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Wellcare: Weekly News – 02/24/2023

February 28, 2023

With the new year well underway, Wellcare would like to provide a few updates they are sure you will find helpful as you continue to work with your members:

  • Member Onboarding Experience - Updated resource explaining path for member onboarding
  • CMS Subcontractor Data Breach - Update on member communication from CMS
  • Inflation Reduction Act (IRA) - Reminder of available member cost share reductions


Member Onboarding Experience  

As part of Wellcare's ongoing commitment to provide exceptional service, they would like to share their updated resource for the member onboarding experience. This process will guide the member through the first weeks of enrollment with regular communication touchpoints.

  • Communications with the member begin once CMS enrollment is confirmed.
  • A combination of outbound calls, direct mail, and SMS messaging are employed to engage the member.
  • Communications include welcome messages, links to helpful resources, and a comprehensive orientation package

Agents are encouraged to review the complete Member Onboarding Resource for a comprehensive overview of the onboarding process.


CMS Subcontractor Data Breach Update

In December 2022 The Centers for Medicare & Medicaid Services (CMS) began responding to a data breach by a subcontractor potentially impacting up to 254,000 Medicare beneficiaries.

Key Points:

  • No CMS systems were breached and no Medicare claims data were involved.
  • Beneficiaries will receive new cards with a new Medicare Beneficiary Identifier (MBI) number.
  • The MBI number change will trigger a chargeback under the old number, however payment will be reissued to the new MBI resulting in a net transaction amount of zero
  • Payments may be validated via the unique Centene ID for the member, which remains unchanged.
  • CMS has mailed a letter to affected beneficiaries explaining the breach and next steps for members.
  • No further action by the member will be required to update a new MBI with the plan.    

More information regarding the data breach is available at CMS.gov.



Inflation Reduction Act (IRA) Reminder

We previously provided information on the Inflation Reduction Act (IRA), which went into effect January 1, 2023 for all Medicare beneficiaries. As a reminder, the IRA provides cost-share reductions to assist Medicare beneficiaries with their Part D drug expenses.

Important Notes:

  • Wellcare members will not pay more than $35 for a one-month supply of each insulin product they use, when their Part D covered prescription is dispensed by a local or mail-order pharmacy.
  • The $35 cap applies to all benefit phases in all Medicare plans.
  • There is no cost sharing for any Part D covered vaccine in all benefit phases.
  • All members are eligible, including those receiving "Extra Help."      


Please refer to the October 2022 Communication for further details on cost-sharing updates, as well as a Special Enrollment Period (SEP) available through the end of 2023 for "Exceptional Circumstances."




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