Contract
H5439

Wellcare · 2027 Star Ratings

HEALTH NET LIFE INSURANCE COMPANY · Local CCP

Parent: Centene Corporation

Summary ratings

Overall
3.0
2026: 3.0±0
Part C · health plan
2.5
2026: 3.0−0.5
Part D · drug plan
3.5
2026: 3.0+0.5

2027 footprint

Members, Sep 2026
19K
2027 plans
5
Open to all ($0 premium)
5 (1)
Counties
10
Special needs plans
None
Drug coverage
Yes
ORWA

Domain stars

Domain20272026Change
HD1Staying Healthy: Screenings, Tests and Vaccines2.03.0−1.0
HD2Managing Chronic (Long Term) Conditions2.03.0−1.0
HD3Member Experience with Health Plan1.01.0±0
HD4Member Complaints and Changes in the Health Plan's Performance4.04.0±0
HD5Health Plan Customer Service5.05.0±0
DD1Drug Plan Customer Service5.05.0±0
DD2Member Complaints and Changes in the Drug Plan's Performance4.04.0±0
DD3Member Experience with the Drug Plan2.02.0±0
DD4Drug Safety and Accuracy of Drug Pricing4.03.0+1.0

Part C measures · health plan

Measure2027 result2027 starsvs 2026
C01Breast Cancer Screening68%2.0±0
C02Colorectal Cancer Screening71%3.0new spec
C03Annual Flu Vaccine53%1.0−1
C04Improving or Maintaining Physical Health68%2.0±0
C05Improving or Maintaining Mental Health85%4.0±0
C06Monitoring Physical Activity48%2.0±0
C07Special Needs Plan (SNP) Care ManagementPlan not required to report measure—
C08Care for Older Adults – Medication ReviewPlan not required to report measure—
C09Care for Older Adults - Functional Status AssessmentPlan not required to report measure—
C10Osteoporosis Management in Women who had a Fracture32%2.0±0
C11Diabetes Care – Eye Exam72%3.0+1
C12Diabetes Care – Blood Sugar Controlled88%3.0±0
C13Kidney Health Evaluation for Patients with Diabetes66%3.0±0
C14Controlling High Blood Pressure78%2.0−1
C15Reducing the Risk of Falling55%2.0+1
C16Improving Bladder Control43%3.0+2
C17Plan All-Cause Readmissions9%4.0±0
C18Statin Therapy for Patients with Cardiovascular Disease81%1.0±0
C19Transitions of Care64%3.0−1
C20Follow-up after Emergency Department Visit for People with Multiple High-Risk Chronic Conditions52%1.0−1
C21Getting Needed Care761.0±0
C22Getting Appointments and Care QuicklyNot enough data available—
C23Customer Service841.0—
C24Rating of Health Care Quality801.0±0
C25Rating of Health Plan741.0±0
C26Care Coordination841.0±0
C27Complaints about the Health Plan0.34.0±0
C28Members Choosing to Leave the Plan11%4.0±0
C29Health Plan Quality ImprovementMedicare shows only a Star Rating for this topic3.0±0
C30Plan Makes Timely Decisions about Appeals100%5.0±0
C31Reviewing Appeals Decisions100%5.0±0
C32Call Center – Foreign Language Interpreter and TTY Availability100%5.0±0

Part D measures · drug plan

Measure2027 result2027 starsvs 2026
D01Call Center – Foreign Language Interpreter and TTY Availability100%5.0±0
D02Complaints about the Drug Plan0.34.0±0
D03Members Choosing to Leave the Plan11%4.0±0
D04Drug Plan Quality ImprovementMedicare shows only a Star Rating for this topic3.0±0
D05Rating of Drug Plan821.0±0
D06Getting Needed Prescription Drugs882.0±0
D07MPF Price Accuracy1005.0±0
D08Medication Adherence for Diabetes Medications88%2.0−1
D09Medication Adherence for Hypertension (RAS antagonists)90%4.0+1
D10Medication Adherence for Cholesterol (Statins)90%4.0±0
D11Statin Use in Persons with Diabetes (SUPD)82%1.0−1
D12Concurrent Use of Opioids and Benzodiazepines (COB)7%5.0—
D13Polypharmacy: Use of Multiple Anticholinergic Medications in Older Adults (Poly-ACH)7%4.0—

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