Plan Benefit Materials | Allwell from MHS Health Wisconsin
Explore your plan and its benefits by reviewing important documents like 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.”
Wellcare Simple (HMO-POS) H8189-008
Counties: Brown, Calumet, Columbia, Dane, Dodge, Fond Du Lac, Jefferson, Kenosha, Kewaunee, Manitowoc, Milwaukee, Outagamie, Ozaukee, Racine, Shawano, Sheboygan, Walworth, Washington, Waukesha, Winnebago
Summary of Benefits
Evidence of Coverage
Dental Benefit Details
- Dental Benefit Details - English (PDF) - Coming Soon
Your OTC Highlight
Wellcare Dual Access Sync (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 Change
- Annual Notice of Change: Wellcare Dual Access (HMO-POS D-SNP) H8189-001 to Wellcare Dual Access Sync (HMO-POS D-SNP) H8189-001 - English (PDF)
- Annual Notice of Change: Wellcare Dual Access (HMO-POS D-SNP) H8189-001 to Wellcare Dual Access Sync (HMO-POS D-SNP) H8189-001 - Arabic (PDF)
- Annual Notice of Change: Wellcare Dual Access (HMO-POS D-SNP) H8189-001 to Wellcare Dual Access Sync (HMO-POS D-SNP) H8189-001 - Hmong (PDF)
- Annual Notice of Change: Wellcare Dual Access (HMO-POS D-SNP) H8189-001 to Wellcare Dual Access Sync (HMO-POS D-SNP) H8189-001 - Laotian (PDF)
- Annual Notice of Change: Wellcare Dual Access (HMO-POS D-SNP) H8189-001 to Wellcare Dual Access Sync (HMO-POS D-SNP) H8189-001 - Russian (PDF)
- Annual Notice of Change: Wellcare Dual Access (HMO-POS D-SNP) H8189-001 to Wellcare Dual Access Sync (HMO-POS D-SNP) H8189-001 - Spanish (PDF)
Summary of Benefits
- Summary of Benefits - English (PDF)
- Summary of Benefits - Arabic (PDF) - Coming Soon
- Summary of Benefits - Hmong (PDF) - Coming Soon
- Summary of Benefits - Laotian (PDF) - Coming Soon
- Summary of Benefits - Russian (PDF) - Coming Soon
- Summary of Benefits - Spanish (PDF)
Evidence of Coverage
- Evidence of Coverage - English (PDF) - Coming Soon
- Evidence of Coverage - Arabic (PDF) - Coming Soon
- Evidence of Coverage - Hmong (PDF) - Coming Soon
- Evidence of Coverage - Laotian (PDF) - Coming Soon
- Evidence of Coverage - Russian (PDF) - Coming Soon
- Evidence of Coverage - Spanish (PDF) - Coming Soon
Dental Benefit Details
- Dental Benefit Details - English (PDF) - Coming Soon
- Dental Benefit Details - Arabic (PDF) - Coming Soon
- Dental Benefit Details - Hmong (PDF) - Coming Soon
- Dental Benefit Details - Laotian (PDF) - Coming Soon
- Dental Benefit Details - Russian (PDF) - Coming Soon
- Dental Benefit Details - Spanish (PDF) - Coming Soon
Your OTC Highlight
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 Change
- Annual Notice of Change - English (PDF)
- Annual Notice of Change - Arabic (PDF)
- Annual Notice of Change - Hmong (PDF)
- Annual Notice of Change - Laotian (PDF)
- Annual Notice of Change - Russian (PDF)
- Annual Notice of Change - Spanish (PDF)
Summary of Benefits
- Summary of Benefits - English (PDF)
- Summary of Benefits - Arabic (PDF) - Coming Soon
- Summary of Benefits - Hmong (PDF) - Coming Soon
- Summary of Benefits - Laotian (PDF) - Coming Soon
- Summary of Benefits - Russian (PDF) - Coming Soon
- Summary of Benefits - Spanish (PDF)
Evidence of Coverage
- Evidence of Coverage - English (PDF) - Coming Soon
- Evidence of Coverage - Arabic (PDF) - Coming Soon
- Evidence of Coverage - Hmong (PDF) - Coming Soon
- Evidence of Coverage - Laotian (PDF) - Coming Soon
- Evidence of Coverage - Russian (PDF) - Coming Soon
- Evidence of Coverage - Spanish (PDF) - Coming Soon
Dental Benefit Details
- Dental Benefit Details - English (PDF) - Coming Soon
- Dental Benefit Details - Arabic (PDF) - Coming Soon
- Dental Benefit Details - Hmong (PDF) - Coming Soon
- Dental Benefit Details - Laotian (PDF) - Coming Soon
- Dental Benefit Details - Russian (PDF) - Coming Soon
- Dental Benefit Details - Spanish (PDF) - Coming Soon
Your OTC Highlight
Additional Forms
- Medicare Step Therapy Part B (PDF) - Coming Soon
- 2026 Medicare Parts A & B Premiums and Deductibles (PDF) - Coming Soon
- Member Secure Portal Guide (PDF) - Coming Soon