Medicare Default Enrollment
In select states, Wellcare Dual Special Needs Plans (D-SNP) participate in Default Enrollment for members that are currently enrolled in the Managed Medicaid plan within the Centene family of health plans and are newly eligible for Medicare due to age or disability. This enrollment is an automated process and requires no action from the new member!
What is the benefit of Default Enrollment to you, the member?
- You will have an uninterrupted transition from Medicaid-only coverage to Medicaid and Medicare Advantage coverage which includes care coordination and supplemental benefits that are not available in Original Medicare
- On a Medicare Advantage plan, will be eligible for extra benefits like dental, vision and hearing that are not offered on Original Medicare
- Increases the ease for you to find providers who accept both Medicare & Medicaid
- There will be no changes to your current Medicaid coverage and Medicaid benefits
- You are not required to complete paperwork to enroll
What happens next?
- There is no additional action that you need to take! You will be auto enrolled into your new Wellcare Medicare Advantage plan!
- You will be receiving your new Wellcare ID card and a Welcome Kit in the mail prior to your effective date
What Additional Assistance is Available Outside of the D-SNP?
- Everyone deserves to live their best life. But a lot of things can get in the way. A phone call to our Community Connections Help Line can connect you with help to pay for food or bills. Plus, it’s here and free for everyone — Wellcare members and even family and friends without health insurance. Our Peer Coaches will listen to your needs and connect you with help all over the country or right in your area.
- Call to get the help you need. 1-866-775-2192 TTY: 1-855-628-7552, 9:00 AM to 6:00 PM Local Monday through Friday
Frequently Asked Questions
Default enrollment is a process that allows a Medicare Advantage (MA) organization like Wellcare to enroll a member of a companion Medicaid Managed Care Organization (MCO) into its Medicare Dual Eligible Special Needs Plan (D-SNP) when that member becomes newly eligible for Medicare. The only default enrollment effective date possible is the date an individual is initially eligible for Medicare Advantage (i.e., has both Medicare Part A and Part B for the first time).
A Dual Special Needs Plan (D-SNP) is a Medicare Advantage plan that has a model of care and benefits designed specifically to serve the unique needs of dual eligible individuals, those with both Medicaid and Medicare. D-SNP plans are required to help coordinate Medicaid benefits for the member.
You currently have Medicaid coverage through a Medicaid plan that is a part of the Centene family of health plans. Because you will soon be eligible for Medicare, Centene will automatically enroll you into our Medicare Advantage Dual Special Needs Plan (D-SNP) for your Medicare benefits. This will help your Medicare and Medicaid benefits work together as well as provide you with additional benefits and resources.
There will be no changes or disruption to your Medicaid benefits. This plan will provide additional benefits and possible cost savings. After your effective date with Wellcare, you will begin receiving Medicare coverage immediately.
Yes, your new Wellcare member ID card will be mailed to you before your effective date. Please continue to use and present your Medicaid card along with your new Wellcare card when receiving services.
Yes, the member ID card that we will mail to you will have a new member ID. Please be sure to always show your new D-SNP plan ID card as well as your current Medicaid ID card to your provider to let them know you have both Medicare and Medicaid coverage.
If your provider is in the Wellcare network, you will be able to continue seeing your doctor. If your provider is not in network, you will be able to choose a new provider that is within the Wellcare network. To check if your provider is in network or find a new one, you can go to wellcare.com/en/fap.
No. You can decide to join a different Medicare Advantage plan or go to Original Medicare with no impact to your Medicaid coverage.
- Transportation
- Medication assistance
- Free/reduced cost dental
- Financial assistance (utility and rent)
- Support groups
- Legal, tax and probate advice
- Financial and estate planning
- Volunteerism or community engagement
- Community-based healthy living programs
- Elder assistance
‘Ohana Health Plan, a plan offered by WellCare Health Insurance of Arizona, Inc.
Washington residents: “Wellcare” is issued by Wellcare of Washington, Inc.
Access New York Wellcare Dual Access D-SNP Notice of Nondiscrimination
Access Arizona Wellcare Dual Liberty D-SNP Notice of Nondiscrimination
Access Wisconsin Wellcare Dual Access D-SNP Notice of Nondiscrimination