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Frequently Asked Questions

Medicaid

Medicaid provides medical coverage to low-income individuals and families. The state and federal government share the cost of the Medicaid program.

Medicaid eligibility is determined either by the State of Hawai'i or the Social Security Administration (for SSI recipients).

Individuals may apply for assistance online at the State of Hawai'i website.

Your provider directory has a listing of all hospitals in your health plan network. Your primary care physician or specialist will coordinate your hospital care.

You can request a copy of a provider directory by contacting our Customer Service Department. Alternatively, you may use the Find a Provider feature to view a listing of providers in your area.

In an emergency, please dial 911 or proceed to the nearest medical facility. Call your primary care physician or our Customer Service Department as soon as possible after the emergency, to ensure that we are aware of your situation and can assist you to receive appropriate follow-up care.

Use the Contact Us form. You can also call the Customer Service number on the back of your card if you have one.

To provide you with important information about your health plan promptly, it is crucial that we have your most current address and contact information on file. If you are moving, please update your records by submitting the Change of Address form available in your member handbook or call the Customer Service department with your new address. You can also use the Contact Us form.

Providers

Please complete our Become a Provider form or Contact Us for more information on how to join our network. If you want to join our Medicaid provider network, please be sure to visit your state-specific Medicaid website to submit a request.

Please check your Wellcare welcome letter. You can also use the Contact Us form for additional help.

To check claim status, log into the secure portal at https://provider.wellcare.com/. The secure portal is for participating Wellcare providers that are contracted through Medicaid or Medicare lines of business.

Here are the steps to check a claim status:

  1. Once you log into the secure provider portal, navigate to the Claims landing page.
  2. Search for the claim in a variety of ways including: WCN Number, Claim Number, Member ID, Provider ID, Member Name and DOB, Medicare ID, Medicaid ID or DCN.
    *Note: Certain items will require that you enter a date range under “Service Date”.
  3. Select the “Search” button and the claim results will display below.

Yes. Wellcare Health Plans, Inc. is pleased to offer providers electronic funds transfer (EFT) and electronic remittance advice (ERA) services at no charge. Offered in partnership with PaySpan Health, you now have access to a secure, quick way to electronically settle claims. Using this no-cost service, providers can settle claims electronically, without making an investment in expensive EDI software.

You can find additional helpful information in your Quick-Reference Guide.

Corporate

Watch the videos and see why we are so passionate about serving our members and the communities in which they live!

Video: A Mission To Serve - WellCare Health Plans 

Visit our Careers page to see current openings.

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