WellCare of Kentucky: Coverage, Benefits & Enrollment
WellCare of Kentucky provides Medicaid and Medicare Advantage plans that offer much more than just doctor visits. From dental and vision to transportation and wellness programs, WellCare goes beyond basic coverage to meet the needs of Kentucky residents.
According to the Centers for Medicare & Medicaid Services (CMS), over 1.6 million people in Kentucky rely on Medicaid or Medicare for healthcare coverage as of 2024. That’s more than 35% of the state’s population.
Among the health plans available, WellCare of Kentucky stands out as a top choice—serving thousands of low-income families, seniors, and individuals with disabilities through Medicaid and Medicare Advantage plans.
What Is WellCare of Kentucky?
WellCare of Kentucky is a managed care organization (MCO) that offers Medicaid, Medicare Advantage, and Dual Special Needs Plans (DSNPs). It’s part of the Centene Corporation, one of the largest healthcare insurers in the United States.
WellCare’s mission is clear: “Transforming the health of the community, one person at a time.”
It works closely with the Kentucky Department for Medicaid Services (DMS) and Medicare to provide quality care with a local touch. They cover doctor visits, prescriptions, and a lot more—at little or no cost to members.
Who’s Eligible for WellCare of Kentucky?
Eligibility depends on the type of plan:
Medicaid Eligibility (WellCare of Kentucky Medicaid Plan)
You may qualify if you meet these conditions:
- Low income (varies by household size)
- A Kentucky resident
- U.S. citizen or qualified non-citizen
- Belong to one of the following groups:
- Pregnant women
- Children under age 19
- Adults aged 19-64 (expanded Medicaid)
- People with disabilities
- Seniors age 65+
- Foster youth or former foster care up to age 26
Example:
A single adult making under $20,783 per year may qualify for Medicaid in 2025.
Medicare Advantage Eligibility (WellCare Medicare Plans)
To join WellCare’s Medicare Advantage in Kentucky:
- You must be 65 or older, or under 65 with certain disabilities
- You must be eligible for Medicare Part A and enrolled in Part B
- Must live in a covered service area
Dual-Eligible Special Needs Plans (DSNPs)
You qualify for a DSNP if:
- You’re enrolled in Medicare and full Medicaid
- Typically for those with limited income and chronic illnesses
What’s Covered Under WellCare of Kentucky?
The core coverage and extra perks for WellCare members in Kentucky.
Basic Medical Coverage
- Primary care visits
- Specialist care
- Hospital stays
- Urgent care & emergency services
- Lab work & diagnostic tests
- Vaccines & preventive care
- Mental health & substance abuse treatment
Prescription Drugs
WellCare offers $0 or low copays for generic medications and covers many brand-name drugs. Their plans follow a Medicare Part D formulary (for Medicare) or Medicaid drug list.
Dental Benefits
WellCare Medicaid and Medicare Advantage plans in Kentucky often include:
- Routine dental exams
- Teeth cleanings
- X-rays
- Fillings
- Dentures or partials (depending on plan)
Example: Medicare Advantage members may get up to $2,000 annually in dental services.
More Opportunities: Top Senior Discounts at Restaurants Nationwide
Vision Coverage
- Eye exams once a year
- Eyeglasses or contact lenses
- Frames & lenses allowance (often $100–$200/year)
Hearing Services
- Hearing exams
- Hearing aid fittings
- Allowance toward hearing aids (often up to $1,000 per ear annually)
Transportation Services
WellCare Medicaid covers non-emergency medical transportation (NEMT). That includes:
- Rides to the doctor
- Trips to pharmacies
- Scheduled specialist appointments
Some Medicare Advantage plans offer 20+ one-way rides per year.
Telehealth & Virtual Care
WellCare provides:
- 24/7 telehealth visits for general medicine
- Mental health consultations online
- Access to a nurse advice line
Wellness & Fitness Programs
- SilverSneakers® gym membership (for Medicare)
- Nutritional counseling
- Tobacco cessation programs
- Weight loss support
Additional Member Perks
WellCare goes beyond the basics. Some bonus benefits include:
- OTC (Over-the-Counter) Allowance – $25–$75/month for items like pain relievers, vitamins, and first aid supplies
- Grocery cards – for healthy food, in some DSNP plans
- Case management – personalized help for chronic illnesses
- In-home support – light housekeeping or meal services for qualifying members
Provider Network & Pharmacies
WellCare of Kentucky partners with thousands of primary care doctors, specialists, hospitals, and pharmacies statewide. Their provider search tool makes it easy to find someone in your area:
You can search by:
- Zip code
- Provider name
- Specialty
- Facility or pharmacy
How to Enroll in WellCare of Kentucky?
Medicaid Enrollment (Year-Round)
You can apply for WellCare Medicaid anytime through:
- Benefind.ky.gov (state portal)
- Kynect.ky.gov (healthcare coverage and benefits)
- By phone: 1-855-459-6328 (WellCare’s Member Services)
- In person at a local DCBS office
Medicare Enrollment Periods
- Initial Enrollment Period (IEP): 3 months before and after your 65th birthday
- Annual Enrollment Period (AEP): Oct 15 – Dec 7 each year
- Special Enrollment Period (SEP): If you move, lose Medicaid, or qualify for DSNP
Use Medicare’s plan finder or call WellCare directly at 1-866-859-9084.
Plan Costs: What Will You Pay?
Medicaid Plan:
- $0 premiums
- $0–$3.90 copays (based on income)
Medicare Advantage Plans:
- Some have $0 monthly premiums
- Low or $0 deductibles
- Out-of-pocket maximums for peace of mind (often under $7,550 annually)
Documents You’ll Need to Enroll
- Social Security number
- Proof of Kentucky residence
- Proof of income or tax returns
- Medicare card (if applying for Medicare plans)
Real Member Reviews
“My son has autism and we use WellCare for all his therapies. The support team has been fantastic with setting up appointments and helping us get approvals.”
— Mary R., Lexington, KY
“I switched from another Medicare Advantage plan to WellCare. The dental benefit alone is worth it for me. Saved over $800 this year.”
— Thomas B., Bowling Green, KY
Final Thought
Whether you’re a parent, senior, or someone managing a chronic condition, WellCare of Kentucky offers flexible health plans that fit real-life needs. With benefits that go beyond the basics—like free rides, dental care, vision, and fitness—it’s no wonder so many Kentuckians trust WellCare.
And the best part? Help is just a phone call or click away. From enrollment to doctor visits, they’ve got you covered.
