Plan Benefit Materials
2027 Plan Benefit Materials
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
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
Annual Notice of Change
Summary of Benefits
Evidence of Coverage
Dental Benefit Details
Your OTC Highlight
HMO D-SNP Plans
Wellcare MHS Health Wisconsin Dual Liberty Sync (HMO-POS D-SNP) H8189-001
Counties: Brown, Calumet, Clark, Columbia, Dane, Dodge, Fond du Lac, Jefferson, Kenosha, Kewaunee, Langlade, Manitowoc, Marathon, Menominee, Milwaukee, Oconto, Outagamie, Ozaukee, Racine, Sheboygan, Taylor, Walworth, Washington, Waukesha, Waupaca, Waushara, Winnebago, Wood
Annual Notice of Change
- Annual Notice of Change: Wellcare Dual Access Sync (HMO-POS D-SNP) H8189-001 to Wellcare MHS Health Wisconsin Dual Liberty Sync (HMO-POS D-SNP) H8189-001 - English (PDF)
- Annual Notice of Change: Wellcare Dual Access Sync (HMO-POS D-SNP) H8189-001 to Wellcare MHS Health Wisconsin Dual Liberty Sync (HMO-POS D-SNP) H8189-001 - Arabic (PDF)
- Annual Notice of Change: Wellcare Dual Access Sync (HMO-POS D-SNP) H8189-001 to Wellcare MHS Health Wisconsin Dual Liberty Sync (HMO-POS D-SNP) H8189-001 - Burmese (PDF)
- Annual Notice of Change: Wellcare Dual Access Sync (HMO-POS D-SNP) H8189-001 to Wellcare MHS Health Wisconsin Dual Liberty Sync (HMO-POS D-SNP) H8189-001 - Chinese (PDF)
- Annual Notice of Change: Wellcare Dual Access Sync (HMO-POS D-SNP) H8189-001 to Wellcare MHS Health Wisconsin Dual Liberty Sync (HMO-POS D-SNP) H8189-001 - Hmong (PDF)
- Annual Notice of Change: Wellcare Dual Access Sync (HMO-POS D-SNP) H8189-001 to Wellcare MHS Health Wisconsin Dual Liberty Sync (HMO-POS D-SNP) H8189-001 - Lao (PDF)
- Annual Notice of Change: Wellcare Dual Access Sync (HMO-POS D-SNP) H8189-001 to Wellcare MHS Health Wisconsin Dual Liberty Sync (HMO-POS D-SNP) H8189-001 - Russian (PDF)
- Annual Notice of Change: Wellcare Dual Access Sync (HMO-POS D-SNP) H8189-001 to Wellcare MHS Health Wisconsin Dual Liberty Sync (HMO-POS D-SNP) H8189-001 - Somali (PDF)
- Annual Notice of Change: Wellcare Dual Access Sync (HMO-POS D-SNP) H8189-001 to Wellcare MHS Health Wisconsin Dual Liberty Sync (HMO-POS D-SNP) H8189-001 - Spanish (PDF)
- Annual Notice of Change: Wellcare Dual Access Sync (HMO-POS D-SNP) H8189-001 to Wellcare MHS Health Wisconsin Dual Liberty Sync (HMO-POS D-SNP) H8189-001 - Ukrainian (PDF)
- Annual Notice of Change: Wellcare Dual Access Sync (HMO-POS D-SNP) H8189-001 to Wellcare MHS Health Wisconsin Dual Liberty Sync (HMO-POS D-SNP) H8189-001 - Vietnamese (PDF)
- Annual Notice of Change: Wellcare Dual Reserve (HMO-POS D-SNP) H8189-007 to Wellcare MHS Health Wisconsin Dual Liberty Sync (HMO-POS D-SNP) H8189-001 - English (PDF)
- Annual Notice of Change: Wellcare Dual Reserve (HMO-POS D-SNP) H8189-007 to Wellcare MHS Health Wisconsin Dual Liberty Sync (HMO-POS D-SNP) H8189-001 - Burmese (PDF)
- Annual Notice of Change: Wellcare Dual Reserve (HMO-POS D-SNP) H8189-007 to Wellcare MHS Health Wisconsin Dual Liberty Sync (HMO-POS D-SNP) H8189-001 - Arabic (PDF)
- Annual Notice of Change: Wellcare Dual Reserve (HMO-POS D-SNP) H8189-007 to Wellcare MHS Health Wisconsin Dual Liberty Sync (HMO-POS D-SNP) H8189-001 - Chinese (PDF)
- Annual Notice of Change: Wellcare Dual Reserve (HMO-POS D-SNP) H8189-007 to Wellcare MHS Health Wisconsin Dual Liberty Sync (HMO-POS D-SNP) H8189-001 - Hmong (PDF)
- Annual Notice of Change: Wellcare Dual Reserve (HMO-POS D-SNP) H8189-007 to Wellcare MHS Health Wisconsin Dual Liberty Sync (HMO-POS D-SNP) H8189-001 - Lao (PDF)
- Annual Notice of Change: Wellcare Dual Reserve (HMO-POS D-SNP) H8189-007 to Wellcare MHS Health Wisconsin Dual Liberty Sync (HMO-POS D-SNP) H8189-001 - Russian (PDF)
- Annual Notice of Change: Wellcare Dual Reserve (HMO-POS D-SNP) H8189-007 to Wellcare MHS Health Wisconsin Dual Liberty Sync (HMO-POS D-SNP) H8189-001 - Somali (PDF)
- Annual Notice of Change: Wellcare Dual Reserve (HMO-POS D-SNP) H8189-007 to Wellcare MHS Health Wisconsin Dual Liberty Sync (HMO-POS D-SNP) H8189-001 - Spanish (PDF)
- Annual Notice of Change: Wellcare Dual Reserve (HMO-POS D-SNP) H8189-007 to Wellcare MHS Health Wisconsin Dual Liberty Sync (HMO-POS D-SNP) H8189-001 - Ukrainian (PDF)
- Annual Notice of Change: Wellcare Dual Reserve (HMO-POS D-SNP) H8189-007 to Wellcare MHS Health Wisconsin Dual Liberty Sync (HMO-POS D-SNP) H8189-001 - Vietnamese (PDF)
Summary of Benefits
- Summary of Benefits - English (PDF)
- Summary of Benefits - Arabic (PDF)
- Summary of Benefits - Burmese (PDF)
- Summary of Benefits - Chinese (PDF)
- Summary of Benefits - Hmong (PDF)
- Summary of Benefits - Lao (PDF)
- Summary of Benefits - Russian (PDF)
- Summary of Benefits - Somali (PDF)
- Summary of Benefits - Spanish (PDF)
- Summary of Benefits - Ukrainian (PDF)
- Summary of Benefits - Vietnamese (PDF)
Evidence of Coverage
- Evidence of Coverage - English (PDF)
- Evidence of Coverage - Burmese (PDF) - Coming Soon
- Evidence of Coverage - Chinese (PDF) - Coming Soon
- Evidence of Coverage - Hmong (PDF) - Coming Soon
- Evidence of Coverage - Lao (PDF) - Coming Soon
- Evidence of Coverage - Russian (PDF) - Coming Soon
- Evidence of Coverage - Somali (PDF) - Coming Soon
- Evidence of Coverage - Spanish (PDF)
- Evidence of Coverage - Ukrainian (PDF) - Coming Soon
- Evidence of Coverage - Vietnamese (PDF) - Coming Soon
Dental Benefit Details
- Dental Benefit Details - English (PDF)
- Dental Benefit Details - Arabic (PDF) - Coming Soon
- Dental Benefit Details - Burmese (PDF) - Coming Soon
- Dental Benefit Details - Chinese (PDF) - Coming Soon
- Dental Benefit Details - Hmong (PDF) - Coming Soon
- Dental Benefit Details - Lao (PDF) - Coming Soon
- Dental Benefit Details - Russian (PDF) - Coming Soon
- Dental Benefit Details - Somali (PDF) - Coming Soon
- Dental Benefit Details - Spanish (PDF) - Coming Soon
- Dental Benefit Details - Ukrainian (PDF) - Coming Soon
- Dental Benefit Details - Vietnamese (PDF) - Coming Soon
Your OTC Highlight
Wellcare MHS Health Wisconsin Dual Select (HMO-POS D-SNP) H8189-007
Counties: Brown, Calumet, Clark, Columbia, Dane, Dodge, Fond du Lac, Jefferson, Kenosha, Kewaunee, Langlade, Manitowoc, Marathon, Menominee, Milwaukee, Oconto, Outagamie, Ozaukee, Racine, Sheboygan, Taylor, Walworth, Washington, Waukesha, Waupaca, Waushara, Winnebago, Wood
Annual Notice of Change
- Annual Notice of Change: Wellcare Dual Access Sync (HMO-POS D-SNP) H8189-001 to Wellcare MHS Health Wisconsin Dual Select (HMO-POS D-SNP) H8189-007 - English (PDF)
- Annual Notice of Change: Wellcare Dual Access Sync (HMO-POS D-SNP) H8189-001 to Wellcare MHS Health Wisconsin Dual Select (HMO-POS D-SNP) H8189-007 - Arabic (PDF)
- Annual Notice of Change: Wellcare Dual Reserve (HMO-POS D-SNP) H8189-007 to Wellcare MHS Health Wisconsin Dual Select (HMO-POS D-SNP) H8189-007 - Arabic (PDF)
- Annual Notice of Change: Wellcare Dual Access Sync (HMO-POS D-SNP) H8189-001 to Wellcare MHS Health Wisconsin Dual Select (HMO-POS D-SNP) H8189-007 - Hmong (PDF)
- Annual Notice of Change: Wellcare Dual Reserve (HMO-POS D-SNP) H8189-007 to Wellcare MHS Health Wisconsin Dual Select (HMO-POS D-SNP) H8189-007 - Hmong (PDF)
- Annual Notice of Change: Wellcare Dual Access Sync (HMO-POS D-SNP) H8189-001 to Wellcare MHS Health Wisconsin Dual Select (HMO-POS D-SNP) H8189-007 - Lao (PDF)
- Annual Notice of Change: Wellcare Dual Reserve (HMO-POS D-SNP) H8189-007 to Wellcare MHS Health Wisconsin Dual Select (HMO-POS D-SNP) H8189-007 - Lao (PDF)
- Annual Notice of Change: Wellcare Dual Access Sync (HMO-POS D-SNP) H8189-001 to Wellcare MHS Health Wisconsin Dual Select (HMO-POS D-SNP) H8189-007 - Russian (PDF)
- Annual Notice of Change: Wellcare Dual Reserve (HMO-POS D-SNP) H8189-007 to Wellcare MHS Health Wisconsin Dual Select (HMO-POS D-SNP) H8189-007 - Russian (PDF)
- Annual Notice of Change: Wellcare Dual Access Sync (HMO-POS D-SNP) H8189-001 to Wellcare MHS Health Wisconsin Dual Select (HMO-POS D-SNP) H8189-007 - Spanish (PDF)
- Annual Notice of Change: Wellcare Dual Reserve (HMO-POS D-SNP) H8189-007 to Wellcare MHS Health Wisconsin Dual Select (HMO-POS D-SNP) H8189-007 - English (PDF)
- Annual Notice of Change: Wellcare Dual Reserve (HMO-POS D-SNP) H8189-007 to Wellcare MHS Health Wisconsin Dual Select (HMO-POS D-SNP) H8189-007 - Arabic (PDF)
- Annual Notice of Change: Wellcare Dual Access Sync (HMO-POS D-SNP) H8189-001 to Wellcare MHS Health Wisconsin Dual Select (HMO-POS D-SNP) H8189-007 - Hmong (PDF)
- Annual Notice of Change: Wellcare Dual Reserve (HMO-POS D-SNP) H8189-007 to Wellcare MHS Health Wisconsin Dual Select (HMO-POS D-SNP) H8189-007 - Hmong (PDF)
- Annual Notice of Change: Wellcare Dual Access Sync (HMO-POS D-SNP) H8189-001 to Wellcare MHS Health Wisconsin Dual Select (HMO-POS D-SNP) H8189-007 - Lao (PDF)
- Annual Notice of Change: Wellcare Dual Reserve (HMO-POS D-SNP) H8189-007 to Wellcare MHS Health Wisconsin Dual Select (HMO-POS D-SNP) H8189-007 - Lao (PDF)
- Annual Notice of Change: Wellcare Dual Access Sync (HMO-POS D-SNP) H8189-001 to Wellcare MHS Health Wisconsin Dual Select (HMO-POS D-SNP) H8189-007 - Russian (PDF)
- Annual Notice of Change: Wellcare Dual Reserve (HMO-POS D-SNP) H8189-007 to Wellcare MHS Health Wisconsin Dual Select (HMO-POS D-SNP) H8189-007 - Russian (PDF)
- Annual Notice of Change: Wellcare Dual Access Sync (HMO-POS D-SNP) H8189-001 to Wellcare MHS Health Wisconsin Dual Select (HMO-POS D-SNP) H8189-007 - Spanish (PDF)
- Annual Notice of Change: Wellcare Dual Reserve (HMO-POS D-SNP) H8189-007 to Wellcare MHS Health Wisconsin Dual Select (HMO-POS D-SNP) H8189-007 - Spanish (PDF)
Summary of Benefits
- Summary of Benefits - English (PDF)
- Summary of Benefits - Arabic (PDF)
- Summary of Benefits - Hmong (PDF)
- Summary of Benefits - Lao (PDF)
- Summary of Benefits - Russian (PDF)
- Summary of Benefits - Spanish (PDF)
Evidence of Coverage
- Evidence of Coverage - English (PDF)
- Evidence of Coverage - Arabic (PDF) - Coming Soon
- Evidence of Coverage - Hmong (PDF) - Coming Soon
- Evidence of Coverage - Lao (PDF) - Coming Soon
- Evidence of Coverage - Russian (PDF) - Coming Soon
- Evidence of Coverage - Spanish (PDF)
Dental Benefit Details
- Dental Benefit Details - English (PDF)
- Dental Benefit Details - Arabic (PDF) - Coming Soon
- Dental Benefit Details - Hmong (PDF) - Coming Soon
- Dental Benefit Details - Lao (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
- 2027 Medicare Parts A & B Premiums and Deductibles (PDF) - Coming Soon
- Member Secure Portal Guide (PDF) - Coming Soon
If you have questions please, contact Member Services.