Plan Benefit Materials | Allwell from Superior HealthPlan

2026 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 By Allwell

HMO Plans

Wellcare Assist (HMO) H5294-013

Counties: Bee, Brooks, Cameron, Duval, Goliad, Hidalgo, Jim Hogg, Jim Wells, Karnes, Kenedy, Kleberg, Maverick, Mcmullen, Nueces, San Patricio, Starr, Webb, Willacy, Zapata

Annual Notice of Change

Summary of Benefits

Evidence of Coverage

  • Evidence of Coverage - English (PDF) - Coming Soon
  • 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 Assist (HMO) H5294-016

Counties: Armstrong, Bailey, Borden, Briscoe, Castro, Crosby, Ector, Fisher, Floyd, Garza, Hockley, Jack, Kent, Kimble, La Salle, Lamb, Lubbock, Lynn, Martin, Mason, Mcculloch, Nolan, Palo Pinto, Potter, Randall, Shackelford, Sterling, Swisher, Terry, Throckmorton

Annual Notice of Change

Summary of Benefits

Evidence of Coverage

  • Evidence of Coverage - English (PDF) - Coming Soon
  • 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 Giveback (HMO) H5294-019

Counties: Armstrong, Bailey, Borden, Briscoe, Castro, Crosby, Ector, Fisher, Floyd, Garza, Glasscock, Hockley, Kent, Lamb, Lubbock, Lynn, Martin, Nolan, Shackelford, Sterling, Swisher, Terry, Throckmorton

Annual Notice of Change

Summary of Benefits

Evidence of Coverage

  • Evidence of Coverage - English (PDF) - Coming Soon
  • 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 Patriot Simple (HMO) H5294-014

Counties: Armstrong, Atascosa, Bailey, Bandera, Bastrop, Bee, Bexar, Blanco, Borden, Briscoe, Brooks, Burnet, Caldwell, Cameron, Castro, Collin, Colorado, Comal, Crosby, Dallas, Denton, Dewitt, Duval, Ector, El Paso, Ellis, Fisher, Floyd, Garza, Glasscock, Goliad, Gonzales, Grimes, Guadalupe, Hays, Hidalgo, Hockley, Hood, Jack, Jim Hogg, Jim Wells, Karnes, Kendall, Kenedy, Kent, Kimble, Kleberg, La Salle, Lamb, Lee, Lubbock, Lynn, Martin, Mason, Maverick, Mcculloch, Mcmullen, Medina, Milam, Nolan, Nueces, Palo Pinto, Parker, Potter, Randall, Real, Refugio, Rockwall, San Patricio, Shackelford, Starr, Sterling, Swisher, Tarrant, Terry, Throckmorton, Uvalde, Webb, Willacy, Williamson, Wilson, Wise, Zapata, Zavala

Annual Notice of Change

Summary of Benefits

Evidence of Coverage

  • Evidence of Coverage - English (PDF) - Coming Soon
  • 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) H5294-011

Counties: Bee, Brooks, Cameron, Duval, Hidalgo, Jim Hogg, Jim Wells, Karnes, Kenedy, Kleberg, Maverick, Mcmullen, Nueces, San Patricio, Starr, Webb, Willacy, Zapata

Annual Notice of Change

Summary of Benefits

Evidence of Coverage

  • Evidence of Coverage - English (PDF) - Coming Soon
  • 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) - Coming Soon
  • 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) H5294-018

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

Summary of Benefits

Evidence of Coverage

  • Evidence of Coverage - English (PDF) - Coming Soon
  • Evidence of Coverage - Spanish (PDF) - Coming Soon

Dental Benefit Details

  • Dental Benefit Details - English (PDF) - Coming Soon
  • Dental Benefit Details - Spanish (PDF) - Coming Soon

HMO D-SNP Plans

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

Counties: Aransas, Armstrong, Atascosa, Bailey, Bandera, Bee, Borden, Bosque, Briscoe, Brooks, Calhoun, Cameron, Carson, Castro, Cochran, Coke, Colorado, Crosby, Deaf Smith, Dewitt, Dickens, Dimmit, Donley, Duval, Ector, Ellis, Erath, Fisher, Floyd, Garza, Gillespie, Glasscock, Goliad, Gonzales, Grayson, Grimes, Hale, Hamilton, Hidalgo, Hill, Hockley, Hood, Hunt, Hutchinson, Irion, Jack, Jim Hogg, Jim Wells, Karnes, Kendall, Kenedy, Kent, Kimble, Kleberg, La Salle, Lamb, Leon, Limestone, Lubbock, Lynn, Madison, Martin, Mason, Maverick, Mcculloch, Mcmullen, Medina, Mills, Mitchell, Navarro, Nolan, Nueces, Palo Pinto, Parker, Potter, Randall, Real, Refugio, Robertson, San Patricio, San Saba, Shackelford, Smith, Somervell, Starr, Sterling, Swisher, Terry, Throckmorton, Uvalde, Van Zandt, Victoria, Webb, Willacy, Wilson, Wise, Zapata, Zavala

Annual Notice of Change

Summary of Benefits

Evidence of Coverage

  • Evidence of Coverage - English (PDF) - Coming Soon
  • 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 Dual Liberty (HMO D-SNP) H5294-010

Counties: Aransas, Atascosa, Bandera, Bee, Bosque, Brooks, Cameron, Castro, Colorado, Dimmit, Duval, Ector, Ellis, Erath, Gonzales, Grayson, Grimes, Hale, Hill, Hood, Hunt, Jim Wells, Kendall, Kleberg, La Salle, Lamb, Leon, Limestone, Lubbock, Maverick, Mcculloch, Medina, Mitchell, Navarro, Nolan, Nueces, Palo Pinto, Parker, Potter, Randall, Real, San Patricio, San Saba, Shackelford, Smith, Somervell, Starr, Uvalde, Van Zandt, Victoria, Webb, Willacy, Wilson, Wise, Zapata, Zavala


Wellcare Dual Liberty Sync (HMO D-SNP) H5294-021

Counties: Cameron, Duval, Jim Hogg, Maverick, McMullen, Starr, Webb, Willacy, Zapata

Annual Notice of Change

Summary of Benefits

Evidence of Coverage

  • Evidence of Coverage - English (PDF) - Coming Soon
  • 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 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

Summary of Benefits

Evidence of Coverage

  • Evidence of Coverage - English (PDF) - Coming Soon
  • 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 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

Summary of Benefits

Evidence of Coverage

  • Evidence of Coverage - English (PDF) - Coming Soon
  • 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 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

Summary of Benefits

Evidence of Coverage

  • Evidence of Coverage - English (PDF) - Coming Soon
  • 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 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

Summary of Benefits

Evidence of Coverage

  • Evidence of Coverage - English (PDF) - Coming Soon
  • 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 By Superior HealthPlan

Wellcare By Superior HealthPlan

HMO D-SNP Plans

Wellcare Superior HealthPlan Dual Align (HMO D-SNP) H0062-011

Counties: Dallas

Annual Notice of Change

  • Annual Notice of Change: Superior HealthPlan STAR+PLUS Medicare-Medicaid (Medicare-Medicaid Plan) H6870-001 to Wellcare Superior HealthPlan Dual Align (HMO D-SNP) H0062-011 - English (PDF) - Coming Soon
  • Annual Notice of Change: Superior HealthPlan STAR+PLUS Medicare-Medicaid (Medicare-Medicaid Plan) H6870-001 to Wellcare Superior HealthPlan Dual Align (HMO D-SNP) H0062-011 - Spanish (PDF) - Coming Soon

  • Annual Notice of Change: Wellcare Dual Access (HMO D-SNP) H0174-004 to Wellcare Superior HealthPlan Dual Align (HMO D-SNP) H0062-011 - English (PDF) - Coming Soon
  • Annual Notice of Change: Wellcare Dual Access (HMO D-SNP) H0174-004 to Wellcare Superior HealthPlan Dual Align (HMO D-SNP) H0062-011 - Spanish (PDF) - Coming Soon

  • Annual Notice of Change: Wellcare Dual Liberty (HMO D-SNP) H0174-006 to Wellcare Superior HealthPlan Dual Align (HMO D-SNP) H0062-011 - English (PDF) - Coming Soon
  • Annual Notice of Change: Wellcare Dual Liberty (HMO D-SNP) H0174-006 to Wellcare Superior HealthPlan Dual Align (HMO D-SNP) H0062-011 - Spanish (PDF) - Coming Soon

Summary of Benefits

  • Summary of Benefits - English (PDF) - Coming Soon
  • Summary of Benefits - Spanish (PDF) - Coming Soon

Evidence of Coverage

  • Member Handbook - English (PDF) - Coming Soon
  • 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

  • Annual Notice of Change: Superior HealthPlan STAR+PLUS Medicare-Medicaid (Medicare-Medicaid Plan) H6870-001 to Wellcare Superior HealthPlan Dual Align (HMO D-SNP) H0062-012 - English (PDF) - Coming Soon
  • Annual Notice of Change: Superior HealthPlan STAR+PLUS Medicare-Medicaid (Medicare-Medicaid Plan) H6870-001 to Wellcare Superior HealthPlan Dual Align (HMO D-SNP) H0062-012 - Spanish (PDF) - Coming Soon

  • Annual Notice of Change: Wellcare Dual Access (HMO D-SNP) H5294-015 to Wellcare Superior HealthPlan Dual Align (HMO D-SNP) H0062-012 - English (PDF) - Coming Soon
  • Annual Notice of Change: Wellcare Dual Access (HMO D-SNP) H5294-015 to Wellcare Superior HealthPlan Dual Align (HMO D-SNP) H0062-012 - Spanish (PDF) - Coming Soon

  • Annual Notice of Change: Wellcare Dual Liberty (HMO D-SNP) H5294-010 to Wellcare Superior HealthPlan Dual Align (HMO D-SNP) H0062-012 - English (PDF) - Coming Soon
  • Annual Notice of Change: Wellcare Dual Liberty (HMO D-SNP) H5294-010 to Wellcare Superior HealthPlan Dual Align (HMO D-SNP) H0062-012 - Spanish (PDF) - Coming Soon

Summary of Benefits

  • Summary of Benefits - English (PDF) - Coming Soon
  • Summary of Benefits - Spanish (PDF) - Coming Soon

Evidence of Coverage

  • Evidence of Coverage - English (PDF) - Coming Soon
  • 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

  • 2026 Medicare Parts A & B Premiums and Deductibles (PDF) - Coming Soon

  • Member Secure Portal Guide (PDF) - Coming Soon