Wellpoint (Amerigroup) Medicare Advantage 2024-2025 Review

Wellpoint plans — formerly Amerigroup — offer flexible benefits but have below-average ratings and a limited service area.

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The bottom line: Wellpoint Medicare Advantage offers low-cost plans in six states, but star ratings and member experience are subpar for the field. Jump to: Full Review

Wellpoint Medicare Advantage

Wellpoint

3.32

CMS Star Rating

(855) 432-0512

TTY 711

Speak to a licensed insurance agent on askchapter.org
GET A QUOTE

on NerdWallet

We will connect you with Medicare companies based on the information you provide. They will help you find a plan that suits your needs. If you prefer to speak to a licensed insurance agent right away, please call the number listed below.

M-F 8am-10pm EST, Sa-Su 9am-9pm EST

Speak to a licensed insurance agent on askchapter.org
(855) 432-0512

TTY 711

Wellpoint Medicare Advantage pros and cons

Pros

$0 premiums: Three-quarters of Wellpoint Medicare Advantage plans (74%) are $0 premium.

Low-cost plans: The average premium for a standard Wellpoint Medicare Advantage prescription drug plan is $12.30, which is lower than the average from all major providers.

Flexible benefits: Some Wellpoint Medicare Advantage plans offer “Essential Extras,” a feature where members choose an extra benefit for their plan, including money toward assistive devices, healthy groceries, or dental, vision or hearing care.

Cons

Limited availability: Wellpoint offers Medicare Advantage plans in only six states: Arizona, Iowa, New Jersey, Tennessee, Texas and Washington.

Low star ratings: Wellpoint plans' average star rating from the Centers for Medicare & Medicaid Services (CMS), weighted by enrollment, is 3.32 stars (the national average for all providers is 3.92 stars).

Low satisfaction: Member experience ratings, which include metrics like customer service and getting needed care, are well below average for major providers.

Limited plan options: Wellpoint offers only HMO and HMO-POS plans, which are the most restrictive in terms of medical flexibility.

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UnitedHealthcare

3.82

CMS Star Rating

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Aetna Medicare Advantage

Aetna

4.27

CMS Star Rating

(855) 432-0512

TTY 711

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on NerdWallet

We will connect you with Medicare companies based on the information you provide. They will help you find a plan that suits your needs. If you prefer to speak to a licensed insurance agent right away, please call the number listed below.

M-F 8am-10pm EST, Sa-Su 9am-9pm EST

Speak to a licensed insurance agent on askchapter.org
(855) 432-0512

TTY 711

Humana Medicare Advantage

Humana

3.63

CMS Star Rating

(866) 215-2655

TTY 711

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Cigna Medicare Advantage

Cigna

3.93

CMS Star Rating

(855) 432-0512

TTY 711

Speak to a licensed insurance agent on askchapter.org
GET A QUOTE

on NerdWallet

We will connect you with Medicare companies based on the information you provide. They will help you find a plan that suits your needs. If you prefer to speak to a licensed insurance agent right away, please call the number listed below.

M-F 8am-10pm EST, Sa-Su 9am-9pm EST

Speak to a licensed insurance agent on askchapter.org
(855) 432-0512

TTY 711

» More options in our roundup of the best Medicare Advantage plans

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3.82

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3.63

CMS Star Rating

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TTY 711

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» More options in our roundup of the best Medicare Advantage plans

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Wellpoint Medicare star ratings

Average star rating, weighted by enrollment: 3.32

Wellpoint Medicare Advantage plans are rated below the industry average, receiving an average rating of 3.32 stars out of 5 from CMS for 2025, weighted by enrollment. For comparison, the average weighted star rating for plans from all providers is 3.92

Centers for Medicare & Medicaid Services. Fact Sheet - 2025 Medicare Advantage and Part D Star Ratings. Accessed Oct 22, 2024.
.

There are no Wellpoint Medicare Advantage plans with a rating higher than 3.5 stars

Centers for Medicare & Medicaid Services. 2025 Star Ratings Data Tables (ZIP). Accessed Oct 22, 2024.
.

CMS maintains star ratings for Medicare Advantage and Medicare Part D plans on a 5-point scale, ranking plans from best (5 stars) to worst (1 star). The agency bases these ratings on plans’ quality of care and measurements of customer satisfaction, and ratings may change from year to year.

You can find a plan’s rating with the Medicare plan finding tool.

What does Wellpoint Medicare Advantage cost?

Three-quarters of Wellpoint standard Medicare Advantage prescription drug plans have $0 premiums

Centers for Medicare & Medicaid Services. CY2025 Landscape (202410) (ZIP). Accessed Oct 22, 2024.
. For plans with a monthly cost, the average premium is $12.30, which is lower than the average from big providers. You'll also still be responsible for paying your Medicare Part B premium, which is $174.70 per month in 2024.

(Most people pay this standard Part B amount, but if your income is above a certain threshold, you'll pay the income-related monthly adjustment amount (IRMAA). Some Medicare Advantage plans cover part or all of your Part B premium

Centers for Medicare & Medicaid Services. Understanding Medicare Advantage Plans. Accessed Oct 22, 2024.
.)

Requirements for copays, coinsurance and deductibles vary depending on your plan, location and the services you use. Other out-of-pocket costs to consider include:

  • Whether the plan covers any part of your monthly Medicare Part B premium.

  • The plan’s yearly deductibles and any other deductibles, such as a drug deductible.

  • Copayments and/or coinsurance for each visit or service. For instance, there may be a $10 copay for seeing your primary doctor and a $45 copay for seeing a specialist.

  • The plan’s in-network and out-of-network out-of-pocket maximums.

  • Whether your medical providers are in-network or out-of-network, or how often you may go out of network for care.

  • Whether you require extra benefits, and if the plan charges for them.

Here are examples of Wellpoint Medicare Advantage costs for three plans in a mid-range city:

Wellpoint Medicare Advantage plans

Pricing

Wellpoint Medicare Advantage (HMO-POS)

Monthly premium: $0.

Deductible: None.

Out-of-pocket max: $6,750 in-network.

Copays:

  • Primary care: $0.

  • Specialist: $45.

  • Emergency care: $125.

  • Inpatient hospital: $350.*

Dental allowance: $2,000.

Wellpoint Extra Help (HMO-POS)

Monthly premium: $9.10.

Deductible: None.

Out-of-pocket max: $4,900 in-network.

Copays:

  • Primary care: $0.

  • Specialist: $25.

  • Emergency care: $125.

  • Inpatient hospital: $325.*

Dental allowance: $3,250.

Wellpoint Medicare Advantage 2 (HMO-POS)

Monthly premium: $0.

Deductible: None.

Out-of-pocket max: $4,150 in-network.

Copays:

  • Primary care: $0.

  • Specialist: $25.

  • Emergency care: $140.

  • Inpatient hospital: $350.*

Dental allowance: $2,500.

Selected plans are available in ZIP code 37901.

*Inpatient hospital copay is per day for days 1-6.

To get a sense of costs, use Medicare’s plan finding tool to compare information among available plans in your area. You can select by insurance carrier to see only Wellpoint plans or compare across carriers.

Wellpoint Medicare Advantage plan types

There are three kinds of Wellpoint Medicare Advantage plans, and all Wellpoint Medicare Advantage plans include prescription drug coverage.

Plan offerings include the following types:

A health maintenance organization (HMO) generally requires that you use a specific network of doctors and hospitals. You may need a referral from your primary doctor in order to see a specialist, and out-of-network benefits are usually very limited.

HMO point-of-service (POS) plans are HMO plans that allow members to get some out-of-network services, but you’ll pay more for those services.

Special needs plans (SNPs) restrict membership to people with certain diseases or characteristics. Hence, the benefits, network and drug formularies are tailored to the needs of those members. Wellpoint offers three types of SNPs:

  • Chronic Condition SNP: Designed to meet the needs of members living with certain chronic conditions, such as diabetes, congestive heart failure and cardiovascular disease.

  • Dual-Eligible SNP: For people who are entitled to Medicare and who also qualify for assistance from a state Medicaid program.

  • Institutional SNP: For people living in a Wellpoint network nursing home or assisted living community, or another plan-approved location.

Wellpoint Medicare Advantage service area

Wellpoint offers Medicare Advantage plans in six states.

Wellpoint's parent company, Elevance Health, is the fourth-largest for-profit Medicare Advantage provider

. Wellpoint-branded plans cover more than 135,000 Medicare Advantage beneficiaries.

About Wellpoint

Wellpoint's parent company, Elevance Health, is headquartered in Indianapolis, Indiana, and was formed in 2004 out of a merger between WellPoint Health Networks and Anthem. In 2022, the company changed its name to Elevance Health, but it still sells Medicare products under a number of brands, including Wellpoint.

Wellpoint offers individual and family plans, dental and vision coverage, Medicare Advantage, Medicare Supplement Insurance and Medicaid plans.

Wellpoint customer service

Here’s how Wellpoint members can contact customer service:

  • Call the number on the back of your ID card, available Monday to Friday from 8 a.m. to 8 p.m. Eastern time.

  • Chat live with a member services representative once you’ve logged into your account online. 

Compare Medicare Advantage providers

Get more information below about some of the major Medicare Advantage providers. These insurers offer plans in most states. The plans you can choose from will depend on your ZIP code and county.

Find the right Medicare Advantage plan

It’s important to do your research before selecting a Medicare Advantage plan for yourself. Here are some questions to consider asking:

  • What are the plan’s costs? Do you understand what the plan’s premium, deductibles, copays and/or coinsurance will be? Can you afford them?

  • Is your doctor in-network? If you have a preferred medical provider or providers, make sure they participate in the plan’s network.

  • Are your prescriptions covered? If you’re on medication, it’s crucial to understand how the plan covers it. What tier are your prescription drugs on, and are there any coverage rules that apply to them?

  • Is there dental coverage? Does the plan offer routine coverage for vision, dental and hearing needs?

  • Are there extras? Does the plan offer any extra benefits, such as fitness memberships, transportation benefits or meal delivery?

If you have additional questions about Medicare, visit Medicare.gov or call 800-MEDICARE (800-633-4227, TTY 877-486-2048).
Wellpoint Medicare Advantage

Wellpoint

3.32

CMS Star Rating

Wellpoint plans are affordable but not widely available, and they score below-average in terms of Medicare stars and member satisfaction.

(855) 432-0512 / TTY 711

M-F 8am-10pm EST, Sa-Su 9am-9pm EST

Speak to a licensed insurance agent on askchapter.org

GET A QUOTE

on NerdWallet

We will connect you with Medicare companies based on the information you provide. They will help you find a plan that suits your needs. If you prefer to speak to a licensed insurance agent right away, please call the number listed below.

States available

6 states


Members in high-rated plans

Low (49% or less)


Member experience

2.24 (Below average)


States available

6 states


Members in high-rated plans

Low (49% or less)


Member experience

2.24 (Below average)


Pros

  • Three-quarters of plans are $0 premium.
  • For plans with a monthly premium, the average cost for a standard Medicare Advantage plan is lower than that of bigger providers.

Cons

  • Available in only six states.
  • Below-average star ratings and member experience scores.
  • Offers only HMO and HMO-POS plans.

Medicare will have big changes in 2025. Compare Medicare Advantage plans