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 Giveback (HMO-POS) H9630-008
Counties: Arkansas, Ashley, Baxter, Benton, Boone, Bradley, Calhoun, Carroll, Chicot, Clark, Clay, Cleburne, Cleveland, Columbia, Conway, Craighead, Crawford, Crittenden, Cross, Dallas, Desha, Drew, Faulkner, Franklin, Fulton, Garland, Grant, Greene, Hempstead, Hot Spring, Howard, Independence, Izard, Jackson, Jefferson, Johnson, Lafayette, Lawrence, Lee, Lincoln, Little River, Logan, Lonoke, Madison, Marion, Miller, Mississippi, Monroe, Montgomery, Nevada, Newton, Ouachita, Perry, Phillips, Pike, Poinsett, Polk, Pope, Prairie, Pulaski, Randolph, Saline, Scott, Searcy, Sebastian, Sevier, Sharp, St. Francis, Stone, Union, Van Buren, Washington, White, Woodruff, Yell
Annual Notice of Change
Summary of Benefits
Evidence of Coverage
- Evidence of Coverage - English (PDF) - Coming Soon
Dental Benefit Details
- Dental Benefit Details - English (PDF) - Coming Soon
Your OTC Highlight
Wellcare Patriot Giveback Preferred (HMO-POS) H9630-015
Counties: Arkansas, Ashley, Baxter, Benton, Boone, Bradley, Calhoun, Carroll, Chicot, Clark, Clay, Cleburne, Cleveland, Columbia, Conway, Craighead, Crawford, Crittenden, Cross, Dallas, Desha, Drew, Faulkner, Franklin, Fulton, Garland, Grant, Greene, Hempstead, Hot Spring, Howard, Independence, Izard, Jackson, Jefferson, Johnson, Lafayette, Lawrence, Lee, Lincoln, Little River, Logan, Lonoke, Madison, Marion, Miller, Mississippi, Monroe, Montgomery, Nevada, Newton, Ouachita, Perry, Phillips, Pike, Poinsett, Polk, Pope, Prairie, Pulaski, Randolph, Saline, Scott, Searcy, Sebastian, Sevier, Sharp, St. Francis, Stone, Union, Van Buren, Washington, White, Woodruff, Yell
Annual Notice of Change
Summary of Benefits
Evidence of Coverage
- Evidence of Coverage - English (PDF) - Coming Soon
Dental Benefit Details
- Dental Benefit Details - English (PDF) - Coming Soon
Your OTC Highlight
Wellcare Simple (HMO-POS) H9630-002
Counties: Arkansas, Ashley, Baxter, Benton, Boone, Bradley, Calhoun, Carroll, Chicot, Clark, Clay, Cleburne, Cleveland, Columbia, Conway, Craighead, Crawford, Crittenden, Cross, Dallas, Desha, Drew, Faulkner, Franklin, Fulton, Garland, Grant, Greene, Hempstead, Hot Spring, Howard, Independence, Izard, Jackson, Jefferson, Johnson, Lafayette, Lawrence, Lee, Lincoln, Little River, Logan, Lonoke, Madison, Marion, Miller, Mississippi, Monroe, Montgomery, Nevada, Newton, Ouachita, Perry, Phillips, Pike, Poinsett, Polk, Pope, Prairie, Pulaski, Randolph, Saline, Scott, Searcy, Sebastian, Sevier, Sharp, St. Francis, Stone, Union, Van Buren, Washington, White, Woodruff, Yell
Annual Notice of Change
- Annual Notice of Change: Wellcare Assist (HMO-POS) H9630-005 to Wellcare Simple (HMO-POS) H9630-002 - English (PDF)
- Annual Notice of Change: Wellcare Simple (HMO-POS) H9630-002 to Wellcare Simple (HMO-POS) H9630-002 - English (PDF)
Summary of Benefits
Evidence of Coverage
- Evidence of Coverage - English (PDF) - Coming Soon
Dental Benefit Details
- Dental Benefit Details - English (PDF) - Coming Soon
Your OTC Highlight
Wellcare Dual Access (HMO-POS D-SNP) H9630-010
Counties: Arkansas, Ashley, Baxter, Benton, Boone, Bradley, Calhoun, Carroll, Chicot, Clark, Clay, Cleburne, Cleveland, Columbia, Conway, Craighead, Crawford, Crittenden, Cross, Dallas, Desha, Drew, Faulkner, Franklin, Fulton, Garland, Grant, Greene, Hempstead, Hot Spring, Howard, Independence, Izard, Jackson, Jefferson, Johnson, Lafayette, Lawrence, Lee, Lincoln, Little River, Logan, Lonoke, Madison, Marion, Miller, Mississippi, Monroe, Montgomery, Nevada, Newton, Ouachita, Perry, Phillips, Pike, Poinsett, Polk, Pope, Prairie, Pulaski, Randolph, Saline, Scott, Searcy, Sebastian, Sevier, Sharp, St. Francis, Stone, Union, Van Buren, Washington, White, Woodruff, Yell
Annual Notice of Change
Summary of Benefits
Evidence of Coverage
- Evidence of Coverage - English (PDF) - Coming Soon
Dental Benefit Details
- Dental Benefit Details - English (PDF) - Coming Soon
Your OTC Highlight
Wellcare Dual Liberty (HMO-POS D-SNP) H9630-011
Counties: Arkansas, Ashley, Baxter, Benton, Boone, Bradley, Calhoun, Carroll, Chicot, Clark, Clay, Cleburne, Cleveland, Columbia, Conway, Craighead, Crawford, Crittenden, Cross, Dallas, Desha, Drew, Faulkner, Franklin, Fulton, Garland, Grant, Greene, Hempstead, Hot Spring, Howard, Independence, Izard, Jackson, Jefferson, Johnson, Lafayette, Lawrence, Lee, Lincoln, Little River, Logan, Lonoke, Madison, Marion, Miller, Mississippi, Monroe, Montgomery, Nevada, Newton, Ouachita, Perry, Phillips, Pike, Poinsett, Polk, Pope, Prairie, Pulaski, Randolph, Saline, Scott, Searcy, Sebastian, Sevier, Sharp, St. Francis, Stone, Union, Van Buren, Washington, White, Woodruff, Yell
Annual Notice of Change
Summary of Benefits
Evidence of Coverage
- Evidence of Coverage - English (PDF) - Coming Soon
Dental Benefit Details
- Dental Benefit Details - English (PDF) - Coming Soon
Your OTC Highlight
Wellcare Dual Reserve (HMO-POS D-SNP) H9630-014
Counties: Arkansas, Ashley, Baxter, Benton, Boone, Bradley, Calhoun, Carroll, Chicot, Clark, Clay, Cleburne, Cleveland, Columbia, Conway, Craighead, Crawford, Crittenden, Cross, Dallas, Desha, Drew, Faulkner, Franklin, Fulton, Garland, Grant, Greene, Hempstead, Hot Spring, Howard, Independence, Izard, Jackson, Jefferson, Johnson, Lafayette, Lawrence, Lee, Lincoln, Little River, Logan, Lonoke, Madison, Marion, Miller, Mississippi, Monroe, Montgomery, Nevada, Newton, Ouachita, Perry, Phillips, Pike, Poinsett, Polk, Pope, Prairie, Pulaski, Randolph, Saline, Scott, Searcy, Sebastian, Sevier, Sharp, St. Francis, Stone, Union, Van Buren, Washington, White, Woodruff, Yell
Annual Notice of Change
Summary of Benefits
Evidence of Coverage
- Evidence of Coverage - English (PDF) - Coming Soon
Dental Benefit Details
- Dental Benefit Details - English (PDF) - Coming Soon
Your OTC Highlight
Additional Forms
- Over-the-Counter Catalog (PDF) - Coming Soon
- Over-the-Counter Catalog and Healthy Food (PDF) - Coming Soon
- 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