Plan Benefit Materials | Allwell from Superior HealthPlan
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 By Allwell

Wellcare Patriot Simple (HMO) H5294-014
Counties: Armstrong, Atascosa, Bailey, Bandera, Bexar, Blanco, Borden, Briscoe, Castro, Collin, Comal, Crosby, Dallas, Denton, DeWitt, Ector, El Paso, Ellis, Fisher, Floyd, Garza, Glasscock, Gonzales, Guadalupe, Hockley, Hood, Kendall, Kent, La Salle, Lamb, Lubbock, Lynn, Martin, Medina, Milam, Nolan, Parker, Potter, Randall, Real, Rockwall, Shackelford, Sterling, Swisher, Tarrant, Terry, Throckmorton, Uvalde, Wilson, Wise, Zavala
Annual Notice of Change
Summary of Benefits
Evidence of Coverage
- Evidence of Coverage - English (PDF)
- Evidence of Coverage - Spanish (PDF) - Coming Soon
Dental Benefit Details
- Dental Benefit Details - English (PDF) - Coming Soon
- Dental Benefit Details - Spanish (PDF) - Coming Soon
Your OTC Highlight
Wellcare Simple (HMO) H5294-017
Counties: Atascosa, Bandera, DeWitt, Gonzales, Kendall, Medina, Wilson
Annual Notice of Change
Summary of Benefits
Evidence of Coverage
- Evidence of Coverage - English (PDF)
- Evidence of Coverage - Spanish (PDF) - Coming Soon
Dental Benefit Details
- Dental Benefit Details - English (PDF) - Coming Soon
- Dental Benefit Details - Spanish (PDF) - Coming Soon
Wellcare Simple (HMO) H5294-018
Counties: Armstrong, Bailey, Borden, Briscoe, Castro, Crosby, Ector, Fisher, Floyd, Garza, Glasscock, Hockley, Kent, La Salle, Lamb, Lubbock, Lynn, Martin, Nolan, Potter, Randall, Real, Shackelford, Sterling, Swisher, Terry, Throckmorton, Uvalde, Zavala
Annual Notice of Change
- Annual Notice of Change - English (PDF)
- Annual Notice of Change: Wellcare Giveback (HMO) H5294-019 to Wellcare Simple (HMO) H5294-018 - Spanish (PDF)
- Annual Notice of Change: Wellcare Giveback (HMO) H5294-019 to Wellcare Simple (HMO) H5294-018 - English (PDF)
- Annual Notice of Change - Spanish (PDF)
Summary of Benefits
Evidence of Coverage
- Evidence of Coverage - English (PDF)
- Evidence of Coverage - Spanish (PDF) - Coming Soon
Dental Benefit Details
- Dental Benefit Details - English (PDF) - Coming Soon
- Dental Benefit Details - Spanish (PDF) - Coming Soon
Your OTC Highlight
Wellcare Simple Value (HMO) H5294-026
Counties: Austin, Bastrop, Baylor, Burleson, Burnet, Caldwell, Callahan, Chambers, Clay, Coleman, Concho, Cooke, Coryell, Crane, Crockett, Dallam, Eastland, Edwards, Falls, Fayette, Fort Bend, Freestone, Frio, Gray, Hansford, Hardin, Hartley, Haskell, Hays, Hidalgo, Howard, Jackson, Johnson, Jones, Kinney, Knox, Lampasas, Lavaca, Lee, Liberty, Llano, Menard, Midland, Montgomery, Moore, Motley, Oldham, Polk, Reagan, Roberts, Runnels, San Jacinto, Schleicher, Sherman, Stephens, Stonewall, Sutton, Taylor, Tom Green, Upton, Washington, Wharton, Wheeler, Williamson, Yoakum
Summary of Benefits
Evidence of Coverage
- Evidence of Coverage - English (PDF)
- Evidence of Coverage - Spanish (PDF) - Coming Soon
Dental Benefit Details
- Dental Benefit Details - English (PDF) - Coming Soon
- Dental Benefit Details - Spanish (PDF) - Coming Soon
Wellcare Superior HealthPlan Dual Liberty (HMO D-SNP) H5294-010
Counties: Atascosa, Bandera, Grayson, Hood, Kendall, Medina, Parker, Smith, Van Zandt, Wilson, Wise
Annual Notice of Change
- Annual Notice of Change: Wellcare Dual Liberty (HMO D-SNP) H5294-010 to Wellcare Superior HealthPlan Dual Liberty (HMO D-SNP) H5294-010 - English (PDF)
- Annual Notice of Change: Wellcare Dual Liberty (HMO D-SNP) H5294-010 to Wellcare Superior HealthPlan Dual Liberty (HMO D-SNP) H5294-010 - Spanish (PDF)
Summary of Benefits
Evidence of Coverage
- Evidence of Coverage - English (PDF)
- Evidence of Coverage - Spanish (PDF) - Coming Soon
Dental Benefit Details
- Dental Benefit Details - English (PDF) - Coming Soon
- Dental Benefit Details - Spanish (PDF) - Coming Soon
Your OTC Highlight
Wellcare Superior HealthPlan Dual Liberty Sync (HMO D-SNP) H5294-021
Counties: Cameron, Duval, Jim Hogg, Maverick, McMullen, Starr, Webb, Willacy, Zapata
Annual Notice of Change
- Annual Notice of Change: Wellcare Dual Liberty (HMO D-SNP) H5294-010 to Wellcare Superior HealthPlan Dual Liberty Sync (HMO D-SNP) H5294-021 - English (PDF)
- Annual Notice of Change: Wellcare Dual Liberty (HMO D-SNP) H5294-010 to Wellcare Superior HealthPlan Dual Liberty Sync (HMO D-SNP) H5294-021 - Spanish (PDF)
- Annual Notice of Change: Wellcare Dual Liberty Sync (HMO D-SNP) H5294-021 to Wellcare Superior HealthPlan Dual Liberty Sync (HMO D-SNP) H5294-021 - English (PDF)
- Annual Notice of Change: Wellcare Dual Liberty Sync (HMO D-SNP) H5294-021 to Wellcare Superior HealthPlan Dual Liberty Sync (HMO D-SNP) H5294-021 - Spanish (PDF)
Summary of Benefits
Evidence of Coverage
- Evidence of Coverage - English (PDF)
- Evidence of Coverage - Spanish (PDF) - Coming Soon
Dental Benefit Details
- Dental Benefit Details - English (PDF) - Coming Soon
- Dental Benefit Details - Spanish (PDF) - Coming Soon
Your OTC Highlight
Wellcare Superior HealthPlan Dual Liberty Sync (HMO D-SNP) H5294-022
Counties: Aransas, Bee, Brooks, Calhoun, Goliad, Jim Wells, Karnes, Kenedy, Kleberg, Nueces, Refugio, San Patricio, Victoria
Annual Notice of Change
- Annual Notice of Change: Wellcare Dual Liberty (HMO D-SNP) H5294-010 to Wellcare Superior HealthPlan Dual Liberty Sync (HMO D-SNP) H5294-022 - English (PDF)
- Annual Notice of Change: Wellcare Dual Liberty (HMO D-SNP) H5294-010 to Wellcare Superior HealthPlan Dual Liberty Sync (HMO D-SNP) H5294-022 - Spanish (PDF)
- Annual Notice of Change: Wellcare Dual Liberty Sync (HMO D-SNP) H5294-022 to Wellcare Superior HealthPlan Dual Liberty Sync (HMO D-SNP) H5294-022 - English (PDF)
- Annual Notice of Change: Wellcare Dual Liberty Sync (HMO D-SNP) H5294-022 to Wellcare Superior HealthPlan Dual Liberty Sync (HMO D-SNP) H5294-022 - Spanish (PDF)
Summary of Benefits
Evidence of Coverage
- Evidence of Coverage - English (PDF)
- Evidence of Coverage - Spanish (PDF) - Coming Soon
Dental Benefit Details
- Dental Benefit Details - English (PDF) - Coming Soon
- Dental Benefit Details - Spanish (PDF) - Coming Soon
Your OTC Highlight
Wellcare Superior HealthPlan Dual Liberty Sync (HMO D-SNP) H5294-023
Counties: Carson, Crosby, Deaf Smith, Floyd, Garza, Hale, Hockley, Hutchinson, Lamb, Lubbock, Lynn, Potter, Randall, Swisher, Terry
Annual Notice of Change
- Annual Notice of Change: Wellcare Dual Liberty (HMO D-SNP) H5294-010 to Wellcare Superior HealthPlan Dual Liberty Sync (HMO D-SNP) H5294-023 - English (PDF)
- Annual Notice of Change: Wellcare Dual Liberty (HMO D-SNP) H5294-010 to Wellcare Superior HealthPlan Dual Liberty Sync (HMO D-SNP) H5294-023 - Spanish (PDF)
- Annual Notice of Change: Wellcare Dual Liberty Sync (HMO D-SNP) H5294-023 to Wellcare Superior HealthPlan Dual Liberty Sync (HMO D-SNP) H5294-023 - English (PDF)
- Annual Notice of Change: Wellcare Dual Liberty Sync (HMO D-SNP) H5294-023 to Wellcare Superior HealthPlan Dual Liberty Sync (HMO D-SNP) H5294-023 - Spanish (PDF)
Summary of Benefits
Evidence of Coverage
- Evidence of Coverage - English (PDF)
- Evidence of Coverage - Spanish (PDF) - Coming Soon
Dental Benefit Details
- Dental Benefit Details - English (PDF) - Coming Soon
- Dental Benefit Details - Spanish (PDF) - Coming Soon
Your OTC Highlight
Wellcare Superior HealthPlan Dual Liberty Sync (HMO D-SNP) H5294-024
Counties: Bosque, Colorado, DeWitt, Erath, Gillespie, Gonzales, Grimes, Hamilton, Hill, Leon, Limestone, Madison, Mills, Robertson, San Saba, Somervell
Annual Notice of Change
- Annual Notice of Change: Wellcare Dual Liberty (HMO D-SNP) H5294-010 to Wellcare Superior HealthPlan Dual Liberty Sync (HMO D-SNP) H5294-024 - English (PDF)
- Annual Notice of Change: Wellcare Dual Liberty (HMO D-SNP) H5294-010 to Wellcare Superior HealthPlan Dual Liberty Sync (HMO D-SNP) H5294-024 - Spanish (PDF)
- Annual Notice of Change: Wellcare Dual Liberty Sync (HMO D-SNP) H5294-024 to Wellcare Superior HealthPlan Dual Liberty Sync (HMO D-SNP) H5294-024 - English (PDF)
- Annual Notice of Change: Wellcare Dual Liberty Sync (HMO D-SNP) H5294-024 to Wellcare Superior HealthPlan Dual Liberty Sync (HMO D-SNP) H5294-024 - Spanish (PDF)
Summary of Benefits
Evidence of Coverage
- Evidence of Coverage - English (PDF)
- Evidence of Coverage - Spanish (PDF) - Coming Soon
Dental Benefit Details
- Dental Benefit Details - English (PDF) - Coming Soon
- Dental Benefit Details - Spanish (PDF) - Coming Soon
Your OTC Highlight
Wellcare Superior HealthPlan Dual Liberty Sync (HMO D-SNP) H5294-025
Counties: Armstrong, Bailey, Borden, Briscoe, Castro, Cochran, Coke, Dickens, Dimmit, Donley, Ector, Fisher, Glasscock, Irion, Jack, Kent, Kimble, La Salle, Martin, Mason, McCulloch, Mitchell, Nolan, Palo Pinto, Real, Shackelford, Sterling, Throckmorton, Uvalde, Zavala
Annual Notice of Change
- Annual Notice of Change: Wellcare Dual Liberty (HMO D-SNP) H5294-010 to Wellcare Superior HealthPlan Dual Liberty Sync (HMO D-SNP) H5294-025 - English (PDF)
- Annual Notice of Change: Wellcare Dual Liberty (HMO D-SNP) H5294-010 to Wellcare Superior HealthPlan Dual Liberty Sync (HMO D-SNP) H5294-025 - Spanish (PDF)
- Annual Notice of Change: Wellcare Dual Liberty Sync (HMO D-SNP) H5294-025 to Wellcare Superior HealthPlan Dual Liberty Sync (HMO D-SNP) H5294-025 - English (PDF)
- Annual Notice of Change: Wellcare Dual Liberty Sync (HMO D-SNP) H5294-025 to Wellcare Superior HealthPlan Dual Liberty Sync (HMO D-SNP) H5294-025 - Spanish (PDF)
Summary of Benefits
Evidence of Coverage
- Evidence of Coverage - English (PDF)
- Evidence of Coverage - Spanish (PDF) - Coming Soon
Your OTC Highlight
HMO D-SNP Plans
Wellcare Superior HealthPlan Dual Align (HMO D-SNP) H0062-011
Counties: Dallas
Annual Notice of Change
Summary of Benefits
Member Handbook
- Member Handbook - English (PDF)
- Member Handbook - Spanish (PDF) - Coming Soon
Dental Benefit Details
- Dental Benefit Details - English (PDF) - Coming Soon
- Dental Benefit Details - Spanish (PDF) - Coming Soon
Your OTC Highlight
Wellcare Superior HealthPlan Dual Align (HMO D-SNP) H0062-012
Counties: Hidalgo
Annual Notice of Change
Summary of Benefits
Member Handbook
- Member Handbook - English (PDF)
- Member Handbook - Spanish (PDF) - Coming Soon
Dental Benefit Details
- Dental Benefit Details - English (PDF) - Coming Soon
- Dental Benefit Details - Spanish (PDF) - Coming Soon
Your OTC Highlight
Wellcare Superior HealthPlan Dual Reserve Value (HMO D-SNP) H0062-013
Counties: Armstrong, Atascosa, Austin, Bailey, Bandera, Bee, Bexar, Blanco, Borden, Bosque, Briscoe, Brooks, Burleson, Burnet, Caldwell, Carson, Castro, Chambers, Clay, Cochran, Coke, Collin, Colorado, Cooke, Coryell, Crane, Crosby, Dallam, Dawson, Deaf Smith, Dickens, Donley, Duval, Edwards, El Paso, Ellis, Erath, Falls, Fayette, Floyd, Fort Bend, Garza, Gillespie, Glasscock, Goliad, Gonzales, Grimes, Hale, Hamilton, Hansford, Hartley, Hays, Hill, Hockley, Howard, Hutchinson, Irion, Jack, Jackson, Jim Hogg, Jim Wells, Johnson, Karnes, Kendall, Kenedy, Kent, Kimble, Kinney, Kleberg, La Salle, Lamb, Lampasas, Lavaca, Lee, Leon, Liberty, Llano, Lubbock, Lynn, Madison, Martin, Mason, McCulloch, McMullen, Medina, Menard, Milam, Mills, Mitchell, Montgomery, Moore, Motley, Navarro, Oldham, Palo Pinto, Potter, Randall, Reagan, Real, Refugio, Roberts, Robertson, Rockwall, San Jacinto, San Saba, Shackelford, Sherman, Smith, Somervell, Starr, Sterling, Swisher, Tarrant, Terry, Throckmorton, Upton, Van Zandt, Washington, Wharton, Willacy, Williamson, Wilson, Wise, Yoakum, Zavala
Summary of Benefits
Evidence of Coverage
- Evidence of Coverage - English (PDF)
- Evidence of Coverage - Spanish (PDF) - Coming Soon
Dental Benefit Details
- Dental Benefit Details - English (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.

