Wellcare Health Insurance review: Wellcare hmo medicare advantage health policy.

I am a 64 y.O. Disabled man that has been disabled for 12 years. I have had multiple suurgeries for various injuries over my lifetime, and I became disabled after fracturing 2 lumbad vertebrea and breaking my rt shoulder in several places. My injuries are well documented. These were why the ss board awarded me full disability at 55 yrs of age.

Last year my physician requested that wellcare approve an mri of my lumbar spine and my cervicel spine, that has also had progressive disk disease for the past 20 years. There have been several mri's done that also document these injuries. Last year the wellcare ppo plan that I had wanted far too much as a co-pay for the 2 scans, so I was forced to wait until I changed plans during open enrollment. I did this and changed to a wellcare hmo that had much broader coverages and lower co pays that someone on disability might be able to afford. So in jan 2022 my dr sent in a new request for these same 2 scans that are very necessary due to the fact that I cannot walk more than 100ft now, without suffering such great pain in my lower back that I cannot function any longer. We submitted the request approx jan 12 2022. In feb, I received a letter of approval from wellcare for both scans. Over a month after we requested the approvals. The problem is, that wellcare sent me letters of approval with dates of service that had to be between feb 16 to may 17 2022. But they sent me approvals on the old policy that was cancelled on december 31, 2021. I called the wellcare customer service and tried to speak with someone from a foriegn country that did not speak english very well, and learned after 20 minutes of spelling out words to this "cs" person, that my mri request from jan 12 had been denied, rejected. Why? Because wellcare is not in the business of healthcare,. They are in the business of making profits and you just can't do that if you provide customers with decent healthcare. Necessary healthcare. My dr has repeatedly sent them notes and other info they wanted as they stalled for time. Its now painfully obvious they never had any intention of approving my hmo policy request because according to the policy, they are responsible for most of the cost. They "bait" people into buying these useless policies with the intention of denying any and all request for services. If I had kept the ppo where I had to pay $300 for the mri's, sure they approved those. Not the hmo though. That was on them, not my expense. So they play this game of sending me approvals on a policy cancelled 2 months before... Thats riduculas!

Wellcare apparently thinks this is a game. This is funny to the patient review panel that gives the approvals or not. It's hard for me to fathom how a company that advertises such wonderful service and such caring for their customers, how in the world they could not even look to see if the policy was in force or not. Yes, they approved my 2 mri scans. On a policy that was cancelled 2 months prior.

Wellcare obviously does not take the well fare of their patients seriously. All they seem to be interested in is collecting as many as they can to get the medicare guaranteed payments each month so they can meet their margins and stay profitable. It's an old story with health insurance. You can't stay profitable if you pay claims.

My mobility is important to me but it's not so important to wellcare. I need these scans so we can determine a course of action and plan surgery, being a paraplegic, or just giving up and dying because I cannot get help from the very people that I once trusted to give me the help that I need as a disabled american that worked everyday of his adult life.

Wellcare has betrayed me and my trust. I will find a way to get these scans done but i'm far from giving up on wellcare and their blatant patient abuse and neglect. They have the power to make me and thousands of others confined to a wheel chair, or bedridden when we could be useful self sufficient americans paying our way thru life. This company is a betrayal of the medicare members trust as well as our payments. In my opinion, wellcare operates a fraudulent business selling medicare advantage policies that they never intend to honor or provide services for.

I will repeat my story everywhere, to anyone, to every state and federal agency or consumer group that exist to protect people like me that get taken advantage of by people like wellcare.