Networks change. We verify your specific WellCare plan before your first visit; call with your member ID and we will confirm benefits, copay and any referral or authorization requirements.
Also appears on cards as: WellCare (Centene), Wellcare by Allwell.
WellCare is Centene's Medicare brand, offering Medicare Advantage HMO and PPO plans and standalone Part D prescription drug plans. It has a large Florida membership, built from its original Tampa headquarters, and a growing presence in South Carolina. WellCare Medicare Advantage plans cover outpatient psychiatry, medication management and psychotherapy for a fixed mental health copay, often $0 to $45 per visit, with no deductible. HMO plans require in-network providers but generally do not require a primary care referral for behavioral health. PPO plans allow out-of-network visits at a higher cost share. Many WellCare plans are dual-eligible special needs plans for people with both Medicare and Medicaid, under which mental health visits are typically free. Telehealth psychiatry is covered at the same copay as office visits for members in Florida and South Carolina.
As a Medicare Advantage carrier, WellCare must cover transcranial magnetic stimulation and Spravato under Medicare's criteria, but it requires prior authorization for both. TMS is covered for major depressive disorder after failure of at least two antidepressants and a psychotherapy trial, with a per-session copay or coinsurance set by your plan. Spravato is covered for treatment-resistant depression with a concurrent oral antidepressant and REMS-certified administration, with cost sharing applied to the drug and the monitoring visit. Stedfast Psychiatry staff verify your WellCare plan and submit authorizations before scheduling.
What we check before your visit
- Whether your plan is in network at the office you chose and for telehealth
- Your copay or coinsurance for an evaluation and for follow-ups
- Whether a primary-care referral is required (common with HMO plans)
- Prior-authorization criteria for Deep TMS and Spravato, if those are being considered
Frequently asked questions
Does Stedfast Psychiatry accept WellCare Medicare Advantage?
Stedfast Psychiatry accepts WellCare Medicare Advantage plans in Florida and South Carolina where contracted. WellCare offers several HMO, PPO and dual-eligible plans in each county, and networks differ among them, so confirm your specific plan with WellCare member services or ask our front desk to verify before scheduling.
What is my copay for a psychiatrist on WellCare?
WellCare Medicare Advantage plans typically charge a fixed copay for outpatient mental health visits, usually between $0 and $45, with no deductible. Dual-eligible special needs plan members generally pay nothing. Your plan's summary of benefits lists the mental health specialty visit amount, and we can confirm it before your appointment.
Does WellCare cover telehealth psychiatry from home?
Yes. WellCare covers video mental health visits from home at the same copay as office visits for members located in Florida or South Carolina during the appointment. Telehealth is convenient for medication follow-ups. Deep TMS and Spravato require in-person treatment at the offices that provide them.
Will WellCare approve Deep TMS?
WellCare covers TMS for major depressive disorder under Medicare's criteria, which require failure of at least two antidepressants and a psychotherapy trial, and it requires prior authorization. Our Palm Beach Gardens TMS team submits your documentation and confirms the per-session cost share before scheduling the 36-session course.
Does WellCare cover Spravato?
WellCare covers Spravato with prior authorization for treatment-resistant depression when you are taking an oral antidepressant and receive treatment at a REMS-certified clinic. Your cost share may be a copay or a percentage of the drug cost and applies to both the drug and the monitoring visit. We provide an estimate before your first induction session.