Local PPO · Special Needs Plan · Contract H4537 · 2026
Wellcare Health Insurance Company OF Oklahoma, Inc
Wellcare Health Insurance Company OF Oklahoma, Inc is a Local PPO Medicare Advantage plan from Wellcare, available in 1 state. Here is its CMS quality rating, drug coverage, and benefits.
- N/R
- Overall CMS rating
- -
- Premium/mo
- 3.5★
- Average
- 1
- States available
Wellcare Health Insurance Company OF Oklahoma, Inc plan score
A single 0-100 verdict combining Wellcare Health Insurance Company OF Oklahoma, Inc's nationwide standing on 1 of 4 CMS-filed measures: quality, affordability, cost protection, and supplemental-benefit richness, each from its own CMS source file. A missing filing drops out and redistributes its weight rather than deflating the score.
43/100
Percentile-weighted across 1 of 4 measures
- CMS quality (star rating)
- N/A not on file
- Affordability (premium)
- N/A not on file
- Cost protection (deductible)
- N/A not on file
- Benefit richness (supplemental coverage)
- D 4 benefits
43th percentile nationwide
Benchmarked live against every plan or plan-county row reporting each measure in the current CMS extract (CY2026 Star Ratings, Landscape file, and Plan Benefit Package). Not a CMS-endorsed score; PlainMedicare's own weighting (quality 40%, affordability 25%, cost protection 15%, benefit richness 20%).
What the CMS Data Shows About Wellcare Health Insurance Company OF Oklahoma, Inc
Wellcare Health Insurance Company OF Oklahoma, Inc operates under CMS contract H4537, issued by Wellcare (parent organization Centene Corporation). The contract is classified as a Local PPO product, which governs how enrollees access care: PPO designs let members see out-of-network providers at higher cost-sharing, giving broader access than an HMO. This contract is also flagged in CMS data as a Special Needs Plan (SNP), meaning enrollment is restricted to beneficiaries meeting specific eligibility criteria, chronic condition, dual Medicare-Medicaid status, or institutional residence. Service area spans 1 state (OK) and 30 counties, a geography set at the CMS service-area definition level.
The overall CMS Star Rating for this contract is not yet published by CMS. This rating synthesizes 19 individual quality measures spanning 6 CMS domains, including clinical outcomes, patient experience (CAHPS), member complaints and appeals, and plan operations. The Part D drug-benefit portion of this contract carries a separate CMS Star Rating of 3.5, which reflects pharmacy cost, adherence to chronic medications, and drug pricing accuracy. Ratings at 4+ stars trigger federal Quality Bonus Payments that insurers typically reinvest in supplemental benefits.
On costs, this contract lists a monthly plan premium of not listed, from the CMS CY2026 Landscape file; every enrollee also pays the standard Part B premium. Beyond standard Medicare Parts A and B, the contract documents 12 supplemental benefits in the CMS benefits file, coverage extras such as dental, vision, hearing aids, fitness programs, and OTC allowances that Original Medicare does not provide. Before enrolling, verify that your preferred providers participate in the plan's network for your specific county, review the current Summary of Benefits, and confirm that your prescriptions appear on the plan formulary. All figures shown come from CMS public-use files for the 2026 contract year; this page is informational only and is not personalized Medicare counseling advice.
Quality Measures by Domain
Managing Chronic Conditions
10 measuresCare for Older Adults – Medication Review
Care for Older Adults – Pain Assessment
Controlling High Blood Pressure
Diabetes Care – Blood Sugar Controlled
Follow-up after Emergency Department Visit for People with Multiple High-Risk Chronic Conditions
Getting Needed Care
Kidney Health Evaluation for Patients with Diabetes
Osteoporosis Management in Women who had a Fracture
Plan All-Cause Readmissions
Reducing the Risk of Falling
Customer Service
1 measuresCall Center – Foreign Language Interpreter and TTY Availability
Drug Plan Customer Service
1 measuresComplaints about the Drug Plan
Drug Safety & Pricing
5 measuresMedication Adherence for Cholesterol (Statins)
Medication Adherence for Diabetes Medications
Medication Adherence for Hypertension (RAS antagonists)
MTM Program Completion Rate for CMR
Statin Use in Persons with Diabetes (SUPD)
Tests & Vaccines
1 measuresAnnual Flu Vaccine
Member Complaints and Changes in the Drug Plan’s Performance
1 measuresRating of Drug Plan
Supplemental Benefits
| Benefit | Covered | Max Benefit |
|---|---|---|
| Hearing Aids | ✓ Yes | - |
| Hearing Exam | ✓ Yes | - |
| Vision, Eye Exam | ✓ Yes | - |
| Vision, Eyewear | ✓ Yes | - |
County Availability
Medicare Advantage Guides
Official Medicare resources
Frequently Asked Questions
What is the star rating for Wellcare Health Insurance Company OF Oklahoma, Inc?
Wellcare Health Insurance Company OF Oklahoma, Inc (Contract H4537) by Wellcare has an overall CMS star rating of Not yet rated out of 5. Star ratings are based on quality measures including preventive care, chronic disease management, and member satisfaction.
How much does Wellcare Health Insurance Company OF Oklahoma, Inc cost per month?
Wellcare Health Insurance Company OF Oklahoma, Inc has a monthly plan premium (Part C + D combined) of not listed for this contract. Every enrollee also pays the standard Part B premium (about $202.90/month in 2026). Premiums are from the CMS CY2026 Landscape file and can vary by county; confirm current costs on Medicare.gov.
What type of plan is Wellcare Health Insurance Company OF Oklahoma, Inc?
Wellcare Health Insurance Company OF Oklahoma, Inc is a Local PPO Medicare Advantage plan offered by Wellcare. This is also a Special Needs Plan (SNP) designed for beneficiaries with specific diseases, characteristics, or care needs. PPO plans offer more provider flexibility, allowing you to see out-of-network providers at a higher cost.
Where is Wellcare Health Insurance Company OF Oklahoma, Inc available?
Wellcare Health Insurance Company OF Oklahoma, Inc is available in 1 state (OK) across 30 counties. Coverage area can vary, check with the insurer or Medicare.gov for exact availability in your ZIP code.
What supplemental benefits does Wellcare Health Insurance Company OF Oklahoma, Inc offer?
Wellcare Health Insurance Company OF Oklahoma, Inc covers 12 supplemental benefits beyond standard Medicare, including hearing aids, hearing exam, vision eye exam, vision eyewear. Many Medicare Advantage plans include dental, vision, and hearing coverage not available under Original Medicare.
How is Wellcare Health Insurance Company OF Oklahoma, Inc rated on quality measures?
CMS evaluates Wellcare Health Insurance Company OF Oklahoma, Inc across 19 individual quality measures spanning 6 domains, including DD1: Drug Plan Customer Service, DD2: Member Complaints and Changes in the Drug Plan’s Performance, DD4: Drug Safety and Accuracy of Drug Pricing and more. These measures cover clinical outcomes, patient experience, and plan operations.
Data Source
Data from CMS Medicare Advantage 2026 Star Ratings and Plan Finder datasets. Contract ID: H4537. Last updated: 2026 plan year.
Nationwide Medicare Advantage plans with similar county footprint or CMS star rating
Data-derived peers across the CMS Landscape file: nearest county inventory and nearest overall CMS star rating at the contract level. Not parent-org containment or same-state overlap.
Similar county footprint
- Usable HMO, Inc. 30 counties
- Bluecross AND Blueshield OF South Carolina 30 counties
- Kaiser Foundation HP, Inc. 30 counties
- Kaiser Foundation HP, Inc. 31 counties
- Sanford Health Plan 31 counties
- Health Care Service Corporation 31 counties
Related
Before you enroll in Wellcare Health Insurance Company OF Oklahoma, Inc
Star rating and network fit matter more than the premium alone.
- This contract's premium is not listed for this contract - compare it against other plans before enrolling. Browse all plans
- Check that your doctors and drugs are in-network before you enroll, and confirm the plan on Medicare.gov. Medicare Plan Compare
- This plan documents 12 supplemental benefits beyond Original Medicare - see how it stacks up against Original Medicare's coverage. MA vs Original Medicare
Figures are from CMS CY2026 public files for this contract; benefits and premiums can vary by the specific plan you enroll in and your county.
PlainMedicare is rendered directly from CMS Medicare Advantage and Part D public files, no number is typed in by an editor. See our editorial standards & corrections policy, the methodology behind these numbers, or report a correction. Data current as of 2026-09-01.
CMS lists 131,985 Medicare Advantage and Part D plan records in the current public files. PlainMedicare refreshes this registry with each annual release.