Wellcare is ready to become your Medicare partner in 2022!

As we prepare to launch our Medicare Advantage plans our January 1, 2022, we want to help you and your patients get to know Wellcare.

The Annual Enrollment Period for your Medicare patients runs from October 15 to December 7, 2021. Your patients have a choice in their Medicare health insurance, and we hope that they will use this Annual Enrollment Period to get acquainted with Wellcare. If they ask you about their coverage options, let them know you accept Wellcare.

As our partner, you can count on our complete support as you continue to focus on providing compassionate and expert care to your patients. Our most helpful provider resources include:

Further provider resources, including dedicated Provider Relations and Contracting contacts, can be found on the Nebraska Total Care’s website at www.nebraskatotalcare.com/providers.html. Wellcare is the Medicare product offered through Nebraska Total Care.

Questions?

  • For Non-Duals/C-SNP dial 1-833-542-0693
  • For Duals/D-SNP dial 1-833-853-0864

Clinical Policy List

A-G H-P Q-Z
Acupuncture (PDF)
Effective Date: 1/1/2022		 H Pylori Testing (PDF)
Effective Date: 1/1/2022		 Radial Head Implant (PDF)
Effective Date: 1/1/2022
ADHD Assessment and Treatment (PDF)
Effective Date: 1/1/2022		 Heart-Lung Transplant (PDF)
Effective Date: 1/1/2022		 Radiofrequency Ablation of Uterine Fibroids (PDF)
Effective Date: 1/1/2022
Air Ambulance
Effective Date: 1/1/2022		 Holter Monitors (PDF)
Effective Date: 1/1/2022		 Reduction mammoplasty and gynecomastia surgery (PDF)
Effective Date: 1/1/2022
Allergy Testing (PDF)
Effective Date: 1/1/2022		 Home Birth (PDF)
Effective Date: 1/1/2022		 Repair of Nasal Valve Compromise (PDF)
Effective Date: 1/1/2022
Allogeneic hematopoietic cell transplants for sickle cell anemia and beta-thalassemia (PDF)
Effective Date: 1/1/2022		 Home phototherapy for neonatal hyperbilirubinemia (PDF)
Effective Date: 1/1/2022		 Robotic Surgery (PDF)
Effective Date: 1/1/2022
Ambulatory EEG (PDF)
Effective Date: 1/1/2022		 Homocysteine Testing (PDF)
Effective Date: 1/1/2022		 Sacroiliac joint fusion (PDF)
Effective Date: 1/1/2022
Ambulatory Surgery Center Optimization (PDF)
Effective Date: 1/1/2022		 Hospice Services (PDF)
Effective Date: 1/1/2022		 Sacroiliac Joint Interventions for Pain Management (PDF)
Effective Date: 1/1/2022
Antithrombin III (Thrombate III, Atryn) (PDF)
Effective Date: 1/1/2022		 Hyperemesis gravidarum treatment (PDF)
Effective Date: 1/1/2022		 Sclerotherapy and Chemical Endovenous Ablation for Varicose Veins (PDF)
Effective Date: 1/1/2022
Articular Cartilage Defect Repairs (PDF)
Effective Date: 1/1/2022		 Hyperhidrosis treatments (PDF)
Effective Date: 1/1/2022		 Selective Dorsal Rhizotomy (PDF)
Effective Date: 1/1/2022
Assisted Reproductive Technology (PDF)
Effective Date: 1/1/2022		 Implantable Hypoglossal Nerve Stimulation for Obstructive Sleep Apnea (PDF)
Effective Date: 1/1/2022		 Selective Nerve Root Blocks and Transforaminal Epidural Injections (PDF)
Effective Date: 1/1/2022
Bariatric Surgery (PDF)
Effective Date: 1/1/2022		 Implantable Intrathecal Pain Pump (PDF)
Effective Date: 1/1/2022		 Short Inpatient Hospital Stay (PDF)
Effective Date: 1/1/2022
Biofeedback (PDF)
Effective Date: 1/1/2022		 Implantable Wireless Pulmonary Artery Pressure Monitoring  (PDF)
Effective Date: 1/1/2022		 Skilled Nursing Facility Leveling (PDF)
Effective Date: 1/1/2022
Bone-anchored hearing aid (PDF)
Effective Date: 1/1/2022		 Inhaled nitric oxide (PDF)
Effective Date: 1/1/2022		 Skin Substitutes for Chronic Wounds (PDF)
Effective Date: 1/1/2022
Bronchial Thermoplasty (PDF)
Effective Date: 1/1/2022
 Intensity-Modulated Radiotherapy (PDF)
Effective Date: 1/1/2022		 Spinal Cord Stimulation (PDF)
Effective Date: 1/1/2022
Burn Surgery (PDF)
Effective Date: 1/1/2022
 Intestinal and multivisceral transplant (PDF)
Effective Date: 1/1/2022		 Stereotactic Body Radiation Therapy (PDF)
Effective Date: 1/1/2022
Cardiac Biomarker Testing for Acute MI (PDF)
Effective Date: 1/1/2022		 Intradiscal Steroid Injections for Pain Management (PDF)
Effective Date: 1/1/2022		 Tandem Transplant (PDF)
Effective Date: 1/1/2022
Caudal or Interlaminar Epidural Steroid Injections (PDF)
Effective Date: 1/1/2022		 Laser Skin Treatment (PDF)
Effective Date: 1/1/2022		 Testing for Select Genitourinary Conditions (previously Diagnosis of Vaginitis) (PDF)
Effective Date: 1/1/2022
Cell-free Fetal DNA Testing (PDF)
Effective Date: 1/1/2022		 Long Term Care Placement Criteria (PDF)
Effective Date: 1/1/2022		 Thymus Transplantation (PDF)
Effective Date: 1/1/2022
Clinical Trials (PDF)
Effective Date: 1/1/2022		 Low-Frequency Ultrasound Wound Therapy (PDF)
Effective Date: 1/1/2022		 Thyroid Testing in Pediatrics (PDF)
Effective Date: 1/1/2022
Cochlear Implant Replacements (PDF)
Effective Date: 1/1/2022		 Lung Transplantation (PDF)
Effective Date: 1/1/2022		 Total artificial heart (PDF)
Effective Date: 1/1/2022
Cosmetic and Reconstructive Surgery (PDF)
Effective Date: 1/1/2022		 Lysis of Epidural Lesions (PDF)
Effective Date: 1/1/2022		 Total Parenteral Nutrition and Intradialytic Parenteral Nutrition (PDF)
Effective Date: 1/1/2022
Dental Anesthesia (PDF)
Effective Date: 1/1/2022		 Measure Serum 1,25 Vitamin D (PDF)
Effective Date: 1/1/2022
 Transcatheter closure of patent foramen ovale (PDF)
Effective Date: 1/1/2022
Diaphragmatic/Phrenic Nerve Stimulation (PDF)
Effective Date: 1/1/2022		 Mechanical Stretching Devices for Joint Stiffness and Contracture (PDF)
Effective Date: 1/1/2022		 Trigger Point Injections for Pain Management (PDF)
Effective Date: 1/1/2022
Disc Decompression Procedures (PDF)
Effective Date: 1/1/2022		 Multiple Sleep Latency Testing(PDF)
Effective Date: 1/1/2022		 Urinary Incontinence Devices and Treatments (PDF)
Effective Date: 1/1/2022
Discography (PDF)
Effective Date: 1/1/2022		 Neonatal abstinence syndrome guidelines (PDF)
Effective Date: 1/1/2022		 Vagus Nerve Stimulation (PDF)
Effective Date: 1/1/2022
Digital EEG Analysis (PDF)
Effective Date: 1/1/2022		 Neonatal sepsis management (PDF)
Effective Date: 1/1/2022		 Ventricular Assist Devices (PDF)
Effective Date: 1/1/2022
Donor lymphocyte infusion (PDF)
Effective Date: 1/1/2022		 Nerve Blocks for Pain Management (PDF)
Effective Date: 1/1/2022		 Video Electroencephalographic Monitoring (PDF)
Effective Date: 1/1/2022
Drugs of Abuse: Definitive Testing (previously Outpatient Testing for Drugs of Abuse) (PDF)
Effective Date: 1/1/2022		 Neuromuscular Electrical Stimulation (NMES) (PDF)
Effective Date: 1/1/2022		  
Durable Medical Equipment (DME) (PDF)
Effective Date: 1/1/2022		 NICU Apnea Bradycardia Guidelines (PDF)
Effective Date: 1/1/2022		  
EEG in Evaluation of Headache (PDF)
Effective Date: 1/1/2022		 NICU discharge guidelines (PDF)
Effective Date: 1/1/2022		  
Electric Tumor Treating Fields (PDF)
Effective Date: 1/1/2022		 Non-Invasive Home Ventilators (PDF)
Effective Date: 1/1/2022		  
Electromyography and Nerve Conduction Studies (PDF)
Effective Date: 1/1/2022		 Non-myeloablative allogeneic stem cell transplants (PDF)
Effective Date: 1/1/2022		  
Endometrial Ablation (PDF)
Effective Date: 1/1/2022		 Obstetrical Home Health Care Programs (PDF)
Effective Date: 1/1/2022		  
Essure Removal (PDF)
Effective Date: 1/1/2022		 Optic nerve decompression surgery (PDF)
Effective Date: 1/1/2022		  
Evoked Potentials (PDF)
Effective Date: 1/1/2022		 Orthognathic Surgery (PDF)
Effective Date: 1/1/2022		  
Experimental Technologies (PDF)
Effective Date: 1/1/2022		 Osteogenic Stimulation (PDF)
Effective Date: 1/1/2022		  
Evoked Potentials (PDF)
Effective Date: 1/1/2022		 Outpatient Cardiac Rehabilitation (PDF)
Effective Date: 1/1/2022		  
Facet Joint Interventions (PDF)
Effective Date: 1/1/2022		 Oxygen Use and Concentrators (PDF)
Effective Date: 1/1/2022		  
Fecal incontinence treatments (PDF)
Effective Date: 1/1/2022		 Pancreas transplant (PDF)
Effective Date: 1/1/2022		  
Ferriscan R2-MRI (PDF)
Effective Date: 1/1/2022		 Panniculectomy (PDF)
Effective Date: 1/1/2022		  
Fertility preservation (PDF)
Effective Date: 1/1/2022		 Pediatric heart transplant (PDF)
Effective Date: 1/1/2022		  
Fetal surgery in utero for prenatally diagnosed malformations (PDF)
Effective Date: 1/1/2022		 Pediatric Liver Transplant (PDF)
Effective Date: 1/1/2022		  
Functional MRI (PDF)
Effective Date: 1/1/2022		 Pediatric Oral Function Therapy (PDF)
Effective Date: 1/1/2022		  
Gastric Electrical Stimulation (PDF)
Effective Date: 1/1/2022		 Percutaneous Left Atrial Appendage Closure Device for Stroke Prevention (PDF)
Effective Date: 1/1/2022		  
Gastrointestinal Pathogen Nucleic Acid Detection Panel Testing (PDF)
Effective Date: 1/1/2022		 Physical, Occupational, and Speech Therapy Services (PDF)
Effective Date: 1/1/2022		  
Gender Affirming Procedures (PDF)
Effective Date: 1/1/2022		 Polymerase Chain Reaction Respiratory Viral Panel Testing (PDF)
Effective Date: 1/1/2022		  
Genetic and Pharmacogenetic Testing (PDF)
Effective Date: 1/1/2022		 Post-Acute Care (PDF)
Effective Date: 1/1/2022		  
  Posterior tibial nerve stimulation for voiding dysfunction (PDF)
Effective Date: 1/1/2022		  
  PROM Testing (PDF)
Effective Date: 1/1/2022		  
  Proton and neutron beam therapies (PDF)
Effective Date: 1/1/2022