Plan Benefit Materials | Allwell from Superior HealthPlan

Plan Materials and Forms

 

Information about plan benefits, services, and drug costs can be found in your plan materials.

Look at your Wellcare By Allwell member ID card for your plan number and type to view materials for your plan. 

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You can also look for plan materials based on the plan name and the county you live in.

If you don’t have a Wellcare By Allwell ID card or have questions about plan materials, give us a call. We’re here to help.

This booklet gives you a summary of costs and coverage in your plan.

Please select the document for your plan and county:

For HMO Members:

Plan Name CMS # County Summary of Benefits
Wellcare No Premium Medicare (HMO) H0062-002 Aransas, Bexar, Collin, Comal, Dallas, Denton, El Paso, Guadalupe, Jim Wells, Nueces, Rockwall, Tarrant, Wilson
Wellcare No Premium Medicare (HMO) H0062-003 Cameron, Hidalgo, Starr
Wellcare No Premium (HMO) H0174-010 Austin, Chambers, Fort Bend, Galveston, Hardin, Harris, Jefferson, Liberty, Montgomery, Orange, San Jacinto, Walker, Waller, Wharton
Wellcare No Premium (HMO) H5294-011 Aransas, Bee, Brooks, Cameron, Duval, Goliad, Hidalgo, Jim Hogg, Jim Wells, Kenedy, Kleberg, La Salle, McMullen, Nueces, Refugio, San Patricio, Starr, Victoria, Webb, Willacy, Zapata
Wellcare No Premium (HMO) H5294-017 Atascosa, Bandera, Bexar, Comal, DeWitt, Dimmit, Gonzales, Guadalupe, Karnes, Kendall, Maverick, Medina, Real, Uvalde, Wilson, and Zavala
Wellcare No Premium (HMO) H5294-018 Armstrong, Bailey, Borden, Briscoe, Castro, Cochran, Coke, Crosby, Dickens, Donley, Fisher, Floyd, Garza, Glasscock, Hale, Hockley, Irion, Kent, Lamb, Lubbock, Lynn, Martin, Mitchell, Nolan, Shackelford, Sterling, Swisher, Terry, Throckmorton
Wellcare TexanPlus Patriot Giveback (HMO) H4506-010 Austin, Brazoria, Chambers, Fort Bend, Galveston (partial county), Hardin, Harris, Jefferson, Liberty, Montgomery, Orange, Walker, Waller
Wellcare TexanPlus No Premium (HMO) H0174-002 Bastrop, Blanco, Burnet, Caldwell, Hays, Lee, Milam, Travis, Williamson
Wellcare TexanPlus No Premium (HMO) H0174-011-001 Bexar, Comal, Guadalupe
Wellcare TexanPlus No Premium (HMO) H0174-011-002 El Paso
Wellcare TexanPlus No Premium (HMO) H0174-011-003 Chambers, Galveston, Walker
Wellcare TexanPlus No Premium (HMO) H0174-011-004 Cooke
Wellcare TexanPlus No Premium (HMO) H0174-014 Collin, Dallas, Denton, Johnson, Rockwall, Tarrant
Wellcare TexanPlus Classic No Premium (HMO) H4506-003 Austin, Brazoria, Chambers, Fort Bend, Galveston (partial County), Hardin, Harris, Jefferson, Liberty, Montgomery, Orange, Walker, Waller
Wellcare Giveback (HMO) H0174-013-001 Bastrop, Blanco, Burnet, Caldwell, Hays, Lee, Milam, Travis, Williamson
Wellcare Giveback (HMO) H0174-013-002 Collin, Cooke, Dallas, Denton, Johnson, Rockwall, Tarrant
Wellcare Giveback (HMO) H0174-013-003 Austin, Chambers, Fort Bend, Galveston, Hardin, Harris, Jefferson, Liberty, Matagorda, Montgomery, Newton, Orange, Polk, San Jacinto, Walker, Waller, Wharton
Wellcare Giveback (HMO) H0174-013-004 Bexar, Comal, Guadalupe
Wellcare Giveback (HMO) H0174-013-005 El Paso
Wellcare Giveback (HMO) H5294-012 Aransas, Bee, Brooks, Cameron, Duval, Goliad, Hidalgo, Jim Hogg, Jim Wells, Kenedy, Kleberg, La Salle, McMullen, Nueces, Refugio, San Patricio, Starr, Victoria, Webb, Willacy, Zapata
Wellcare Giveback (HMO) H5294-019 Armstrong, Bailey, Borden, Briscoe, Castro, Cochran, Coke, Crosby, Dickens, Donley, Fisher, Floyd, Garza, Glasscock, Hale, Hockley, Irion, Kent, Lamb, Lubbock, Lynn, Martin, Mitchell, Nolan, Shackelford, Sterling, Swisher, Terry, Throckmorton
Wellcare Patriot No Premium (HMO) H5294-014 Aransas, Armstrong, Atascosa, Bailey, Bandera, Bastrop, Bee, Bexar, Blanco, Borden, Bosque, Briscoe, Brooks, Burnet, Caldwell, Calhoun, Cameron, Castro, Cochran, Coke, Collin, Colorado, Comal, Crosby, Dallas, Denton, DeWitt, Dickens, Dimmit, Donley, Duval, El Paso, Erath, Fayette, Fisher, Floyd, Garza, Gillespie, Glasscock, Goliad, Gonzales, Grayson, Grimes, Guadalupe, Hale, Hamilton, Hays, Hidalgo, Hill, Hockley, Hunt, Irion, Jack, Jim Hogg, Jim Wells, Karnes, Kendall, Kenedy, Kent, Kimble, Kleberg, La Salle, Lamb, Lee, Leon, Limestone, Lubbock, Lynn, Martin, Mason, Maverick, McCulloch, McMullen, Medina, Milam, Mills, Mitchell, Navarro, Nolan, Nueces, Palo Pinto, Real, Refugio, Rockwall, San Patricio, San Saba, Shackelford, Somervell, Starr, Sterling, Swisher, Tarrant, Terry, Throckmorton, Uvalde, Van Zandt, Victoria, Webb, Willacy, Williamson, Wilson, Zapata, Zavala
Wellcare Assist (HMO) H0174-009 Austin, Bastrop, Bexar, Blanco, Burnet, Caldwell, Chambers, Collin, Comal, Cooke, Dallas, Denton, El Paso, Fort Bend, Galveston, Guadalupe, Hardin, Harris, Hays, Jefferson, Johnson, Lee, Liberty, Matagorda, Milam, Montgomery, Newton, Orange, Polk, Rockwall, San Jacinto, Tarrant, Travis, Walker, Waller, Wharton, Williamson
Wellcare Complement Assist (HMO) H5294-013 Aransas, Bee, Brooks, Cameron, Duval, Goliad, Hidalgo, Jim Hogg, Jim Wells, Kenedy, Kleberg, La Salle, McMullen, Nueces, Refugio, San Patricio, Starr, Victoria, Webb, Willacy, Zapata
Wellcare Complement Assist (HMO) H5294-016 Armstrong, Atascosa, Bailey, Bandera, Bastrop, Bexar, Blanco, Borden, Bosque, Briscoe, Burnet, Caldwell, Calhoun, Castro, Cochran, Coke, Collin, Colorado, Comal, Crosby, Dallas, Denton, DeWitt, Dickens, Dimmit, Donley, El Paso, Erath, Fayette, Fisher, Floyd, Garza, Gillespie, Glasscock, Gonzales, Grayson, Grimes, Guadalupe, Hale, Hamilton, Hays, Hill, Hockley, Hunt, Irion, Jack, Karnes, Kendall, Kent, Kimble, Lamb, Lee, Leon, Limestone, Lubbock, Lynn, Martin, Mason, Maverick, McCulloch, Medina, Milam, Mills, Mitchell, Navarro, Nolan, Palo Pinto, Real, Rockwall, San Saba, Shackelford, Somervell, Sterling, Swisher, Tarrant, Terry, Throckmorton, Uvalde, Van Zandt, Williamson, Wilson, Zavala

For HMO D-SNP Members:

Plan Name CMS # County Summary of Benefits
Wellcare Dual Access (HMO D-SNP) H0174-004 Austin, Bastrop, Bexar, Blanco, Burnet, Caldwell, Chambers, Comal, Dallas, Denton, El Paso, Fort Bend, Galveston, Guadalupe, Hardin, Harris, Hays, Jefferson, Johnson, Lee, Liberty, Matagorda, Milam, Montgomery, Newton, Orange, Polk, San Jacinto, San Patricio, Tarrant, Walker, Waller, Wharton
Wellcare Dual Access Harmony (HMO D-SNP) H5294-015 Aransas, Armstrong, Atascosa, Bailey, Bandera, Bastrop, Bee, Bexar, Blanco, Borden, Bosque, Briscoe, Brooks, Burnet, Caldwell, Calhoun, Cameron, Castro, Cochran, Coke, Collin, Colorado, Comal, Crosby, Dallas, Denton, DeWitt, Dickens, Dimmit, Donley, Duval, El Paso, Erath, Fayette, Fisher, Floyd, Garza, Gillespie, Glasscock, Goliad, Gonzales, Grayson, Grimes, Guadalupe, Hale, Hamilton, Hays, Hidalgo, Hill, Hockley, Hunt, Irion, Jack, Jim Hogg, Jim Wells, Karnes, Kendall, Kenedy, Kent, Kimble, Kleberg, La Salle, Lamb, Lee, Leon, Limestone, Lubbock, Lynn, Martin, Mason, Maverick, McCulloch, McMullen, Medina, Milam, Mills, Mitchell, Navarro, Nolan, Nueces, Palo Pinto, Real, Refugio, Rockwall, San Patricio, San Saba, Shackelford, Somervell, Starr, Sterling, Swisher, Tarrant, Terry, Throckmorton, Uvalde, Van Zandt, Victoria, Webb, Willacy, Williamson, Wilson, Zapata, Zavala
Wellcare Dual Liberty (HMO D-SNP) H0174-006 Austin, Bastrop, Bexar, Blanco, Burnet, Caldwell, Chambers, Comal, Cooke, Dallas, Denton, El Paso, Fort Bend, Galveston, Guadalupe, Hardin, Harris, Hays, Jefferson, Johnson, Lee, Liberty, Matagorda, Milam, Montgomery, Newton, Orange, Polk, San Jacinto, San Patricio, Tarrant, Walker, Waller, Wharton
Wellcare Dual Liberty Nurture (HMO D-SNP) H5294-010 Aransas, Armstrong, Atascosa, Bailey, Bandera, Bee, Bexar, Borden, Bosque, Briscoe, Brooks, Calhoun, Cameron, Castro, Cochran, Coke, Collin, Colorado, Comal, Crosby, Dallas, Denton, DeWitt, Dickens, Dimmit, Donley, Duval, El Paso, Erath, Fayette, Fisher, Floyd, Garza, Gillespie, Glasscock, Goliad, Gonzales, Grayson, Grimes, Guadalupe, Hale, Hamilton, Hidalgo, Hill, Hockley, Hunt, Irion, Jack, Jim Hogg, Jim Wells, Karnes, Kendall, Kenedy, Kent, Kimble, Kleberg, La Salle, Lamb, Leon, Limestone, Lubbock, Lynn, Martin, Mason, Maverick, McCulloch, McMullen, Medina, Mills, Mitchell, Navarro, Nolan, Nueces, Palo Pinto, Real, Refugio, Rockwall, San Patricio, San Saba, Shackelford, Somervell, Starr, Sterling, Swisher, Tarrant, Terry, Throckmorton, Uvalde, Van Zandt, Victoria, Webb, Willacy, Wilson, Zapata, Zavala

For HMO C-SNP Members

Plan Name CMS # County Summary of Benefits
Wellcare Specialty No Premium (HMO C-SNP) H0174-008 Austin, Bexar, Chambers, Comal, El Paso, Fort Bend, Galveston, Guadalupe, Harris, Liberty, Matagorda, Montgomery, Polk, San Jacinto, Walker, Waller, Wharton

For HMO-POS Members

Plan Name CMS # County Summary of Benefits
Wellcare No Premium (HMO-POS) H0174-012-001 Bastrop, Blanco, Burnet, Caldwell, Hays, Lee, Milam, Travis, Williamson
Wellcare No Premium (HMO-POS) H0174-012-002 Collin, Cooke, Dallas, Denton, Johnson, Rockwall, Tarrant
Wellcare No Premium (HMO-POS) H0174-012-003 Austin, Chambers, Fort Bend, Galveston, Hardin, Harris, Jefferson, Liberty, Matagorda, Montgomery, Newton, Orange, Polk, San Jacinto, Walker, Waller, Wharton
Wellcare No Premium (HMO-POS) H0174-012-004 Bexar, Comal, Guadalupe
Wellcare No Premium (HMO-POS) H0174-012-005 El Paso
Wellcare TexanPlus No Premium (HMO-POS) H4506-029 Austin, Brazoria, Chambers, Fort Bend, Galveston (partial county), Hardin, Harris, Jefferson, Liberty, Montgomery, Orange, Walker, Waller

For PPO Members

Plan Name CMS # County Summary of Benefits
Wellcare Low Premium Open (PPO) H7323-001 Bastrop, Blanco, Burnet, Caldwell, Hays, Lee, Milam, Travis, Williamson
Wellcare Low Premium Open (PPO) H7323-002 Collin, Dallas, Denton, Johnson, Rockwall, Tarrant
Wellcare Low Premium Open (PPO) H7323-003 Austin, Brazoria, Chambers, Fort Bend, Galveston, Hardin, Harris, Jefferson, Liberty, Montgomery, Orange, Polk, San Jacinto, Walker, Waller
Wellcare No Premium Open (PPO) H7323-004 Atascosa, Bexar, El Paso, Medina
Wellcare Dual Access Open (PPO D-SNP) H7323-005 Atascosa, Austin, Bastrop, Bexar, Blanco, Brazoria, Burnet, Caldwell, Chambers, Collin, Comal, Cooke, Dallas, Denton, El Paso, Fort Bend, Galveston, Guadalupe, Hardin, Harris, Hays, Hidalgo, Jefferson, Johnson, Lee, Liberty, Medina, Milam, Montgomery, Orange, Polk, Rockwall, San Jacinto, Starr, Tarrant, Travis, Walker, Waller, Williamson
Wellcare No Premium Rx Plus Open (PPO) H7323-006  
Wellcare No Premium Open (PPO) H7323-007 Hidalgo, Starr

For PPO D-SNP Members

Plan Name CMS # County Summary of Benefits
Wellcare Dual Access Open (PPO D-SNP) H7323-005 Atascosa, Austin, Bastrop, Bexar, Blanco, Brazoria, Burnet, Caldwell, Chambers, Collin, Comal, Cooke, Dallas, Denton, El Paso, Fort Bend, Galveston, Guadalupe, Hardin, Harris, Hays, Hidalgo, Jefferson, Johnson, Lee, Liberty, Medina, Milam, Montgomery, Orange, Polk, Rockwall, San Jacinto, Starr, Tarrant, Travis, Walker, Waller, Williamson

This booklet gives you a complete list of services, limitations and exclusions for your plan coverage.

Please select the document for your plan and county:

For HMO Members:

Plan Name CMS # County Evidence of Coverage 
Wellcare No Premium Medicare (HMO) H0062-002

Aransas, Bexar, Collin, Comal, Dallas, Denton, El Paso, Guadalupe, Jim Wells, Nueces, Rockwall, Tarrant, Wilson

Wellcare No Premium Medicare (HMO) H0062-003

Cameron, Hidalgo, Starr

Wellcare No Premium (HMO) H0174-010 Austin, Chambers, Fort Bend, Galveston, Hardin, Harris, Jefferson, Liberty, Montgomery, Orange, San Jacinto, Walker, Waller, Wharton
Wellcare No Premium (HMO) H5294-011 Aransas, Bee, Brooks, Cameron, Duval, Goliad, Hidalgo, Jim Hogg, Jim Wells, Kenedy, Kleberg, La Salle, McMullen, Nueces, Refugio, San Patricio, Starr, Victoria, Webb, Willacy, Zapata
Wellcare No Premium (HMO) H5294-017 Atascosa, Bandera, Bexar, Comal, DeWitt, Dimmit, Gonzales, Guadalupe, Karnes, Kendall, Maverick, Medina, Real, Uvalde, Wilson, Zavala
Wellcare No Premium (HMO) H5294-018 Armstrong, Bailey, Borden, Briscoe, Castro, Cochran, Coke, Crosby, Dickens, Donley, Fisher, Floyd, Garza, Glasscock, Hale, Hockley, Irion, Kent, Lamb, Lubbock, Lynn, Martin, Mitchell, Nolan, Shackelford, Sterling, Swisher, Terry, Throckmorton
Wellcare TexanPlus Patriot Giveback (HMO) H4506-010 Austin, Brazoria, Chambers, Fort Bend, Galveston (partial county), Hardin, Harris, Jefferson, Liberty, Montgomery, Orange, Walker, Waller
Wellcare TexanPlus No Premium (HMO) H0174-002 Bastrop, Blanco, Burnet, Caldwell, Hays, Lee, Milam, Travis, Williamson
Wellcare TexanPlus No Premium (HMO) H0174-011-001 Bexar, Comal, Guadalupe
Wellcare TexanPlus No Premium (HMO) H0174-011-002 El Paso
Wellcare TexanPlus No Premium (HMO) H0174-011-003 Chambers, Galveston, Walker
Wellcare TexanPlus No Premium (HMO) H0174-011-004 Cooke
Wellcare TexanPlus No Premium (HMO)  H0174-014 Collin, Dallas, Denton, Johnson, Rockwall, Tarrant
Wellcare TexanPlus Classic No Premium (HMO) H4506-003 Austin, Brazoria, Chambers, Fort Bend, Galveston (partial County), Hardin, Harris, Jefferson, Liberty, Montgomery, Orange, Walker, Waller
Wellcare Giveback (HMO) H0174-013-001 Bastrop, Blanco, Burnet, Caldwell, Hays, Lee, Milam, Travis, Williamson
Wellcare Giveback (HMO) H0174-013-002 Collin, Cooke, Dallas, Denton, Johnson, Rockwall, Tarrant
Wellcare Giveback (HMO) H0174-013-003 Austin, Chambers, Fort Bend, Galveston, Hardin, Harris, Jefferson, Liberty, Matagorda, Montgomery, Newton, Orange, Polk, San Jacinto, Walker, Waller, Wharton
Wellcare Giveback (HMO) H0174-013-004 Bexar, Comal, Guadalupe
Wellcare Giveback (HMO) H0174-013-005 El Paso
Wellcare Giveback (HMO) H5294-012 Aransas, Bee, Brooks, Cameron, Duval, Goliad, Hidalgo, Jim Hogg, Jim Wells, Kenedy, Kleberg, La Salle, McMullen, Nueces, Refugio, San Patricio, Starr, Victoria, Webb, Willacy, Zapata
Wellcare Giveback (HMO) H5294-019 Armstrong, Bailey, Borden, Briscoe, Castro, Cochran, Coke, Crosby, Dickens, Donley, Fisher, Floyd, Garza, Glasscock, Hale, Hockley, Irion, Kent, Lamb, Lubbock, Lynn, Martin, Mitchell, Nolan, Shackelford, Sterling, Swisher, Terry, Throckmorton
Wellcare Patriot No Premium (HMO) H5294-014 Aransas, Armstrong, Atascosa, Bailey, Bandera, Bastrop, Bee, Bexar, Blanco, Borden, Bosque, Briscoe, Brooks, Burnet, Caldwell, Calhoun, Cameron, Castro, Cochran, Coke, Collin, Colorado, Comal, Crosby, Dallas, Denton, DeWitt, Dickens, Dimmit, Donley, Duval, El Paso, Erath, Fayette, Fisher, Floyd, Garza, Gillespie, Glasscock, Goliad, Gonzales, Grayson, Grimes, Guadalupe, Hale, Hamilton, Hays, Hidalgo, Hill, Hockley, Hunt, Irion, Jack, Jim Hogg, Jim Wells, Karnes, Kendall, Kenedy, Kent, Kimble, Kleberg, La Salle, Lamb, Lee, Leon, Limestone, Lubbock, Lynn, Martin, Mason, Maverick, McCulloch, McMullen, Medina, Milam, Mills, Mitchell, Navarro, Nolan, Nueces, Palo Pinto, Real, Refugio, Rockwall, San Patricio, San Saba, Shackelford, Somervell, Starr, Sterling, Swisher, Tarrant, Terry, Throckmorton, Uvalde, Van Zandt, Victoria, Webb, Willacy, Williamson, Wilson, Zapata, Zavala
Wellcare Assist (HMO) H0174-009 Austin, Bastrop, Bexar, Blanco, Burnet, Caldwell, Chambers, Collin, Comal, Cooke, Dallas, Denton, El Paso, Fort Bend, Galveston, Guadalupe, Hardin, Harris, Hays, Jefferson, Johnson, Lee, Liberty, Matagorda, Milam, Montgomery, Newton, Orange, Polk, Rockwall, San Jacinto, Tarrant, Travis, Walker, Waller, Wharton, Williamson
Wellcare Complement Assist (HMO) H5294-013 Aransas, Bee, Brooks, Cameron, Duval, Goliad, Hidalgo, Jim Hogg, Jim Wells, Kenedy, Kleberg, La Salle, McMullen, Nueces, Refugio, San Patricio, Starr, Victoria, Webb, Willacy, Zapata
Wellcare Complement Assist (HMO) H5294-016 Armstrong, Atascosa, Bailey, Bandera, Bastrop, Bexar, Blanco, Borden, Bosque, Briscoe, Burnet, Caldwell, Calhoun, Castro, Cochran, Coke, Collin, Colorado, Comal, Crosby, Dallas, Denton, DeWitt, Dickens, Dimmit, Donley, El Paso, Erath, Fayette, Fisher, Floyd, Garza, Gillespie, Glasscock, Gonzales, Grayson, Grimes, Guadalupe, Hale, Hamilton, Hays, Hill, Hockley, Hunt, Irion, Jack, Karnes, Kendall, Kent, Kimble, Lamb, Lee, Leon, Limestone, Lubbock, Lynn, Martin, Mason, Maverick, McCulloch, Medina, Milam, Mills, Mitchell, Navarro, Nolan, Palo Pinto, Real, Rockwall, San Saba, Shackelford, Somervell, Sterling, Swisher, Tarrant, Terry, Throckmorton, Uvalde, Van Zandt, Williamson, Wilson, Zavala

 

For HMO D-SNP Members:

Plan Name CMS # County  Evidence of Coverage
Wellcare Dual Access (HMO D-SNP) H0174-004

Austin, Bastrop, Bexar, Blanco, Burnet, Caldwell, Chambers, Comal, Dallas, Denton, El Paso, Fort Bend, Galveston, Guadalupe, Hardin, Harris, Hays, Jefferson, Johnson, Lee, Liberty, Matagorda, Milam, Montgomery, Newton, Orange, Polk, San Jacinto, San Patricio, Tarrant, Walker, Waller, Wharton

Wellcare Dual Access Harmony (HMO D-SNP) H5294-015

Aransas, Armstrong, Atascosa, Bailey, Bandera, Bastrop, Bee, Bexar, Blanco, Borden, Bosque, Briscoe, Brooks, Burnet, Caldwell, Calhoun, Cameron, Castro, Cochran, Coke, Collin, Colorado, Comal, Crosby, Dallas, Denton, DeWitt, Dickens, Dimmit, Donley, Duval, El Paso, Erath, Fayette, Fisher, Floyd, Garza, Gillespie, Glasscock, Goliad, Gonzales, Grayson, Grimes, Guadalupe, Hale, Hamilton, Hays, Hidalgo, Hill, Hockley, Hunt, Irion, Jack, Jim Hogg, Jim Wells, Karnes, Kendall, Kenedy, Kent, Kimble, Kleberg, La Salle, Lamb, Lee, Leon, Limestone, Lubbock, Lynn, Martin, Mason, Maverick, McCulloch, McMullen, Medina, Milam, Mills, Mitchell, Navarro, Nolan, Nueces, Palo Pinto, Real, Refugio, Rockwall, San Patricio, San Saba, Shackelford, Somervell, Starr, Sterling, Swisher, Tarrant, Terry, Throckmorton, Uvalde, Van Zandt, Victoria, Webb, Willacy, Williamson, Wilson, Zapata, Zavala

Wellcare Dual Liberty (HMO D-SNP) H0174-006

Austin, Bastrop, Bexar, Blanco, Burnet, Caldwell, Chambers, Comal, Cooke, Dallas, Denton, El Paso, Fort Bend, Galveston, Guadalupe, Hardin, Harris, Hays, Jefferson, Johnson, Lee, Liberty, Matagorda, Milam, Montgomery, Newton, Orange, Polk, San Jacinto, San Patricio, Tarrant, Walker, Waller, Wharton

Wellcare Dual Liberty Nurture (HMO D-SNP) H5294-010 Aransas, Armstrong, Atascosa, Bailey, Bandera, Bee, Bexar, Borden, Bosque, Briscoe, Brooks, Calhoun, Cameron, Castro, Cochran, Coke, Collin, Colorado, Comal, Crosby, Dallas, Denton, DeWitt, Dickens, Dimmit, Donley, Duval, El Paso, Erath, Fayette, Fisher, Floyd, Garza, Gillespie, Glasscock, Goliad, Gonzales, Grayson, Grimes, Guadalupe, Hale, Hamilton, Hidalgo, Hill, Hockley, Hunt, Irion, Jack, Jim Hogg, Jim Wells, Karnes, Kendall, Kenedy, Kent, Kimble, Kleberg, La Salle, Lamb, Leon, Limestone, Lubbock, Lynn, Martin, Mason, Maverick, McCulloch, McMullen, Medina, Mills, Mitchell, Navarro, Nolan, Nueces, Palo Pinto, Real, Refugio, Rockwall, San Patricio, San Saba, Shackelford, Somervell, Starr, Sterling, Swisher, Tarrant, Terry, Throckmorton, Uvalde, Van Zandt, Victoria, Webb, Willacy, Wilson, Zapata, Zavala

For HMO C-SNP Members

Plan Name CMS # County  Evidence of Coverage
Wellcare Specialty No Premium (HMO C-SNP) H0174-008

Austin, Bexar, Chambers, Comal, El Paso, Fort Bend, Galveston, Guadalupe, Harris, Liberty, Matagorda, Montgomery, Polk, San Jacinto, Walker, Waller, Wharton

For HMO-POS Members

Plan Name CMS # County  Evidence of Coverage
Wellcare No Premium (HMO-POS) H0174-012-001

Bastrop, Blanco, Burnet, Caldwell, Hays, Lee, Milam, Travis, Williamson

Wellcare No Premium (HMO-POS) H0174-012-002 Collin, Cooke, Dallas, Denton, Johnson, Rockwall, Tarrant
Wellcare No Premium (HMO-POS) H0174-012-003 Austin, Chambers, Fort Bend, Galveston, Hardin, Harris, Jefferson, Liberty, Matagorda, Montgomery, Newton, Orange, Polk, San Jacinto, Walker, Waller, Wharton
Wellcare No Premium (HMO-POS) H0174-012-004 Bexar, Comal, Guadalupe
Wellcare No Premium (HMO-POS) H0174-012-005 El Paso
Wellcare TexanPlus No Premium (HMO-POS) H4506-029 Austin, Brazoria, Chambers, Fort Bend, Galveston (partial county), Hardin, Harris, Jefferson, Liberty, Montgomery, Orange, Walker, Waller

For PPO Members

Plan Name CMS # County  Evidence of Coverage
Wellcare No Premium Open (PPO) H7323-001

Bastrop, Blanco, Burnet, Caldwell, Hays, Lee, Milam, Travis, Williamson

Wellcare No Premium Open (PPO) H7323-002

Collin, Dallas, Denton, Johnson, Rockwall, Tarrant

Wellcare No Premium Open (PPO) H7323-003

Austin, Brazoria, Chambers, Fort Bend, Galveston, Hardin, Harris, Jefferson, Liberty, Montgomery, Orange, Polk, San Jacinto, Walker, Waller

Wellcare No Premium Open (PPO) H7323-004

Atascosa, Bexar, El Paso, Medina

Wellcare No Premium Rx Plus Open (PPO) H7323-006 Atascosa, Austin, Bastrop, Bexar, Blanco, Brazoria, Burnet, Caldwell, Chambers, Collin, Comal, Cooke, Dallas, Denton, El Paso, Fort Bend, Galveston, Guadalupe, Hardin, Harris, Hays, Hidalgo, Jefferson, Johnson, Lee, Liberty, Medina, Milam, Montgomery, Orange, Polk, Rockwall, San Jacinto, Starr, Tarrant, Travis, Walker, Waller, Williamson
Wellcare No Premium Open (PPO) H7323-007 Hidalgo, Starr

For PPO D-SNP Members

Plan Name CMS # County  Evidence of Coverage
Wellcare Dual Access Open (PPO D-SNP) H7323-005

Atascosa, Austin, Bastrop, Bexar, Blanco, Brazoria, Burnet, Caldwell, Chambers, Collin, Comal, Cooke, Dallas, Denton, El Paso, Fort Bend, Galveston, Guadalupe, Hardin, Harris, Hays, Hidalgo, Jefferson, Johnson, Lee, Liberty, Medina, Milam, Montgomery, Orange, Polk, Rockwall, San Jacinto, Starr, Tarrant, Travis, Walker, Waller, Williamson

If you were enrolled in Superior HealthPlan Medicare Advantage last year, this booklet will tell you about changes to your plan’s costs and benefits for the coming year.

Please select the document for your plan and county:

For HMO Members:

Plan Name CMS # County Annual Notice of Changes
Wellcare No Premium Medicare (HMO) H0062-002

Aransas, Bexar, Collin, Comal, Dallas, Denton, El Paso, Guadalupe, Jim Wells, Nueces, Rockwall, Tarrant, Wilson

Allwell Medicare (HMO) to Wellcare No Premium Medicare (HMO) H0062-001 - H0062-002

Aransas, Bexar, Collin, Comal, Dallas, Denton, El Paso, Guadalupe, Jim Wells, Nueces, Rockwall, Tarrant, Wilson

Wellcare No Premium Medicare (HMO) H0062-003

Cameron, Hidalgo, Starr

Wellcare No Premium (HMO) H5294-011 Aransas, Bee, Brooks, Cameron, Duval, Goliad, Hidalgo, Jim Hogg, Jim Wells, Kenedy, Kleberg, La Salle, McMullen, Nueces, Refugio, San Patricio, Starr, Victoria, Webb, Willacy, Zapata
Wellcare Giveback (HMO) H5294-012  
Wellcare Complement Assist (HMO) H5294-013  
Wellcare Patriot No Premium (HMO) H5294-014  
Wellcare Complement Assist (HMO) H5294-016  
Wellcare No Premium (HMO) H5294-017 Atascosa, Bandera, Bexar, Comal, DeWitt, Dimmit, Gonzales, Guadalupe, Karnes, Kendall, Maverick, Medina, Real, Uvalde, Wilson, Zavala
Wellcare No Premium (HMO) H5294-018 Armstrong, Bailey, Borden, Briscoe, Castro, Cochran, Coke, Crosby, Dickens, Donley, Fisher, Floyd, Garza, Glasscock, Hale, Hockley, Irion, Kent, Lamb, Lubbock, Lynn, Martin, Mitchell, Nolan, Shackelford, Sterling, Swisher, Terry, Throckmorton

For HMO D-SNP Members:

Plan Name CMS # County Annual Notice of Changes
Wellcare Dual Liberty Nurture (HMO D-SNP) H5294-010 Aransas, Armstrong, Atascosa, Bailey, Bandera, Bee, Bexar, Borden, Bosque, Briscoe, Brooks, Calhoun, Cameron, Castro, Cochran, Coke, Collin, Colorado, Comal, Crosby, Dallas, Denton, DeWitt, Dickens, Dimmit, Donley, Duval, El Paso, Erath, Fayette, Fisher, Floyd, Garza, Gillespie, Glasscock, Goliad, Gonzales, Grayson, Grimes, Guadalupe, Hale, Hamilton, Hidalgo, Hill, Hockley, Hunt, Irion, Jack, Jim Hogg, Jim Wells, Karnes, Kendall, Kenedy, Kent, Kimble, Kleberg, La Salle, Lamb, Leon, Limestone, Lubbock, Lynn, Martin, Mason, Maverick, McCulloch, McMullen, Medina, Mills, Mitchell, Navarro, Nolan, Nueces, Palo Pinto, Real, Refugio, Rockwall, San Patricio, San Saba, Shackelford, Somervell, Starr, Sterling, Swisher, Tarrant, Terry, Throckmorton, Uvalde, Van Zandt, Victoria, Webb, Willacy, Wilson, Zapata, Zavala
Wellcare Dual Access Harmony (HMO D-SNP) H5294-015

Aransas, Armstrong, Atascosa, Bailey, Bandera, Bastrop, Bee, Bexar, Blanco, Borden, Bosque, Briscoe, Brooks, Burnet, Caldwell, Calhoun, Cameron, Castro, Cochran, Coke, Collin, Colorado, Comal, Crosby, Dallas, Denton, DeWitt, Dickens, Dimmit, Donley, Duval, El Paso, Erath, Fayette, Fisher, Floyd, Garza, Gillespie, Glasscock, Goliad, Gonzales, Grayson, Grimes, Guadalupe, Hale, Hamilton, Hays, Hidalgo, Hill, Hockley, Hunt, Irion, Jack, Jim Hogg, Jim Wells, Karnes, Kendall, Kenedy, Kent, Kimble, Kleberg, La Salle, Lamb, Lee, Leon, Limestone, Lubbock, Lynn, Martin, Mason, Maverick, McCulloch, McMullen, Medina, Milam, Mills, Mitchell, Navarro, Nolan, Nueces, Palo Pinto, Real, Refugio, Rockwall, San Patricio, San Saba, Shackelford, Somervell, Starr, Sterling, Swisher, Tarrant, Terry, Throckmorton, Uvalde, Van Zandt, Victoria, Webb, Willacy, Williamson, Wilson, Zapata, Zavala

Allwell Medicare Nurture (HMO D-SNP) to Wellcare Dual Access Harmony (HMO D-SNP) H5294-010 - H5294-015  



Take Charge of Your Mental Health

We all have our struggles.

Finding support to focus on your emotional health is important.

Now you can use web and mobile tools to help you get better and stay mentally strong.

myStrength is a free online tool to help you live your best life. myStrength is available 24/7 from your computer or mobile device. It offers personalized resources to improve your mood. Learning to use myStrength’s tools can help you overcome the challenges you face.

On myStrength you will find:

  • Hundreds of wellness resources
  • Self-help tools
  • Online health trackers
  • Personalized activities
  • Uplifting daily quotes

Safe, secure, effective.

Your privacy is our top priority. myStrength is a confidential and safe place for you.

SIGN UP TODAY

1. Visit the myStrength website.

2. Complete the myStrength sign-up process and personal profile.

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American Diabetes Association Diabetes Resources

Allwell from Superior HealthPlan has partnered with the American Diabetes Association (ADA) to help our members living with diabetes thrive! This partnership offers educational support and content to help manage diabetes, through food and healthy eating. Explore what we have to offer below to get the most of your diabetes care. Access ADA’s diabetes food hub, meal plans, budget-friendly recipes and much more!

From the nutrition experts at the American Diabetes Association, Diabetes Food Hub® is the premier food and cooking destination for people living with diabetes.  Click the link above to go to the Hub.

Diabetes Food Hub – How to Use (PDF)

Meal Plan – Budget-Friendly (PDF)

Meal Plan – Latin Foods (PDF)

Meal Plan – Southern-Style Foods (PDF)

Click here to watch how to use the Food Hub

 

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