Wellcare to Offer Medicare Advantage and Medicare Prescription Drug Plans in 205 Texas Counties in 2026

Rhea-AI Summary

Wellcare (NYSE: CNC) will offer Medicare Advantage and Medicare Prescription Drug plans in 205 Texas counties for 2026, with coverage starting Jan. 1, 2026 for enrollments completed by Dec. 7, 2025. The company will launch an integrated Dual Eligible Special Needs Plan (Wellcare Superior HealthPlan Dual Align HMO D-SNP) in Dallas and Hidalgo counties as part of a transition from Medicare-Medicaid Plans to D-SNPs effective Jan. 1, 2026.

Wellcare said it will serve more than 51 million beneficiaries across 32 states (about 75% of eligible beneficiaries), added 51 counties to its footprint, and highlights benefits such as the Wellcare Spendables card (usable at 66,000+ retailers), a ~60,000 pharmacy network, insulin cost caps, and Part D protections.

Positive

• Expansion to 205 Texas counties for 2026 coverage
• Serving more than 51 million beneficiaries across 32 states
• Added 51 counties to national footprint for 2026
• Integrated D-SNP launched in Dallas and Hidalgo counties
• Wellcare Spendables card accepted at 66,000+ retailers
• Access to a network of 60,000 pharmacies nationwide

Negative

• Existing dual eligible members in Dallas and Hidalgo will be automatically enrolled in the new D-SNP unless they opt out
• As VBID phases out, some extra benefits move to a different program, and members not eligible for those programs will be limited to certain benefits

Insights

Health plan strategy expert

Wellcare/Centene expands Medicare and integrated Duals presence in Texas and nationally, widening access and benefit offerings for 2026.

In plain terms, Wellcare (a Centene company) will offer Medicare Advantage and PDP products in 205 Texas counties for 2026, with AEP running Oct. 15, 2025 through Dec. 7, 2025 and coverage effective Jan. 1, 2026. The company says it will serve more than 51 million beneficiaries nationwide across over 1,850 counties in 32 states, and it added 51 counties to its footprint this year. It will transition certain Medicare‑Medicaid Plan members into an integrated D‑SNP model, launching an HMO D‑SNP in Dallas and Hidalgo Counties and auto‑enrolling existing MMP/HIDEP members unless they opt out.

The business mechanism is expanded geographic and product reach plus deeper integration for Dual Eligibles. That can increase membership, revenues, and operational scale by capturing more Medicare Advantage and PDP enrollees and by administering both Medicare and Medicaid benefits under D‑SNPs. Key dependencies and risks include successful operational transitions for duals, member communications and retention during automatic enrollments, and execution of digital/onboarding investments to avoid service friction. The announcement lists concrete benefit features that may drive uptake: $0 or low PCP copays, a Wellcare Spendables® card, Dario digital mental health access, capped insulin costs at either $35 or 25%, and $0 cost‑sharing for ACIP adult Part D vaccinations.

Practical items to watch in the near term are enrollment counts at the close of AEP (Dec. 7, 2025), retention or opt‑out rates among transitioned duals in Dallas and Hidalgo, and any communications or Annual Notice of Change that affect benefits or network access. Over a 6–12 month horizon, monitor reported membership changes and operational metrics tied to integrated D‑SNP rollout to assess whether scale and integration materially advance plan performance and member experience.

In 2026, Wellcare will also expand coverage for individuals who qualify for both Medicare and Medicaid, providing access to more comprehensive care and benefits

AUSTIN, Texas, Nov. 10, 2025 /PRNewswire/ -- Wellcare, Wellcare By Allwell, and Wellcare By Superior HealthPlan, the Medicare products offered by Superior HealthPlan, a company of Centene Corporation (NYSE: CNC), will be available in 205 counties across Texas in 2026. This includes the cities of Austin, Dallas, El Paso, Houston, San Antonio and several others. The 2026 Medicare Annual Enrollment Period (AEP) begins Oct. 15, 2025, and runs through Dec. 7, 2025. Texans who enroll by Dec. 7, 2025, will have coverage starting Jan. 1, 2026.

"Superior HealthPlan has proudly delivered quality Medicare coverage to Texans for more than 15 years," said Superior HealthPlan President and CEO, Mitch Wasden. "Throughout that time, we've remained focused on evolving our product offerings and believe our 2026 plans will provide our most comprehensive healthcare coverage yet."

The company's multi-year journey to maximize Centene's unique market position focuses on creating a seamless integrated experience for Dual Eligible Special Needs Plan (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.

As part of evolving support and product offerings for D-SNP members, Wellcare will launch the first phase of an enhanced integrated Duals model across eight states, including in Texas. This is part of the broader transition from Medicare-Medicaid Plans (MMPs) to integrated Dual Eligible Special Needs Plans (D-SNPs), effective Jan. 1, 2026. The plan, formally Wellcare Superior HealthPlan Dual Align (HMO D-SNP), will be offered in Dallas and Hidalgo Counties.

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, which includes Texas, and will seamlessly transition members in those markets to new integrated D-SNPs that administer both Medicare and Medicaid benefits.

This transition is designed to enhance the coordination of care and streamline services for both Medicare and Medicaid eligibles, while delivering improved outcomes. Existing Wellcare dual eligible members enrolled in our MMP or Highly Integrated Dual Eligible Special Needs Plan in the Texas counties of Dallas and Hidalgo will be automatically enrolled in their new integrated D-SNP, unless they opt out and choose another Medicare plan. Members should review their Annual Notice of Change (ANOC) for important updates regarding their coverage and benefits.

"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."

The company continues to enhance the member experience by investing in digital tools and resources for both current 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.
• Initiating and maintaining communication with members to help them understand their  benefits, including available services and provider options.
• Leveraging data, analytics and technology to measure our operational performance and adjust to meet members' needs and improve 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 for more details about Medicare Prescription Drug Plans (PDP) visit pdpwellcare.com.

Wellcare's 2026 Plan Offerings

For 2026, Wellcare will offer plans to more than 51 million beneficiaries across the nation, 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, North Carolina and Texas.

Medicare Advantage Prescription Drug (MAPD) Plan 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.
  • As the Value-Based Insurance Design (VBID) program phases out, extra benefits  such as help with groceries, gas, rent and, utilities will now be available through a different program for members who meet specific health conditions. We've simplified the process so members can more easily check their eligibility. 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 (MA) 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 access to more than 60,000 total pharmacies nationwide.
• 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; and
  • 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. 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 (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.

H0062_WCM_4749234E_M FINAL1 Approved 11072025

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SOURCE Superior HealthPlan

FAQ

What Texas counties will Wellcare (CNC) serve in 2026 and when does coverage start?

Wellcare will serve 205 Texas counties; enroll by Dec. 7, 2025 for coverage starting Jan. 1, 2026.

How will the transition from MMPs to D-SNPs affect Wellcare members in Dallas and Hidalgo (CNC)?

Existing dual eligible members in Dallas and Hidalgo will be automatically enrolled into the new integrated D-SNP on Jan. 1, 2026, unless they opt out.

How large is Wellcare's 2026 national footprint under CNC?

Wellcare plans to serve more than 51 million beneficiaries across 32 states, covering over 75% of eligible beneficiaries.

What pharmacy and retail benefits do Wellcare (CNC) Medicare plans offer in 2026?

Plans include access to a ~60,000-pharmacy network, preferred retail partners like Walgreens and CVS, and the Wellcare Spendables card accepted at 66,000+ retailers.

Will Wellcare (CNC) limit out-of-pocket costs for insulin and Part D spending in 2026?

Yes; insulin costs are capped at either $35 or 25% of the price (whichever is lower) and Part D out-of-pocket costs are capped at $2,100 for the plan year.

Where can Texans find more information about Wellcare (CNC) Medicare Advantage and PDP plans for 2026?

Visit WellcareNow.com for Medicare Advantage details and pdpwellcare.com for Medicare Prescription Drug Plan information.