Plan Benefit Materials | Allwell from Silver Summit Health

Plan Materials and Forms

 

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

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

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 NAMECMS #CountySummary of Benefits
Wellcare No Premium (HMO)H6446-001Clark, Nye
Wellcare No Premium (HMO)H6446-010Carson City, Churchill, Douglas, Lyon, Storey, Washoe

For HMO D-SNP Members:

Plan NameCMS #CountySummary of Benefits
Wellcare Dual Access (HMO D-SNP)H6446-014Clark, Nye
Wellcare Dual Access (HMO D-SNP)H6446-016Carson City, Churchill, Douglas, Lyon, Storey, Washoe

For HMO C-SNP Members:

Plan NameCMS #CountySummary of Benefits
Wellcare Specialty No Premium (HMO C-SNP)H6446-017Clark, Nye

For PPO Members:

Plan NameCMS #CountySummary of Benefits
Wellcare No Premium Open (PPO)H8458-003Carson City, Clark, Churchill, Douglas, Lyon, Storey, Washoe
 

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 NameCMS #CountyEvidence of Changes
Wellcare No Premium (HMO)H6446-001Clark, Nye

 

 
Wellcare No Premium (HMO)H6446-010Carson City, Churchill, Douglas, Lyon, Storey, Washoe

 

For HMO D-SNP Members:

Plan NameCMS #CountyEvidence of Changes
Wellcare Dual Access (HMO D-SNP)H6446-014Clark, Nye
 
Wellcare Dual Access (HMO D-SNP)H6446-016Carson City, Churchill, Douglas, Lyon, Storey, Washoe
 

For HMO C-SNP Members:

Plan NameCMS #CountyEvidence of Changes
Wellcare Specialty No Premium (HMO C-SNP)H6446-017Clark, Nye

 

 

For PPO Members:

Plan NameCMS #CountyEvidence of Changes
Wellcare No Premium Open (PPO)H8458-003Carson City, Clark, Churchill, Douglas, Lyon, Storey, Washoe

 

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 NameCMS #CountyAnnual Notice of Changes
Wellcare No Premium (HMO)H6446-001Clark, Nye
 
Wellcare Giveback (HMO) to Wellcare No Premium (HMO) H6446-003 to H6446-001Clark, Nye
 
Wellcare Assist (HMO) to Wellcare No Premium (HMO)H6446-011 to H6446-001Clark, Nye
Wellcare Giveback (HMO) to Wellcare No Premium (HMO)H6446-005 to H6446-010Carson City, Churchill, Douglas, Lyon, Storey, Washoe
 
Wellcare No Premium (HMO)H6446-010Carson City, Churchill, Douglas, Lyon, Storey, Washoe
 
Wellcare Assist (HMO) to Wellcare No Premium (HMO)H6446-013 to H6446-010Carson City, Churchill, Douglas, Lyon, Storey, Washoe
 

For HMO D-SNP and C-SNP Members:

Plan NameCMS #CountyAnnual Notice of Changes
Wellcare Dual Access (HMO D-SNP)H6446-014Clark, Nye
 
Wellcare Dual Access (HMO D-SNP)H6446-016Carson City, Churchill, Douglas, Lyon, Storey, Washoe
 
Wellcare Specialty No Premium (HMO C-SNP)H6446-017Clark, Nye

 


For PPO Members:

Plan NameCMS #CountyAnnual Notice of Changes
Wellcare No Premium Open (PPO)H8458-003Carson City, Churchill, Clark, Douglas, Lyon, Nye, Storey, Washoe
 
Wellcare No Premium Open (PPO) to Wellcare No Premium Open (PPO) H8458-001 to H8458-003Carson City, Churchill, Clark, Douglas, Lyon, Nye, Storey, Washoe