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Wellcare Value Script (PDP)

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Plan Specific Documents

This document includes any changes in coverage, costs or service area between your previous and current plan year.

This document provides some of the features of this plan. For a complete list of benefits, see your Evidence of Coverage.

This document includes a legal, detailed description of your benefits and costs as a member.

Use this form to enroll in a Prescription Drug Plan.

Star Ratings judge how well Medicare health and drug plans perform in different categories. They are distributed by Medicare. Medicare evaluates plans based on a 5-Star rating system. Star Ratings are calculated each year and may change from one year to the next.

Related Materials

The language in this update is current as of August 2024. If there are any changes, they will be available by October 15 on the plan’s website.

This document includes information about multi-language interpreter services for speakers of Arabic, Chinese Cantonese, Chinese Mandarin, French Creole, French, German, Hindi, Italian, Japanese, Korean, Polish, Portuguese, Russian, Spanish, Tagalog, and Vietnamese.

Looking for your PDP member ID card? View, print, or order a replacement card through the secure member portal. In a hurry? Print a temporary ID card now.

Use this form to authorize us to withdraw your monthly premiums from your bank.

Complete this form to request reimbursement for covered medical services that you paid for out of pocket.

Complete this form to request reimbursement/refund for covered prescription drugs that you paid full price for.

This form confirms your request for a particular person to act as your representative in connection with a claim.

Each member requesting to be disenrolled must complete their own form.


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Y0020_WCM_164006E_M Last Updated On: 10/1/2024