Wellcare as of January 1, 2022, is no longer included in the Trinity Healthcare Network in Michigan. Medicare Beneficiaries have a variety of options available.
Wellcare & Trinity Health Changes Insurance carriers for Medicare enter into contracts for hospital carriers to provide services for
Medicare beneficiaries. Wellcare was not able to renew its contact with Trinity Health. In the Michigan area includes the following Medicare Facilities:
*St. Joseph Mercy Health Care System - Ann Arbor/Chelsea * St. Mary Mercy Hospital System- Livonia * Livonia Medical Center - Livonia *Up to 579 Facilities in the Trinity Healthcare Network Here This would include Physicians, Laboratories, Senior Care Homes, Mental Health Services and more affiliated within the Trinity Healthcare Network. Check with your Doctor or Facility if they are associated with Trinity Healthcare to determine how the change with Wellcare and Trinity Healthcare impacts the services you receive. What is Wellcare Saying on the Trinity Health Issue:
" It has been determined that Affinia/Trinity will no longer be participating in the Wellcare provider network effective 1/1/22. This includes all hospitals, facilities and providers associated with Affinia/Trinity.
Our contract with Affinia/Trinity is national, and because of this, it was not initially clear if the termination of the contract would impact all or only some of the hospitals, facilities, and providers in the Michigan market.
We regret to inform you that this will impact all Affinia/Trinity providers in MI, however not impacting contracts in other states. While members will not be able to see these providers utilizing our HMO and PPO plans as an in-network basis, it has been determined that Wellcare will honor any prior authorizations that fall under the continuity to care."
How Does This Impact Me If on Wellcare? If you have a Wellcare Medicare plan is a HMO - Home Maintenance Organization, you are
required to receive healthcare services outside of emergency situations within the plans network Hospitals, Physicians, Laboratories, Senior Care Homes, Mental Health Services and more. If services outside of emergency situations are received at locations Out of Network, the Medicare beneficiary could face up to 100% of all charges. If the Wellcare Medicare plan is a PPO - Preferred Provider Organization, you can receive for
healthcare services from In-Network and Out-of-Network Hospitals, Physicians, Laboratories, Senior Care Homes, Mental Health Services and more.
The amount of coverage for Out-of-Network would be determined by the plan. Review the Summary of Benefits for your associated plan to determine the levels of coverage Out-of-Network. Trinity Health would be Out-of-Network plan for a Wellcare PPO associated plan.
What Can We Do If We Prefer To Keep Wellcare or Review Other Options:
For beneficiaries under a HMO - Home Maintenance Organization plan preferring to keep Wellcare and continue to use Trinity Health associated Hospitals, Physicians, Laboratories, Senior Care Homes, Mental Health Services and more; they can maintain and only use the Trinity Health Network for Emergencies only.
Another option for beneficiaries under a HMO - Home Maintenance Organization plan preferring to keep Wellcare is change into Wellcare PPO - Preferred Provider Organization plan. Trinity Health would be Out-of-Network in this case would be subject to the Summary of Benefits for the associated plan to determine the levels of coverage Out-of-Network.
As well, an additional option would be to elect the Open Enrollment Period to review other Medicare Advantage options within your area. Ways to review these options include contacting Medicare directly at 800-Medicare (800-633-4227), visiting Medicare.gov or MRW Solutions Group can assist with reviewing options either of the below links:
Connect with Monica on Medicare questions by contacting 866-630-6338 or 866-630-MEDU or book an appointment online to discuss today.