Wellcare by Centene Medicare Plans in North Carolina
Star Rating
3.5 out of 5
Enrollment
2.1M+ members
National Rank
#4
Network Types
HMO, PPO
Wellcare by Centene is a major Medicare insurance providers in North Carolina, offering Medicare Advantage, Medicare Advantage with prescription drug coverage, Part D prescription drug plans to beneficiaries across the state. With 3.5-star ratings and coverage in Charlotte, Raleigh, Asheville and surrounding areas, Wellcare by Centene serves North Carolina's 1.8+ million Medicare-eligible residents.
North Carolina has 41% of Medicare beneficiaries enrolled in Medicare Advantage plans, near the national average. Wellcare by Centene's North Carolina plans typically include dual-eligible expertise and low-income programs, making them a strong choice for beneficiaries in the NC market.
The Bottom Line
Wellcare by Centene is a solid choice for North Carolina Medicare beneficiaries who want dual-eligible expertise with 3.5-star rated plans. Compare Wellcare by Centene options with other North Carolina carriers to find the best fit for your healthcare needs and budget.
Wellcare by Centene Pros and Cons
Pros
- Many $0 premium plan options
- Strong D-SNP plans for dual-eligibles
- Good rural area coverage
- Spendables card for OTC purchases
- Transportation benefits included
Cons
- Lower star ratings than some competitors
- Provider networks can be limited
- Customer service reviews are mixed
- Fewer PPO options available
Wellcare by Centene Plan Types in North Carolina
Wellcare by Centene offers multiple Medicare plan types to North Carolina residents, each designed for different healthcare needs and budgets:
Medicare Advantage (Part C): Wellcare by Centene's North Carolina Medicare Advantage plans combine hospital (Part A), medical (Part B), and usually prescription drug (Part D) coverage into one plan. Many Wellcare by Centene MA plans in North Carolina have $0 monthly premiums beyond the Part B premium, with benefits including dental, vision, hearing, and fitness programs.
Part D Prescription Drug Plans: Wellcare by Centene's standalone Part D plans in North Carolina provide prescription drug coverage for those on Original Medicare. Plans vary in formulary coverage and preferred pharmacy networks.
Dual Eligible Special Needs Plans (D-SNP): For North Carolina residents who qualify for both Medicare and NC Medicaid, Wellcare by Centene offers D-SNP plans with coordinated benefits and additional support services.
Wellcare by Centene Provider Networks in North Carolina
Wellcare by Centene's North Carolina Medicare Advantage plans use HMO and PPO networks. Network size and provider participation vary by plan and county.
In Charlotte and surrounding Mecklenburg County, Wellcare by Centene networks typically include major health systems. However, provider participation can change annually, so always verify your doctors are in-network before enrolling.
For beneficiaries in Charlotte, Raleigh, Asheville, Wellcare by Centene generally offers good hospital and specialist coverage. Rural areas of North Carolina may have more limited network options, making PPO plans with out-of-network benefits a consideration.
Use Wellcare by Centene's online provider directory at https://www.wellcare.com/find-a-provider to verify network participation for any North Carolina doctor or facility.
Wellcare by Centene North Carolina Plan Costs
Wellcare by Centene Medicare plan costs in North Carolina vary by plan type, county, and coverage level. Here's what to expect:
Medicare Advantage Premiums: Many Wellcare by Centene MA plans in North Carolina offer $0 monthly premiums beyond the Part B premium (often $0). Higher-benefit plans may have premiums of $20-$100+/month.
Out-of-Pocket Maximums: All Wellcare by Centene Medicare Advantage plans include annual out-of-pocket limits, protecting you from catastrophic costs. Limits typically range from $3,000-$8,000 depending on the plan.
Medigap Premiums: Wellcare by Centene Medigap plans in North Carolina average $155-$255/month for Plan G, varying by age, gender, and tobacco use. Rates are typically lower when you enroll during your Medigap Open Enrollment Period.
Wellcare by Centene Star Ratings in North Carolina
Wellcare by Centene's Medicare plans currently hold 3.5-star ratings (out of 5) from CMS. Star ratings measure quality across categories including:
- Staying healthy (screenings, tests, vaccines) - Managing chronic conditions - Member experience and satisfaction - Member complaints and access to care - Customer service quality
Plans with 4+ stars are considered high-performing and may offer additional benefits. Wellcare by Centene's competitive ratings in North Carolina reflect solid performance across these quality measures.
Wellcare by Centene Key Facts
Frequently Asked Questions
Is Wellcare by Centene a good Medicare plan in North Carolina?
Wellcare by Centene is a reputable Medicare insurers in North Carolina with 3.5-star ratings. Whether it's the best choice for you depends on your doctors, medications, and coverage preferences. Wellcare by Centene is known for dual-eligible expertise and low-income programs.
Does Wellcare by Centene Medicare cover my Charlotte doctors?
Wellcare by Centene's North Carolina provider networks include many doctors and hospitals in Charlotte and surrounding areas. However, network participation varies by specific plan. Always verify your doctors are in-network using Wellcare by Centene's provider directory before enrolling.
How much do Wellcare by Centene Medicare plans cost in North Carolina?
Many Wellcare by Centene Medicare Advantage plans in North Carolina have $0 monthly premiums beyond the Part B premium. Costs vary by plan type, benefits, and your county. Wellcare by Centene Medigap plans typically cost $155-$255/month for Plan G.
Can I switch to Wellcare by Centene Medicare in North Carolina?
You can switch to Wellcare by Centene during the Annual Enrollment Period (October 15 - December 7), during a Special Enrollment Period if you qualify, or during the Medicare Advantage Open Enrollment Period (January 1 - March 31) if you're currently in a Medicare Advantage plan.
Does Wellcare by Centene offer $0 premium plans in North Carolina?
Yes, Wellcare by Centene offers several $0 premium Medicare Advantage plans in many North Carolina counties. These plans still require you to pay your Part B premium. $0 premium plans may have different benefit levels and cost-sharing than plans with monthly premiums.
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