies in the communities in which it operates. Its Medicaid plans provide its members with access to a spectrum of medical benefits from primary care and preventive programs to full hospitalization and long-term care. TANF assists low-income families with children. ABD and SSI assist low-income aged, blind or disabled individuals. CHIPs assist qualifying families not eligible for Medicaid. MLTC programs are designed to help people with chronic illnesses or having disabilities and need health and long-term care services, such as home care or adult day care, to enable them to stay in their homes and communities as long as possible.
Medicare Health Plans
As of December 31, 2016, the Company's Medicare Health Plans segment program provided healthcare coverage primarily to individuals of age 65 or older, as well as to individuals with certain disabilities, and consisted of four parts, labeled A through D. Part A provides hospitalization benefits financed through Social Security taxes and requires beneficiaries to pay out-of-pocket deductibles and coinsurance. Part B provides benefits for medically necessary services and supplies, including outpatient care, physician services and home healthcare. Parts A and B are referred to as Original Medicare. Medicare beneficiaries may elect to receive their Medicare benefits through MA plans as an alternative to Original Medicare. Under MA, private health plans, including health maintenance organizations (HMO) and preferred provider organizations (PPO), contract with Centers for Medicare & Medicaid Services (CMS) to provide benefits (such as, including prescription drug coverage and supplemental benefits) to Medicare beneficiaries than Original Medicare. Beneficiaries enrolled in Original Medicare can either join a stand-alone PDP plan or forgo Part D prescription drug coverage. Beneficiaries enrolled in Medicare Advantage plans can join a plan with Part D coverage (an MA-PD plan), select a standalone PDP plan or forgo Part D prescription drug coverage. It contracts with CMS under the Medicare program to provide an array of Part C and Part D benefits to Medicare eligible persons, through its MA plans.
The Company's Medicare PDPs segment has contracted with CMS to serve as a plan sponsor offering standalone Medicare Part D PDP plans to Medicare-eligible beneficiaries through its Medicare PDPs segment. As of January 1, 2017, the Company offered PDPs in 50 states and the District of Columbia. The Company's PDPs offer national in-network prescription drug coverage, including a pharmacy network, subject to limitations in certain circumstances.
WellCare Health Plans Inc
8735 Henderson Rd
TAMPA FL 33634-1143
Company Web Links
- CVS, Aetna win U.S. approval for $69 billion deal
- CVS, Aetna win U.S. approval for $69 billion deal |
- UPDATE 3-CVS, Aetna win U.S. approval for $69 bln deal
- Aetna, seeking antitrust nod, sells Medicare drug business to WellCare
- UPDATE 3-Aetna, seeking antitrust nod, sells Medicare drug business to WellCare