Medicare AdvantageAdministrativeHigh impact
24-1237m Important 2025 Medicare and Medicare DSNP Plan Changes
Health Net·CA · Optometry·Prior Authorization
Effective date
Jan 1, 2025
We identified it
Jun 20, 2026
Summary
Wellcare Medicare plans are implementing significant changes for 2025, including new plan codes, plan name updates (No Premium plans becoming Simple plans), new counties being added/removed, plan discontinuations, and a new vision vendor (Premier Eye Care replacing Envolve Vision). All members will receive new ID cards by December 31, 2024.
Action Required
By January 1, 2025: Billing team must update patient eligibility verification systems with new 2025 Wellcare plan codes and names (Simple Focus, Simple Ruby replacing No Premium plans). Update vision vendor from Envolve Vision to Premier Eye Care (833-883-2339) for Medicare supplemental benefits. Verify all member ID cards are updated by December 31, 2024. Check member eligibility for discontinued plans H0562-128 and H7360. Update system to reflect new counties served and DSNP enrollment changes.