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Wellcare Standards for Appointment Scheduling

Wellcare wants to ensure appointments for medical and behavioral health services are available to all our Medicare members on a timely basis. The following Appointment Availability standards can also be found in the Provider Manual. Please ensure these standards are implemented by your organization.

All Providers (from 5 p.m. to 8 a.m. local time and all weekends and holidays)

  • Answering service or system that can contact a physician. Member should receive a response within 30 minutes.
  • Advice nurse with access to physician.
  • Office telephone that transfers calls to a cell phone; or any method that ensures 24-hour phone access for members.

Should not exceed 15 minutes maximum

  • Urgent Visit: 24 hours
  • Non-Urgent Visit: Seven business days
  • Routine Visit: Seven business days
  • After-Hours Care: 24 hours; seven days per week

  • Urgent Visit: 24 hours
  • Routine Visit: 30 business days

  • Non-Life-Threatening Emergency: Six hours
  • Urgent Visit: 48 hours
  • Initial Routine Care: 10 business days
  • Routine Care Follow-Up: 10 business days

Resources & Tips

Non-urgent sign language and language interpreter services.

Urgent/emergent language interpreter services.

Confidential, free, 24/7/365 support from a trained counselor for mental health, substance use or suicidal crisis.

Telehealth Offerings

Virtual healthcare.