We have been working for several months to secure a new contract with WellCare, but we have made little progress. Baptist Health hospitals, outpatient clinics, home care and Baptist Health Medical Group practices will be out of network with WellCare Medicare Advantage plans as of January 1, 2024.

The open enrollment period for Medicare Advantage continues through December 7, 2023. During this window, you may have the ability to choose an alternative insurance plan for 2024.

The most important issue in our discussions with WellCare was to protect your relationship with your physician/clinician and your access to the care you need. It is our experience that many Medicare Advantage plans – including WellCare – routinely deny or delay approval or payment for medical care recommended by your physician, meaning WellCare believes they know better than your own doctor what kind of care you need. We disagree. We believe your need for medical care should be determined by you and your doctor, not an insurance company.

During the Medicare Advantage open enrollment period (through December 7, 2023), you may have the ability to choose an alternative insurance plan for your coverage beginning in 2024. For a list of Medicare Advantage plans that are currently in network with Baptist Health, download a PDF version of our status chart.

All Baptist Health hospitals, outpatient clinics, home care and Baptist Health Medical Group practices will be out of network with WellCare Medicare Advantage plans as of January 1, 2024.

We are in network until the end of the year, so please keep any appointments you have scheduled for the rest of 2023.

During the Medicare Advantage open enrollment period (through December 7, 2023), you may have the ability to choose an alternative insurance plan for your coverage beginning in 2024. For a list of Medicare Advantage plans that are currently in network with Baptist Health, download a PDF version of our status chart.

If you are experiencing a medical emergency, please go to the nearest emergency room. Insurance companies are required to pay for any emergency services at in-network rates.

Insurance companies are required by law to continue paying for treatment at in-network rates for patients with certain medical conditions through a program called “Continuity of Care.” Examples of situations that may qualify for Continuity of Care include pregnancy, chronic medical conditions, and ongoing and active medical treatment such as chemotherapy or dialysis or home healthcare services. It's important to note that only WellCare can determine if you qualify. To understand if you qualify, call the number on the back of your insurance card.

You may be eligible for out-of-network benefits or have access to coverage through a program called “Continuity of Care.” Only WellCare can provide you information on whether you qualify. We recommend you call WellCare at the number on the back of your insurance card to understand if you qualify for continued care. 

Baptist Health will continue to treat all emergency patients – and plan-approved cases for continuity of care coverage – regardless of Medicare Advantage payer or plan type.

Without continuity of care benefits, your ability to continue to access Baptist Health will depend on the type of plan you have.

• Individual PPO plan: If you have an individual PPO plan (meaning you picked your Medicare Advantage plan as an individual), you can continue to access your Baptist Health providers and services, but you may have higher out-of-pocket costs for that care.
• Group PPO Plan: If you have a group PPO plan (meaning your Medicare Advantage plan is through an employer or retiree group), you likely have what are called “mirror benefits.” You can continue to access your Baptist Health providers and services as if you were in network. Your group plan administrator or employer can provide more information on those benefits.
• HMO plan: If you have an HMO plan, your out-of-pocket costs could be significantly higher because of your plan type. Baptist Health cannot, in good conscience, schedule HMO plan members for services on or after January 1, 2024, and HMO plan patients already scheduled for services on or after January 1 will be cancelled. We will call you to make those arrangements.

Exceptions: Baptist Health will schedule you if:

• You have applied for or intend to apply for continuity of care benefits.
• You plan to change to a Medicare Advantage plan that is in network with Baptist Health in 2024.

Your ability to continue to access Baptist Health will depend on the type of plan you have. Your insurance card will indicate your specific plan, usually on the top left corner on the front of the card next to the logo.

• Individual PPO plan: If you have an individual PPO plan (meaning you picked your Medicare Advantage plan as an individual), you can continue to access your Baptist Health providers and services, but you may have higher out-of-pocket costs for that care.
• Group PPO Plan: If you have a group PPO plan (meaning your Medicare Advantage plan is through an employer or retiree group), you likely have what are called “mirror benefits.” You can continue to access your Baptist Health providers and services as if you were in network. Your group plan administrator or employer can provide more information on those benefits.
• HMO plan: If you have an HMO plan, your out-of-pocket costs could be significantly higher because of your plan type. Baptist Health cannot, in good conscience, schedule HMO plan members for services on or after January 1, 2024, and HMO plan patients already scheduled for services on or after January 1 will be cancelled. We will call you to make those arrangements.

Exceptions: Baptist Health will schedule you if:

• You have applied for or intend to apply for continuity of care benefits.
• You plan to change to a Medicare Advantage plan that is in network with Baptist Health in 2024.

Baptist Health hospitals, outpatient clinics, home care and Baptist Health Medical Group will be out of network for WellCare Medicare Advantage patients as of January 1, 2024. Commercial and Medicaid plan members are not affected.