WellCare/Centene: Retroactive Enrollment Reminders

WellCare/Centene Announcement from 11/13/20:

Retroactive Enrollment Reminders

Did You Know – CMS monitors and scrutinizes retroactive enrollments that result from broker errors during the initial enrollment application process? As such, these largely preventable, broker-related errors present compliance issues for Centene that may have downstream effects on any related broker contractual arrangements. As a best practice, please review all applications prior to submitting to ensure accuracy of the submission.

For further insight, we have identified some of the most common mistakes to watch for:

  • Incorrect effective dates selected
  • Plan name and plan number mismatches
  • Missing required information, and no responses to our requests for information
  • Incorrect plan segment (PBP) selected by agent during agent assisted web application

If you have any further questions, please contact your Cornerstone rep.

Centene/WellCare 2021 Star Ratings

Centene is pleased to announce their 2021 Star Ratings!

Each year, the Centers for Medicare & Medicaid Services (CMS) issues objective ratings on all Medicare Advantage and Medicare Drug plans to determine if they provide high-quality care for their members.

These quality scores include several factors, such as the clinical care members receive, their service experience, and member feedback detailing how well plans did in various categories. Using a one through five-Star rating system, CMS evaluates nearly 50 measures, broken into multiple areas.

Centene oversees CMS Star measures and performance within five chapters:

  • Admin/Ops (service quality)
  • CAHPS (member satisfaction)
  • HEDIS (clinical services)
  • HOS (Health Outcomes Survey)
  • Pharmacy (taking prescribed medications)

Achieving positive quality ratings is vital. These ratings are crucial to Centene members, brokers and partners, and their overall growth. With CMS’ increased focus on patient experience and access to care, Centene must continue to put members first and empower them to partner with their providers to make good healthcare decisions.

Downloadable 2021 Star Ratings:

  • Click here to access 2021 Star Ratings for all Centene health plans.


NOTE: 2021 Star Ratings are state- and product-specific.


Action Required: Please ensure that you are distributing the most current 2021 Star Ratings. Be sure to dispose of any outdated Star Ratings.


Centene/WellCare Partners with the National Council of Aging

Centene message from 10/27/20:

Centene Partners with the National Council on Aging (NCOA)

We are pleased to announce that Centene has joined forces with the National Council on Aging (NCOA) to help improve the health and well-being of older Americans.

This exciting, joint effort gives our valued customers and employees access to NCOA’s BenefitsCheckUp, a free and confidential web-based service that helps older adults with limited incomes identify what benefits they may qualify for and how to apply for them. Since 2001, nearly 9 million people have used BenefitsCheckUp to find programs that help them pay for prescription drugs, health care, food, housing, utilities, tax relief and more.

BenefitsCheckUp can be used on any computer or mobile device. The tool includes more than 2,500 public and private benefits programs from all 50 states. A BenefitsCheckUp screening can be completed here.

Additionally, on Oct. 28, leaders from NCOA and Centene’s WellCare of Florida plan will air a Facebook event called “Navigating Your Medicare and Medicaid Choices in 2021” to help Medicare beneficiaries select the right plan for them for 2021. This will serve as a great resource to guide your beneficiaries to information that can help them make an informed decision this Annual Enrollment Period.

To learn more about NCOA and its BenefitsCheckUp tool, please visit www.ncoa.org.

And don’t forget to check out NCOA’s Facebook page on Oct. 28 at 5:45 p.m. ET for the premiere of “Navigating Your Medicare and Medicaid Choices in 2021.”