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) 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 transition certain Medicare‑Medicaid Plans (MMPs) into integrated Dual Eligible Special Needs Plans (D‑SNPs), with the first phase effective Jan 1, 2026.

Highlights include the Wellcare Spendables® card at ~66,000 retailers, integrated rewards, $0 or low PCP copays, capped insulin costs ($35 or 25% rule), and PDP options with 68 PDPs across 34 regions.

Positive

• MA coverage expanded to 51 million beneficiaries in 32 states
• PDP offering continued to > 8 million members nationwide
• Added 51 counties across eight states for 2026
• Phase‑in of integrated D‑SNPs effective Jan 1, 2026 for MMP transitions
• Wellcare Spendables® card accepted at ~66,000 retailers

Negative

• Phase out of VBID limits extra nonmedical benefits to members meeting specific health conditions
• Members in transitioned plans will be automatically enrolled and must review ANOC for coverage changes

Insights

Senior Healthcare Strategy Analyst

Wellcare expands Medicare footprint, integrates MMPs into D-SNPs and enhances member benefits for 2026.

Wellcare increases Medicare Advantage availability to over 51 million beneficiaries across 32 states and adds 51 counties, while maintaining nationwide Prescription Drug Plans serving over 8 million members. The company will transition select Medicare‑Medicaid Plans (MMPs) into integrated Dual Eligible Special Needs Plans (D‑SNPs) effective Jan 1, 2026, and already offers integrated D‑SNPs in several states; existing Centene members will be automatically enrolled and should review their Annual Notice of Change.

The business mechanism is expansion of geographic footprint and a product integration strategy that centralizes Medicare and Medicaid benefits under D‑SNPs, paired with member-experience investments (digital onboarding, multilingual content, rewards, and the Wellcare Spendables® card). This aims to simplify benefit administration and increase member engagement through predictable copays, $0 primary care visits, and capped insulin costs ($35 or 25% where applicable).

Dependencies and risks include successful operational transitions in each state and adherence to state-specific rules for integrated D‑SNPs; coordination with federal/state partners is stated but outcomes are not guaranteed. The phase-out of MMPs under the Financial Alignment Initiative requires smooth member transfers; monitoring of ANOC communications and enrollment execution is critical. Watch implementation timelines around the 2026 AEP (AEP runs Oct. 15, 2025–Dec. 7, 2025) and the automatic enrollment process starting Jan 1, 2026. Expected near-term indicators to monitor include county-level launch execution, member onboarding metrics, and uptake of enhanced benefits over the next plan year.

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

COLUMBIA, S.C., Nov. 10, 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 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.

"Choosing the right Medicare plan is one of the most important decisions seniors make each year," said John McClellan, CEO of Absolute Total Care. "At Absolute Total Care and Wellcare, we are committed to helping South Carolinians access quality, affordable healthcare. Our Medicare Advantage plans and integrated D-SNP options are designed to make it easier for caregivers to coordinate care and for seniors to receive preventive services and essential benefits from providers they know and trust in their own communities."           

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 wellbeing," 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 – South Carolina, Arizona, Delaware, Illinois, Iowa, Michigan, Ohio 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. 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.

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SOURCE Absolute Total Care

FAQ

What Medicare Advantage coverage will Wellcare (CNC) offer 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 switch MMP members to integrated D‑SNPs (CNC)?

The transition to integrated D‑SNPs begins with a first phase effective Jan 1, 2026 for specified states.

How many PDPs will Wellcare (CNC) offer in 2026 and where?

Wellcare will offer 68 PDPs across 34 regions, available in all 50 states and the District of Columbia.

What member benefits does Wellcare (CNC) highlight for Medicare Advantage plans in 2026?

Highlights include the Wellcare Spendables® card at ~66,000 retailers, integrated rewards, $0/low PCP copays, and capped insulin costs.

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

With VBID phased out, extra benefits like groceries or rent assistance are restricted to members who meet specific health condition eligibility.

Will existing Centene members need to take action after Wellcare (CNC) plan changes?

Existing Centene members will be automatically enrolled into new integrated D‑SNPs and should review their Annual Notice of Change (ANOC) for updates.