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We’re currently experiencing an issue with Pharmacy searches in our Find a Provider/Pharmacy search tool. For immediate assistance, please contact Member Services. We apologize for the inconvenience.
Main Menu
- Shop for Plans show Shop for Plans menu
- I'm a Member show I'm a Member menu
-
Pharmacy Benefits
show Pharmacy Benefits menu
-
- Find a Doctor or Pharmacy
- List of Drugs (Formulary)
- Medication Therapy Management (MTMP)
- Mail Order Service
- Specialty Pharmacy
- Coverage Determinations and Redeterminations
- Prior Authorization, Step Therapy & Quantity Limitations
- Out-of-Network Pharmacies
- Medication (Drug) Management and Safety
- Drug Transition Policy
- Pharmacy Forms
- Medicare Prescription Payment Plan
-
- Caregivers show Caregivers menu
Plan Benefit Materials | Allwell from MHS Health Wisconsin
Plan Benefit Materials
Learn about your plan and all that it has to offer by reviewing helpful plan documents such as the Annual Notice of Change (ANOC), Summary of Benefits, and Evidence of Coverage.
To get started, locate your plan in the list of plans below and select “Plan Benefits.”
HMO
Additional Forms
Plan Benefit Materials
Learn about your plan and all that it has to offer by reviewing helpful plan documents such as the Annual Notice of Change (ANOC), Summary of Benefits, and Evidence of Coverage.
To get started, locate your plan in the list of plans below and select “Plan Benefits.”
HMO D-SNP
Wellcare Dual Access (HMO POS D-SNP) H8189-001
Counties: Adams, Brown, Calumet, Clark, Columbia, Dane, Dodge, Fond du Lac, Green Lake, Jefferson, Kenosha, Kewaunee, Langlade, Lincoln, Manitowoc, Marathon, Marinette, Marquette, Menominee, Milwaukee, Oconto, Outagamie, Ozaukee, Portage, Racine, Shawano, Sheboygan, Taylor, Walworth, Washington, Waukesha, Waupaca, Waushara, Winnebago, Wood
Annual Notice of Changes
- Annual Notice of Change: Wellcare All Dual Assure (HMO D-SNP) to Wellcare Dual Access (HMO-POS D-SNP) - English (PDF)
- Annual Notice of Change: Wellcare All Dual Assure (HMO D-SNP) to Wellcare Dual Access (HMO-POS D-SNP) - Spanish (PDF)
- Annual Notice of Change: Wellcare All Dual Assure (HMO D-SNP) to Wellcare Dual Access (HMO-POS D-SNP) - Chinese (PDF)
- Annual Notice of Change: Wellcare Dual Access (HMO-POS D-SNP) - English (PDF)
- Annual Notice of Change: Wellcare Dual Access (HMO - POS D-SNP) - Spanish (PDF)
- Annual Notice of Change: Wellcare Dual Access (HMO- POS D-SNP) - Chinese (PDF)
Summary of Benefits
- Summary of Benefits – English (PDF)
- Summary of Benefits – Spanish (PDF)
- Summary of Benefits - Chinese (PDF)
Evidence of Coverage
- Evidence of Coverage – English (PDF)
- Evidence of Coverage – Spanish (PDF)
- Evidence of Coverage - Chinese (PDF)
- Dental Benefit Details – English (PDF)
- Dental Benefit Details - Arabic (PDF)
- Dental Benefit Details - Chinese (PDF)
- Dental Benefit Details - Russian (PDF)
- Dental Benefit Details - Korean (PDF)
- Dental Benefit Details - Spanish (PDF)
- Dental Benefit Details - Vietnamese (PDF)
- Dental Benefit Details - Albanian (PDF)
- Dental Benefit Details - HIN (PDF)
- Dental Benefit Details - POL (PDF)
- Dental Benefit Details - BUR (PDF)
- Dental Benefit Details - HRV (PDF)
- Dental Benefit Details - LAO (PDF)
- Dental Benefit Details - SOM (PDF)
Wellcare Dual Reserve (HMO POS D-SNP) H8189-007
Counties: Adams, Brown, Calumet, Clark, Columbia, Dane, Dodge, Fond du Lac, Green Lake, Jefferson, Kenosha, Kewaunee, Langlade, Lincoln, Manitowoc, Marathon, Marinette, Marquette, Menominee, Milwaukee, Oconto, Outagamie, Ozaukee, Portage, Racine, Shawano, Sheboygan, Taylor, Walworth, Washington, Waukesha, Waupaca, Waushara, Winnebago, Wood
Annual Notice of Changes
- Annual Notice of Change – English (PDF)
- Annual Notice of Change – Spanish (PDF)
- Annual Notice of Change – Chinese (PDF)
Summary of Benefits
- Summary of Benefits – English (PDF)
- Summary of Benefits – Spanish (PDF)
- Summary of Benefits - Chinese (PDF)
Evidence of Coverage
- Evidence of Coverage – English (PDF)
- Evidence of Coverage – Spanish (PDF)
- Evidence of Coverage - Chinese (PDF)
- Dental Benefit Details – English (PDF)
- Dental Benefit Details - Spanish (PDF)
- Dental Benefit Details - Vietnamese (PDF)
- Dental Benefit Details - Arabic (PDF)
- Dental Benefit Details - Chinese (PDF)
- Dental Benefit Details - Korean (PDF)
- Dental Benefit Details - Albanian (PDF)
- Dental Benefit Details - HIN (PDF)
- Dental Benefit Details - POL (PDF)
- Dental Benefit Details - Russian (PDF)
- Dental Benefit Details - Burmese (PDF)
- Dental Benefit Details - HRV (PDF)
- Dental Benefit Details - LAO (PDF)
- Dental Benefit Details - SOM (PDF)
Additional Forms
- Over-the-Counter Catalog and Healthy Food - English (PDF)
- Over-the-Counter Catalog and Healthy Food - Spanish (PDF)
- Over-the-Counter Catalog and Healthy Food - Albania (PDF)
- Over-the-Counter Catalog and Healthy Food - Arabic (PDF)
- Over-the-Counter Catalog and Healthy Food - Burmese (PDF)
- Over-the-Counter Catalog and Healthy Food - Chinese (PDF)
- Over-the-Counter Catalog and Healthy Food - Hindi (PDF)
- Over-the-Counter Catalog and Healthy Food - HRV (PDF)
- Over-the-Counter Catalog and Healthy Food - Korean (PDF)
- Over-the-Counter Catalog and Healthy Food - Lao (PDF)
- Over-the-Counter Catalog and Healthy Food - Polish (PDF)
- Over-the-Counter Catalog and Healthy Food - Russian (PDF)
- Over-the-Counter Catalog and Healthy Food - Somali (PDF)
- Over-the-Counter Catalog and Healthy Food - Vietnamese (PDF)
If you have questions please, contact Member Services.
https://www.wellcarefindaprovider.com/,https://www.wellcarefindaprovider.com,www.wellcarefindaprovider.com,
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