Wellcare seems to have many of the same customer-unfriendly initiatives as most insurers do, from failing to publish an accurate formulary list BEFORE the start of coverage at a new year to making patients jump through proverbial hoops to get certain kinds of 'ordinary' medication paid for. Thank God, it hasn't been too much of a rodeo lately to have regular maintenance medications filled and properly paid for, but received push-back and denial when the doc added a new drug to the regimen. When I went to pick up the medication, the pharmacy tech explained that insurance denied the drug and 'suggested' that the doc try a different drug first. Step therapy is common these days, so maybe that could've been expected. HOWEVER... the drug that they 'recommended' be taken first is the SAME DRUG that was prescribed almost 4 months ago for the same condition!!! Neither their system nor the pharmacy's system was able to identify the fact that the 'recommended' drug had already been prescribed and dispensed! When I pointed that out to the pharmacist, that the Dr. was indeed engaging in 'step therapy,' then it was the knee-jerk response ... "you need preauthorization and the doctor has to fill out paperwork!" What good is step therapy when ultimately the doctor has to spend the same amount of time to request a particular drug regardless? What good is having an electronic database at the pharmacy if the insurer and pharmacy don't exchange information and nobody bothers to look to see whether someone has already been prescribed a certain drug?
The folks running Wellcare seem to be inept and profit-focused rather than on what their name implies.