Wellcare Advantage Simple (PFFS) (PFFS) 2025 Plan Details for Yates County, New York Residents
Wellcare Advantage Simple (PFFS) (PFFS) 2025 Plan Details for Yates County, New York Residents
Wellcare Advantage Simple (PFFS) is a PFFS Medicare Advantage plan, from Wellcare, {with_without_pdp} a prescription drug plan. It's CMS Plan ID is: H2816-038-0. It is not available in all areas. The list of locations where this plan is available can be found below.
According to CMS enrollment data (July, 2025), there are approximately 962 members enrolled in this plan.
Wellcare Advantage Simple (PFFS) (PFFS) Overview
| CMS Fact | Landscape Value |
|---|---|
| Health Plan ID: | H2816-038-0 |
| CMS Overall Rating: | 0.0 out of 5 stars* |
| Medicare Advantage Plan Type: | PFFS |
| Coverage Year: | CY2026 |
| Monthly Premium: | $0.00 Plus your Medicare Part B premium. |
| Health Plan Deductible: | $0.00 |
| Annual Out-of-Pocket Maximum: | $6700.00 (In-Network) |
| Part B Give Back: | $0.00/mo |
| Part D Drug Plan Benefit: | Not Included |
| Additional Benefits: | Dental, Vision, Hearing |
| Availability: | Yates County, NY |
| Insured By: | Wellcare |
| Last Plan Content Update: |
Plan Availability by Location
Health Plan Out-of-Pocket Costs
Prescription Drug Costs & Benefits
This plan does not include a Medicare Part D plan for prescriptions.
CMS 5-Star Rating Marks
Each year, the Centers for Medicare & Medicaid Services (CMS) assesses health plans (Part C) and drug plans (Part D) based on a 5-star rating system. These ratings provide an overview of the plan’s performance in areas such as preventive care, managing chronic conditions, and member experience.
Considering a plan’s star rating can be an important part of your decision-making process, as higher ratings often reflect stronger performance in key areas of healthcare and customer service.
| CMS Measure | Star Rating |
|---|---|
| 2026 Overall Rating | |
| Staying Healthy: Screenings, Tests, Vaccines | |
| Managing Chronic (Long Term) Conditions | |
| Member Experience with Health Plan | |
| Complaints and Changes in Plans Performance | |
| Health Plan Customer Service | Not enough data available |
| Drug Plan Customer Service | |
| Complaints and Changes in the Drug Plan | |
| Member Experience with the Drug Plan | Not enough data available |
| Drug Safety and Accuracy of Drug Pricing |
Need Help Enrolling?
| Website: | Wellcare Plan Page |
|---|---|
| Providers: | Wellcare Providers Page |
| New Member Health Plan Help: | (800)225-8017 |
| New Member Health Plan TTY: | 711 |
Frequently Asked Questions
📘 What does Medicare plan code H2816 038 mean?
Wellcare Advantage Simple (PFFS) is a Medicare Advantage plan by Wellcare. The code H2816 is the CMS contract ID, whereas 038 is its plan ID.
- Plan Name: Wellcare Advantage Simple (PFFS)
- Plan Type: PFFS
- Premium: $0.00/mo + your monthly Part B premium
- Out-of-Pocket Max: $6700.00 (in-network)
- Drug Coverage: {pdp_faq_summary}
- CMS Star Rating: 0.0 out of 5
- Contract Year: 2026
This information is based on official CMS data and is provided for educational purposes. Always review your plan’s official documents or contact the provider directly before making enrollment decisions.
📋 What type of plan is H2816 038?
This plan is a PFFS — specifically, it's an PFFS plan with a Medicare Advantage contract that's offered by Wellcare. It comes with defined provider network rules you should be aware of.
- Plan Marketing Name: Wellcare Advantage Simple (PFFS)
- Network Type: {plan_type_expanded}
- Referral Requirement: {referral_required_expanded}
- Prescription Coverage: {pdp_faq_summary}
Plan types like HMOs and PPOs determine whether you can go out-of-network or need referrals to see specialists.
📦 What benefits are included in H2816 038?
This plan covers all Medicare Part A and Part B services. Depending on the plan, it may also include valuable extras like dental, vision, and hearing benefits.
- Medical Services: Hospital, doctor visits, preventive care
- Prescription Drugs: Not Included
- Dental: {dental_benefit}
- Vision: {vision_benefit}
- Hearing: {hearing_benefit}
Benefit availability may vary by location and plan version. Confirm specific details in your plan's Evidence of Coverage (EOC).