CMS has lifted an enrollment suspension on Wellcare of Missouri’s Medicare Advantage prescription drug plan, effective Jan. 1, 2026.
The sanction was originally imposed Sept. 6, 2024, after Wellcare failed to meet the federal minimum medical loss ratio of 85% for three consecutive years, reporting 78.9% in 2021, 77.7% in 2022 and 84% in 2023.
On July 17, Wellcare reported an MLR above 85% for 2024, bringing the plan back into compliance. Wellcare can resume enrolling new members during the upcoming annual enrollment period for coverage beginning in 2026.
CMS warned that Wellcare could face enrollment sanctions again if its MLR drops below 85% for three consecutive years in the future.
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