Wellcare’s Value Script Premium Hike Leaves Hundreds of Thousands of Medicare Beneficiaries Without Drug Coverage

In 2026 Wellcare’s Value Script Medicare prescription-drug plan raised monthly premiums from $0 to as little as $3.60. Beneficiaries who failed to pay within a three-month grace period were automatically disenrolled, losing drug coverage for the remainder of the year. Approximately 140,000 members were dropped in April, with about 40,000 eligible for the low-income “Extra Help” subsidy.

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Medicare added prescription-drug coverage (Part D) in 2003, delegating enrollment to private insurers that compete for roughly 56 million beneficiaries. Zero-premium plans, such as Wellcare’s Value Script, have driven enrollment; the plan is the nation’s top stand-alone drug plan with nearly 6 million members. After a zero-premium year in 2025, Wellcare announced premium changes in a CMS-required notice sent in September 2025, but many beneficiaries missed the information.

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• Disenrolled members: ~140,000 (April 2026)

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• Potential “Extra Help” qualifiers: ~40,000

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• Unpaid premiums leading to loss: as low as $8.10 for three months (Nevada) and $28.80 for three months (Minnesota case)

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• Monthly premium for some members in 2026: $3.60

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• 90 % of Medicare beneficiaries take at least one prescription; half have four or more chronic conditions.

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Loss of coverage can be life-threatening. Jude Pare (77, Minnesota) stopped receiving his blood-thinner Xarelto, a drug he described as essential to avoid fatal bleeding. His partner, Diane Tix, noted the medication now costs about $1,800 for a 90-day supply via a discount website. Others, such as Wayne Bennett (74, North Carolina), who takes nine prescriptions, face uncertainty about future costs and risk a permanent late-enrollment penalty that rises annually.

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• CMS spokesperson Christopher Krepich: The agency does not publicly release plan-specific disenrollment figures or state-level breakdowns. Legal limits restrict CMS’s ability to intervene for beneficiaries who lose coverage due to non-payment.

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• Centene senior vice president Sarah Baiocchi (Wellcare’s parent): “We recognize how disruptive a loss of coverage can be and are committed to helping members understand their options.” She also noted that all Value Script members received the required annual notice.

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• Centene’s senior director of communications: The Social Security Administration’s cessation of automatic premium deductions when a plan’s premium changed was a “key driver of non-payment disenrollments.”

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State officials, including Nevada insurance commissioner Ned Gaines and West Virginia SHIP director Rebecca Gouty, reported similar disenrollment figures and warned that many seniors assumed automatic Social Security deductions would continue despite the premium change. Advocacy groups argue that the notification process is insufficient for a population vulnerable to scams and “junk mail.”

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Beneficiaries like Pare and Bennett discovered their coverage termination only after returning home or after a pharmacy refill failed. Bennett’s attempt to pay the $3.60 premium was rejected because the plan had already been canceled. Local nonprofit Senior PharmAssist assisted a participant in enrolling in an alternative plan, but most affected seniors must wait until the open-enrollment window in the fall.

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CMS and Centene declined to provide exact disenrollment numbers, leaving the 140,000 figure based on internal sources and state officials. No plan-specific data are publicly available, creating uncertainty about the full scope of the issue.

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• “He could bleed to death without it,” — Diane Tix, partner of Jude Pare

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• “Medicare should be doing something about this so that we can go ahead and get coverage now," said Wayne Bennett, 74, who lives in Durham, North Carolina.” — Wayne Bennett, 74, Durham, NC

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• “They didn't realize that when the plan was a zero premium in 2025, that stopped the Social Security premium deduction and they would have had to reelect it for 2026," Gouty said.” — Rebecca Gouty, West Virginia SHIP director

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• “We recognize how disruptive a loss of coverage can be and are committed to helping members understand their options,” — Sarah Baiocchi, senior vice president, Centene

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• “The agency does not publicly provide plan-specific disenrollment figures or state-level breakdowns related to the non-payment of premiums,” — Christopher Krepich, CMS spokesperson

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• “why wouldn't they think this was a scam?” — Gina Upchurch, executive director, Senior PharmAssist

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CMS will release the 2027 premium schedule in September, and the annual open-enrollment period will open in the fall for coverage beginning Jan. 1 2027. Beneficiaries who lose coverage mid-year may qualify for a special enrollment period only under limited circumstances, such as relocation or state-run assistance programs. Advocacy groups are urging policy reforms to improve notification and prevent automatic disenrollment for minimal unpaid premiums.

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