Allwell Medicare Insurance Review 2021 | #specialneeds | #kids


Pros Explained

  • Part of one of the largest Medicare Advantage insurers in the country: Centene, Allwell’s parent company, has a large national presence in Medicare, which it has recently expanded. 
  • State-specific branding and services: Each Allwell plan has its own local brand identity, website, and customer service. This state-specific approach can create a disjointed online experience if you’re trying to get a view into the company overall, but it also means that you can get just the information and service you need in your home state.
  • Range of extra benefits: Extra benefits vary by state and plan, but Allwell offers a nice range of member perks. Members may get telehealth, dental, vision, and hearing benefits, as well as meal, transportation, and over-the-counter supplemental support. Allwell also offers My Health Pay, which provides financial rewards for healthy behaviors.

Cons Explained

  • Relatively low ratings from health plan accreditation agency: Most Allwell plans are not rated by the National Committee for Quality Assurance (NCQA), one of the main health plan quality organizations. The two Allwell plans that are rated earned just 2.5 and 3.0 out of 5.0, but scored worse on measures of customer satisfaction.
  • No stand-alone Prescription Drug Plans: Allwell offers only Medicare Advantage plans, including HMO, PPO, and Special Needs Plans. If all you need is supplemental prescription drug coverage, Allwell does not have options for you. 
  • Disjointed online experience: Each state where Allwell operates has its own website so it is not easy to get an overview or learn about the plan overall. Within the state-specific plans, you must provide some basic information before you can see the plan options; many competitors provide overview information with more details available if you enter your information. The site also contains several broken links.

Available Plans

Medicare Advantage Plans

Allwell offers several types of Medicare Advantage plans, including HMO, PPO, and two kinds of Special Needs Plans: Chronic Condition Special Needs Plans (C-SNP) and Dual-eligible Special Needs Plans (D-SNP). Most HMO plans limit members’ choice of providers, whereas PPO plans are more flexible. Many Allwell HMO plans include prescription drug coverage along with extra benefits. D-SNPs offer comprehensive coverage for people who qualify for both Medicare and Medicaid, and C-SNPs are geared toward people with chronic conditions such as diabetes or heart disease.

Allwell does not offer Medicare Supplemental (Medigap) insurance plans or stand-alone Prescription Drug Plans.

Extra Benefits 

Allwell’s extra benefits vary by state and by plan within each state. In general, Allwell offers member perks such as dental coverage, vision and hearing benefits, zero-dollar telehealth visits, home-delivered meals following a hospitalization, over-the-counter supplemental benefits, the Silver and Fit exercise and fitness program, a 24-hour nurse hotline, and transportation to and from medical visits. Through My Health Pays, some members can get financial rewards for healthy behaviors such as getting vaccinations or health screenings. Specific extra benefits differ by plan.


What You Need to Know

Some Allwell members get My Health Pays, a program that gives members financial rewards for doing healthy things, like getting a flu shot or a bone density test.


Customer Service

Allwell customer service is set up by state. Each Allwell plan has its own website and phone numbers for prospective and current members. Customer service for both prospective and current members is available from 8 a.m. to 8 p.m. local time, seven days a week between October 1 and March 31, and Monday through Friday between April 1 and September 30. 

There is no centralized customer service number for Allwell; each state has its own customer service and website to serve members and people interested in joining the plan.

Allwell members can create online accounts which they can use to see benefits and claims information, request a new ID card, find a doctor, and communicate securely with the plan.


Customer Satisfaction 

The National Association of Insurance Commissioners (NAIC) tracks complaints against insurance companies and compares the number of complaints to insurers’ market share. The resulting complaint index shows how proportionate insurers’ complaints are relative to their size. A complaint index of less than 1.0 suggests the insurer has disproportionately fewer complaints; greater than 1.0 means it has disproportionately more complaints.

Allwell itself is not rated by NAIC, but many of its individual plans are. In most states, Allwell plans in the NAIC database had zero complaints between 2018 or 2020; some had just one complaint in one of those years. A few plans, though, had significantly more complaints, particularly plans in Kansas, Nevada, and Ohio.

Complaints
State  
Plan Name
 
2020
 
2019
 
2018
Kansas Sunflower Health Plan 11 16 10
Nevada Silver Summit Health Plan 8 22 25
Ohio Buckeye Health Plan 16 22 20

Complaint Index
State  
Plan Name
 
2020
 
2019
 
2018
Kansas Sunflower Health Plan Not calculated 2.62 1.48
Nevada Silver Summit Health Plan Not calculated 2.62 3.66
Ohio Buckeye Health Plan Not calculated 1.76 2.05

Third-Party Ratings

Financial Strength

AM Best is a credit rating agency that rates insurance companies based on their financial strength. Centene Corporation is not rated by AM Best, nor are the subsidiary health plans that operate under the Allwell brand.

J.D. Power

In 2020, J.D. Power rated Medicare Advantage plans based on member satisfaction with coverage and benefits, choice of providers, cost, customer service, plan information and communications, and financial aspects like billing and payments. Centene, Allwell’s parent company, ranked ninth in the top 10 Medicare Advantage plans. Overall, Centene scored 775 points out of 1,000.

NCQA

Neither Allwell nor its parent company Centene is accredited by the National Committee for Quality Assurance (NCQA), one of the main accrediting agencies for health plans. Some individual subsidiaries are in NCQA’s system but have not reported data on which to be evaluated. Only Arizona Complete Health has two plans rated by NCQA; one earned 2.5 and the other earned 3.0 out of 5.0. On customer satisfaction measures, these plans earned 1.5 and 2.0, respectively, out of 5.0.

Most Allwell plans are not rated by NCQA, a standard for evaluating health plan quality; those that are rated do not score particularly well.

Medicare Star Ratings

The Centers for Medicare and Medicaid Services (CMS) rates Medicare insurance plans on a five-point Star Rating scale. Star Ratings are based on factors such as customer satisfaction and access to care. Not every Allwell plan is rated by CMS; some are too new to be rated or don’t have enough data to be judged. Of the Allwell plans rated by CMS, the range is 3.0 to 4.5 Stars, averaging 3.36. On Part C (Medicare Advantage), Allwell plans earned between 2.5 and 4.5, with an average of 3.27. On Part D (prescription drug coverage included in the Medicare Advantage plans), Allwell’s plans get between 3.0 and 4.0 Stars with an average of 3.39.


Cost

Health plan costs include premiums, deductibles, and other cost-sharing like copayments. Prices range by geography and specific plan. The best way to find specific costs is to search on Medicare.gov. A selection of Allwell plan costs in certain states (IN, LA, OH, PA) include:

HMO plans with prescription drug coverage

  • Monthly premiums range from $0 to $29.60, averaging $10.30.
  • Deductibles range from $0 to $445, averaging $186.19.  
  • Annual out-of-pocket maximums for in-network services range from $3,450 to $7,550, averaging $6,600. 

HMO plans without prescription drug coverage

  • There are no monthly premiums or annual deductibles on these plans. 
  • Annual out-of-pocket maximums for in-network services range from $3,450 to $5,500 and average $4,243.

PPO plans with prescription drug coverage 

  • The one Allwell PPO plan in Indiana has a $19 monthly premium, a $200 deductible, and a $5,500 annual out-of-pocket maximum.

Competition: Allwell vs. UnitedHealthcare

Allwell is connected with Centene, the ninth-largest provider of Medicare Advantage plans in the country. UnitedHealthcare is bigger, ranking fourth overall for Medicare Advantage members nationwide. Allwell has a decent footprint, but UnitedHealthcare is virtually nationwide. UnitedHealthcare beats Allwell on quality, as measured by the average CMS Star Ratings, and on the J.D. Power 2020 Medicare Advantage Study, where UnitedHealthcare scored 800 to Centene’s 775. Allwell has some lower average costs on certain plans, but it also offers only Medicare Advantage options. For breadth of choice, geographical coverage, and quality, UnitedHealthcare comes out on top.

   
Allwell
 
UnitedHealthcare
Number of States Available  16  47
Medicare Plans  3  5
Customer Service Options  Telephone, online, or request a call back via online form  Telephone, online, in person, chat
AM Best Rating  Not rated  A- (Excellent)
Average CMS Star Rating  3.36  3.78


Final Verdict

Allwell is a large Medicare Advantage insurer and part of a growing network of plans in the Centene corporate family. It offers some low-priced plans, which may make Medicare Advantage coverage accessible and affordable. But buyer beware: Most Allwell plans are not rated by the primary health plan quality organizations. Though that doesn’t necessarily mean the plans are not high quality, it indicates the company has not submitted data that reflects the rigorous processes required by entities like NCQA.



How We Reviewed Medicare Providers

Even Medicare health plans with a national presence can vary locally in their cost, quality, and customer satisfaction. To evaluate Medicare plans, we looked at health insurance industry ratings from the primary accrediting agency for health plans, NCQA, and the Medicare Star Ratings from CMS, the regulatory agency that oversees Medicare. We included the National Association of Insurance Commissioners’ complaint index, and AM Best’s financial stability ratings. We also considered information from the companies on their programs and strategies.

Investopedia requires writers to use primary sources to support their work. These include white papers, government data, original reporting, and interviews with industry experts. We also reference original research from other reputable publishers where appropriate. You can learn more about the standards we follow in producing accurate, unbiased content in our editorial policy .

  1. Kaiser Family Foundation. “10 Things to Know about Medicaid Managed Care.” Accessed February 27, 2021.

  2. Becker’s Payer Issues. “10 top Medicare Advantage plans, ranked by members.” Accessed February 27, 2021.

  3. NCQA. “NCQA Health Insurance Plan Ratings 2019-2020 – Summary Report (Medicare).” Accessed February 27, 2021.

  4. AM Best. “Centene Corporation operating insurance entities.” Accessed February 27, 2021.

  5. AM Best. “Centene Corporation.” Accessed February 27, 2021.

  6. J.D. Power. “Medicare Advantage Plans Struggle to Communicate Effectively with Members, J.D. Power Finds.” Accessed February 27, 2021.

  7. Center for Medicare & Medicaid Services. “Part C and D Performance Data, 2021 Star Ratings Data Table.” Accessed December 11, 2020.

  8. Centers for Medicare and Medicaid Services. “2021 MA Landscape Source Files.” Accessed January 19, 2021.

  9. Center for Medicare & Medicaid Services. “Part C and D Performance Data, 2021 Star Ratings Data Table.” Accessed December 18, 2020. 





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