2023 Wellcare By Allwell Products

Wellcare by Allwell carries Medicare Advantage (MA) plans in health maintenance organizations (HMOs) by leveraging our vast network of providers. Members can pick between a variety of options to keep costs low and work closely with their primary care provider to determine the appropriate specialists for their needs.

Our Preferred Provider Organization (PPO) offerings for the 2023 Plan Year offer flexibility as members navigate their care journeys. Wellcare by Allwell covers all Medicare-covered Part A and Part B services received from a broad network of in-network providers, yet offer the flexibility for members to use providers outside of the plan’s network.

PPO members do not need a referral from a primary care physician for specialist or hospital visits. However, using providers in the vast Wellcare by Allwell network may cost less than choosing one that is out-of-network. Medicare providers who do not contract with Wellcare by Allwell are under no obligation to treat our members, except in emergency situations

Wellcare by Allwell's Duals Special Needs Plans (DSNP) for members eligible for both Medicare and Medicaid. Our DSNP plans provide additional benefits to assist with expenses at low or no cost. Our DSNP plans are an integrated approach to care coordination and offer other benefits that cannot be received through original Medicare, including preventative dental and vision care, prescription drug benefits, coverage for over-the counter health items, and more. 

PPO BILLING FOR SERVICES  

If you provide services to a Wellcare by Allwell PPO member, whether you are in- or out-of-network, we make it easy to seek prior authorizations and submit claims. Please reference the table below for the web links and phone numbers to do so.

Referrals or authorizations to see out-of-network providers are not required, however they are highly encouraged.

• Wellcare By Allwell Payer ID: 68069
• Secure Provider Portal: Buckeye Health Plan/providers
• Prior Authorization Form:  Prior Auth - Medicare
• Prior Authorization Fax (Medical):  833-660-1992
• Prior Authorization Fax (Behavioral Health):
  • Inpatient: 833-320-2895/Outpatient: 833-320-2892
• Transplant Requests Fax: 1-844-974-3115
• Expedited Prior Authorization Phone Number: 855-766-1851
• Provider Services: 855-766-1851

These phone numbers can be found in the top right corner of the form.

Note: Out-of-network providers should bill Wellcare By Allwell first. However, if the member has already paid, we will reimburse the member for our share of the cost for covered services.