Wellcare Enhances Offering of Affordable, Quality Medicare Advantage and Medicare Prescription Drug Plans in 2026

Rhea-AI Summary

Wellcare (NYSE: CNC) announced its 2026 Medicare offerings, expanding Medicare Advantage (MA) coverage to more than 51 million beneficiaries in 32 states and continuing Prescription Drug Plans (PDP) to over 8 million members nationwide. The company added 51 counties across eight states and will launch the first phase of an enhanced integrated Dual Eligible Special Needs Plan (D-SNP) model across eight states, with the transition of existing Medicare‑Medicaid Plans (MMPs) to integrated D-SNPs effective Jan 1, 2026.

Notable benefits include the Wellcare Spendables® card, a network of >60,000 pharmacies, an insulin cap of $35 or 25% (whichever is lower), $0 copays for many preventive services, and two PDP products (Classic and Value Script) offered in all regions.

Positive

• MA coverage expanded to >51 million beneficiaries in 32 states
• PDP products continue nationwide to >8 million members
• Added 51 counties across eight states to MA footprint
• Integrated D‑SNP transition effective Jan 1, 2026 across eight states
• Preferred pharmacy network expected >60,000 pharmacies
• Insulin cap set at $35 or 25% under Medicare plans

Negative

• Phase‑out of VBID limits extra benefits (groceries, gas, rent) to members meeting specific health conditions
• Expansion of integrated D‑SNPs depends on state‑specific guidelines, limiting guaranteed near‑term growth
• Automatic enrollment into new D‑SNPs may require members to review ANOC for coverage changes

Insights

Medicare Strategy Analyst

Wellcare expands MA reach and integrates MMPs into D-SNPs, widening dual-eligible coordination and nationwide PDP availability.

Wellcare will offer Medicare Advantage to over 51 million beneficiaries across 32 states and continue Prescription Drug Plans to more than 8 million members nationwide. The company adds 51 new counties, launches an integrated Duals model across eight states, and will transition existing MMP members to integrated D-SNPs effective Jan 1, 2026. The product mix highlights predictable copays, an expanded Spendables® card, combined rewards, and several $0 cost-sharing items ($0 primary care, preventive services) plus an insulin cap at $35 or 25% of price and an out‑of‑pocket Part D cap of $2,100.

The shift from MMP demonstrations to integrated D-SNPs directly affects members who are dual-eligible by consolidating Medicare and Medicaid administration into one plan. This change increases operational complexity during enrollment and state coordination; successful rollout depends on state-by-state rules and smooth ANOC communications to automatically enrolled members. The announcement cites collaboration with federal and state partners but gives no quantitative transition risk metrics.

Near-term items to watch include member transition notices and enrollment churn through the AEP running Oct 15, 2025 through Dec 7, 2025, the success of the first-phase launches in the eight named states, and uptake of integrated benefits and the Spendables® card within 2026. Over a 6–18 month horizon, track plan retention, appeals or grievances tied to benefit packaging, and state approvals for further D-SNP expansion.

Medicare Advantage plans will be available to more than 51 million beneficiaries in 32 states; Prescription Drug Plans will continue to be offered nationwide

New in 2026  Wellcare to transition Medicare-Medicaid Plans (MMPs) demonstrations to integrated Dual Eligible Special Needs Plans (D-SNPs) in five states

DETROIT, Nov. 18 2025 /PRNewswire/ -- Wellcare, a company offering a comprehensive range of Medicare products and the Medicare brand and company of Centene Corporation (NYSE: CNC), will offer Medicare Advantage (MA) to over 51 million beneficiaries in 32 states and Prescription Drug Plan (PDP) products to more than 8 million members across all 50 states. This includes 51 new counties across eight markets, with a focus on D-SNPs, enhancements to the Wellcare Spendables® card and improving member experience. Wellcare's PDP plans will continue to be available nationwide. The 2026 Medicare Annual Enrollment Period (AEP) begins Oct. 15, 2025, and runs through Dec. 7, 2025. Members who enroll by Dec. 7, 2025, will have coverage starting Jan. 1, 2026.  

"As we look ahead to 2026, we're excited to introduce our most comprehensive healthcare plans yet as we provide quality Medicare coverage for Michiganders across the state," said Patricia Graham, Plan President and CEO of Meridian of Michigan. "Wellcare of Michigan's plans are designed to meet the evolving needs of our members and continue delivering the trusted care they deserve."

The company's multi-year journey to maximize Centene's unique market position focuses on creating a seamless integrated experience for D-SNP members, caregivers and their providers. Medicare provides coverage primarily based on a member being 65 and older or eligible through disability, while Medicaid typically offers coverage to individuals and families who meet specific income and financial eligibility requirements. Members eligible for both programs are referred to as "Dual Eligibles" or "Duals."

"We are deeply committed to offering a diverse range of plans that support our members' health and well-being," said Wellcare Chief Executive Officer, Michael Carson. "We're especially excited about the continued growth and integration of our Dual Eligible Special Needs Plans, in collaboration with our federal and state partners, which help us better serve individuals who are eligible for both Medicare and Medicaid. Supporting the health of our aging population isn't just a priority – it's a responsibility. These offerings reflect our dedication to delivering quality care, improving health outcomes and creating a seamless experience for some of the most vulnerable populations in our communities."

As part of their evolving support and product offerings for D-SNP members, Wellcare will launch the first phase of its enhanced integrated Duals model across eight states – Michigan, Arizona, Delaware, Illinois, Iowa, Ohio, South Carolina and Texas – as part of the broader transition of MMPs to integrated D-SNPs effective Jan 1, 2026.

This shift aligns with the conclusion of the Medicare-Medicaid Financial Alignment Initiative (FAI), which phases out MMPs nationwide. Wellcare currently offers MMPs in five of the eight launch states (Illinois, Michigan, Ohio, South Carolina, and Texas) and will seamlessly transition members in those markets to new integrated D-SNPs that administer both Medicare and Medicaid benefits. The company already offers integrated D-SNP products in California, Florida, Hawaii and New Jersey, and plans to expand this model to additional markets in the coming years, based on state-specific guidelines.

This transition is designed to enhance the coordination of care and streamline services for both Medicare and Medicaid eligibles, while delivering improved outcomes. Existing Centene members will be automatically enrolled in their new integrated D-SNP and should review their Annual Notice of Change (ANOC) for important updates regarding their coverage and benefits.

The company also continues to invest in member experience with digital tools and resources for members and prospective members. This includes:

• Delivering a modernized, supportive and engaging onboarding experience to new and renewing members.
• Providing member onboarding videos in eight languages: Spanish, Vietnamese, Russian, Tagalog, Chinese Traditional, Chinese Taiwan, Chinese Hong Kong and Korean.
• Proactively engaging and communicating with members on understanding their benefits and access to services and providers.
• Leveraging data, analytics and technology to adjust to meet members' needs and improve the overall experience.
• Conducting frequent member surveys to better understand what matters most to them and where we can improve to make their experience better.

For more details about Wellcare's MA plans visit WellcareNow.com and Medicare PDPs, visit pdpwellcare.com.

Wellcare's 2026 Plan Offerings

For 2026, Wellcare will offer plans to more than 51 million beneficiaries, which accounts for more than 75% of the eligible beneficiaries in 32 states and more than 1,850 counties. Wellcare has added 51 counties to its footprint across the following states: California, Illinois, Iowa, Kansas, Michigan, Nevada, Texas and North Carolina.

MAPD Highlights:

In 2026, a variety of plan offerings for value-conscious beneficiaries are available with predictable copays and extra benefits:

• The Wellcare Spendables® card continues to offer eligible members a single card with preloaded funds available at more than 66,000 nationwide retailers across Wellcare's 32-state footprint. Eligible members may use their Wellcare Spendables® card on multiple benefits. Depending on the plan, benefits may include an allowance for over-the-counter health items and covered out-of-pocket dental, vision and hearing costs. Members who are eligible may use the allowance for other benefits to support their overall well-being. Additionally, an integrated experience combines the Wellcare Spendables® card and Wellcare Rewards™ programs into one platform.
• Members earn rewards for health actions, including annual preventive visits, using the member portal, flu shots and health screenings.
• With the phase out of the Value-Based Insurance Design (VBID) program, extra benefits like assistance with groceries, gas, rent and utilities will only be available to members who meet specific health conditions under a different program, but we've made the process easier for members to check if they are eligible. Members who aren't eligible for additional benefits will be limited to certain types of care, like over-the-counter items or out-of-pocket medical costs.
• $0 or low copay for primary care physician visits on all plans.
• Dario's digital mental health and social support resources (formerly Twill Therapeutics) provide online behavioral health support and is available 24/7 across all Medicare Advantage plans. Services include peer-to-peer support, self-guided behavioral health programs and access to Centene health plan resources.
• Monthly cost for insulin under Medicare plans will be capped at either $35 or 25% of the drug's negotiated or maximum fair price, whichever is lower.
• $0 cost-sharing for Part D vaccinations recommended for adults by the Advisory Committee on Immunization Practices (ACIP).
• The Part D benefit will continue to consist of three phases with members' out-of-pocket costs capped at no more than $2,100 for the plan year.
• Preferred retail pharmacy networks will include Walgreens*, CVS* and select grocers*. A robust network is expected with more than 60,000 total pharmacies.
• Express Scripts® Pharmacy home delivery will continue to be the preferred mail order (Home Delivery) pharmacy focusing on providing convenient and efficient service for prescriptions that are filled for more than 35 days.
• Benefits also include $0 for: routine physical exams to support annual preventive visits; kidney evaluation and A1c labs; preventive and diagnostic mammograms; preventive and diagnostic colonoscopies; routine/medical eye exams for diabetics; and Tier 6 adherence meds at preferred pharmacies.

Medicare Prescription Drug Plans (PDP) Highlights:

Wellcare's Prescription Drug Plans (PDP) will continue to be available nationwide with competitive benefits:

• Two products (Classic and Value Script) will be offered in all 34 regions across all 50 states and the District of Columbia; 68 PDPs nationwide.
• We continue to offer products to meet the unique needs of Medicare beneficiaries including:
  • Dual eligibles
  • Low premium "value" shoppers
• A competitive formulary design will be offered across both plans.
• The Value Script plan will continue to offer members a cost-effective option, with one of the lowest premiums in the nation.
• The Classic plan will be under the Centers for Medicare and Medicaid Services (CMS) benchmark in all regions making this plan a great option for members receiving a Low-Income Subsidy (LIS).
• Both plans feature a $0 copay on Tier 1 (Preferred Generic) prescriptions when filled at a preferred pharmacy.

About Wellcare
Wellcare offers a range of Medicare products, including Medicare Advantage and Medicare Prescription Drug Plans (PDP), which offer affordable coverage beyond Original Medicare. Wellcare is the Medicare brand of Centene Corporation, a leading healthcare enterprise committed to helping people live healthier lives. Beginning Jan. 1, 2022, Centene's Medicare brands, including Allwell, Health Net, Fidelis Care, Trillium Advantage, 'Ohana Health Plan and TexanPlus transitioned to the Wellcare brand. For more information about Wellcare, visit www.wellcare.com. 

Benefits and allowance amounts vary by plan. Please call for more details. Allowance amounts cannot be combined with other benefit allowances which may be on the prepaid card. Limitations and restrictions may apply.

Wellcare Meridian Dual Align (HMO D-SNP) is a health plan that contracts with both Medicare and Michigan Medicaid to provide benefits of both programs to members. Enrollment in our plan depends on contract renewal. Benefits mentioned are a part of Special Supplemental Benefits for the Chronically Ill. Not all members will qualify. In addition to being high-risk, you must have one or more of the following chronic conditions: cancer, cardiovascular disorders, chronic and disabling mental health conditions, chronic lung disorders, diabetes. There are other eligible conditions not listed. Eligibility for this benefit cannot be guaranteed based solely on your condition. All applicable eligibility requirements must be met before the benefit is provided. For details, please contact us or see the plan's Evidence of Coverage/Member Handbook.

*Other Pharmacies/Physicians/Providers are available in our network. 

H7435_WCM_4749230E_M FINAL1 Approved 11162025

 

View original content to download multimedia:https://www.prnewswire.com/news-releases/wellcare-enhances-offering-of-affordable-quality-medicare-advantage-and-medicare-prescription-drug-plans-in-2026-302618553.html

SOURCE Wellcare

FAQ

What Medicare Advantage coverage did Wellcare (CNC) announce for 2026?

Wellcare will offer MA to more than 51 million beneficiaries in 32 states, covering over 1,850 counties for 2026.

When does Wellcare's transition from MMPs to integrated D‑SNPs take effect for CNC members?

The transition to integrated D‑SNPs is effective Jan 1, 2026, with the first phase launching across eight states.

How many Prescription Drug Plans will Wellcare (CNC) offer in 2026 and where?

Wellcare will offer 68 PDPs (Classic and Value Script) across all 50 states and DC in 34 regions.

What changes to member benefits did Wellcare announce for 2026 (CNC)?

Highlights include the Wellcare Spendables® card, $0 primary care copays, a $35 or 25% insulin cost cap, and $0 copays for many preventive services.

Will Wellcare members be auto‑enrolled into new integrated D‑SNPs for 2026?

Existing Centene members in transitioning markets will be automatically enrolled and should review their Annual Notice of Change (ANOC).

How does the VBID phase‑out affect Wellcare (CNC) members' extra benefits in 2026?

With VBID phased out, extra benefits like groceries or rent assistance will only be available to members who meet specific health condition criteria.