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 to >51 million beneficiaries across 32 states (more than 75% of eligible beneficiaries in those states) and offering Prescription Drug Plans to over 8 million members nationwide.

Key actions include adding 51 counties across eight states, launching an enhanced integrated Dual Eligible Special Needs Plan (D-SNP) model and transitioning Medicare-Medicaid Plans (MMPs) to integrated D-SNPs effective Jan 1, 2026. The 2026 AEP runs Oct 15–Dec 7, 2025.

Positive

• Medicare MA reach expanded to >51 million beneficiaries
• Footprint growth including 51 new counties across eight states
• MMP-to-D-SNP transition effective Jan 1, 2026 across eight states
• PDP nationwide availability with >8 million members and 68 PDPs

Negative

• Phase-out of VBID limits extra non-health benefits to eligible members
• Some enhanced benefits now available only to members meeting specific conditions

Insights

Healthcare Strategy Analyst

Wellcare expands Medicare coverage footprint and converts MMPs to integrated D-SNPs, increasing scale and operational complexity ahead of Jan 1, 2026.

Wellcare will offer Medicare Advantage to over 51 million beneficiaries across 32 states and nationwide PDPs, adding 51 counties and launching integrated Dual Eligible Special Needs Plans (D-SNPs) in eight states as it phases out MMPs. These moves increase addressable membership and consolidate benefit administration for duals by moving from demonstrations to standardized D-SNP operations.

The impacts depend on execution risk around seamless enrollment, state-specific program rules and systems integration; automatic enrollment and ANOC communications reduce disruption but increase short-term operational load. Benefit design elements like the Wellcare Spendables® card, $0 primary care visits and Part D caps ($35 or 25%) sharpen competitiveness but also require careful cost management and payer-provider coordination.

Watch member retention and claims trends through the 2026 Annual Enrollment Period (Oct. 15–Dec. 7, 2025), the effectiveness of the Jan 1, 2026 transition, and early utilization metrics in the first full plan year starting Jan 1, 2026. Near-term horizon: operational and member-experience signals in the next 3–12 months; medium term: enrollment and medical cost trends across the first 12–24 months post-transition.

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

TAMPA, Fla., Oct. 15, 2025 /PRNewswire/ -- Wellcare, a company offering a comprehensive range of Medicare products and the Medicare brand 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 Duals, 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.

Experience the full interactive Multichannel News Release here: https://www.multivu.com/centene_corporation/9333151-en-wellcare-enhances-offering-affordable-quality-medicare-advantage-prescription-drug-plans

"We are deeply committed to offering a diverse range of plans that support our members' health and wellbeing," said Wellcare Chief Executive Officer, Michael Carson. "We're especially excited about the continued growth and integration of our dual-eligible 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."

The company's multi-year journey to maximize Centene's unique market position focuses on creating a seamless integrated experience for dual-eligible 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.

As part of their evolving support and product offerings for dual-eligible members, Wellcare will launch the first phase of its enhanced integrated Duals model across eight states – Arizona, Delaware, Illinois, Iowa, Michigan, 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 wellbeing. 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 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. Washington residents: "Wellcare" is issued by Coordinated Care of Washington, Inc., a subsidiary of Centene Corporation. Washington residents: Health Net Life Insurance Company is contracted with Medicare for PPO plans. "Wellcare" is issued by Health Net Life Insurance Company. Washington residents: "Wellcare" is issued by WellCare Health Insurance Company of Washington, Inc., a subsidiary of Centene Corporation. "Wellcare" is issued by WellCare Prescription Insurance, Inc. 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. For Wellcare Giveback (HMO), Wellcare Simple (HMO), and Wellcare Specialty Simple (HMO C-SNP): Wellcare's pharmacy network includes limited lower-cost, preferred pharmacies in rural areas of Arizona. 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) or consult the online pharmacy directory at go.wellcare.com/AZ. 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 1-844-796-6811 (TTY: 711) for Wellcare Dual Liberty Sync (HMO-POS D-SNP) and Wellcare Dual Access Sync Open (PPO D-SNP); or call 1-800-977-7522 (TTY: 711) for Wellcare Giveback (HMO-POS), Wellcare Simple (HMO-POS), Wellcare Assist Open (PPO), and Wellcare Simple Open (PPO); or consult the online pharmacy directory at go.wellcare.com/NE. For Wellcare Dual Liberty (HMO-POS D-SNP): Wellcare's pharmacy network includes limited lower-cost, preferred pharmacies in rural areas of Ohio. 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 1-833-998-4953 (TTY: 711) or consult the online pharmacy directory at go.wellcare.com/OH. For Wellcare Dual Liberty Sync (HMO D-SNP): Wellcare's pharmacy network includes limited lower-cost, preferred pharmacies in rural areas of Texas. 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 1-833-444-9089 (TTY: 711) or consult the online pharmacy directory at go.wellcare.com/Medicare. For Wellcare By Allwell: Wellcare's pharmacy network includes limited lower-cost, preferred pharmacies in rural areas of Texas. 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 Simple (HMO) or call 1-855-445-3556 (TTY: 711) for Wellcare Dual Liberty Sync (HMO D-SNP), or consult the online pharmacy directory at go.wellcare.com/AllwellTX. Arizona D-SNP plans: Contract services are funded in part under contract with the State of Arizona. Louisiana D-SNP prospective enrollees: For detailed information about Louisiana Medicaid benefits, please visit the Medicaid website at https://ldh.la.gov/medicaid or https://www.louisianahealthconnect.com. 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. Texas D-SNP prospective enrollees: For detailed information about Texas Medicaid benefits, please visit the Texas Medicaid website at https://www.hhs.texas.gov/services/health/medicaid chip/medicaid-chip-members/starplus. To request a written copy of our Medicaid Provider Directory, please contact us. Wellcare By Allwell (HMO and HMO SNP) includes products that are underwritten by Superior HealthPlan, Inc. Wellcare (HMO, HMO SNP, and PPO) includes products that are underwritten by WellCare of Texas, Inc., WellCare National Health Insurance Company, Superior HealthPlan, Inc., and SelectCare of Texas, Inc.

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

Y0020_WCM_4749218E_M FINAL1 CMS Accepted 10142025

 

 

 

View original content:https://www.prnewswire.com/news-releases/wellcare-enhances-offering-of-affordable-quality-medicare-advantage-and-medicare-prescription-drug-plans-in-2026-302584244.html

SOURCE Wellcare

FAQ

What does Wellcare (CNC) offer for Medicare Advantage in 2026?

Wellcare will offer Medicare Advantage to >51 million beneficiaries in 32 states, adding 51 counties and enhanced benefits for 2026.

When does Wellcare transition MMPs to integrated D-SNPs for CNC members?

The transition to integrated D-SNPs begins effective Jan 1, 2026 for the listed launch states.

How long is the 2026 Medicare Annual Enrollment Period for Wellcare (CNC)?

The AEP runs from Oct 15, 2025 through Dec 7, 2025; coverage starts Jan 1, 2026 for enrollments by Dec 7.

Will Wellcare (CNC) PDP plans be available nationwide in 2026?

Yes. Wellcare will offer Prescription Drug Plans nationwide with two products across 34 regions and 68 PDPs.

What member benefits changes should CNC dual-eligible members expect in 2026?

Dual-eligible members will move to an integrated D-SNP model intended to streamline Medicare and Medicaid benefits; existing members will be auto-enrolled.

How does the Wellcare Spendables card change for 2026 Medicare plans?

The Wellcare Spendables card remains available with preloaded funds at 66,000+ retailers and integrates with Wellcare Rewards for health actions.