Plan Benefit Materials | Allwell at Arizona Complete Health
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) H0351-054
Counties: Cochise, Coconino, Gila, Graham, Greenlee, La Paz, Mohave, Navajo, Santa Cruz, Yavapai, Yuma
Annual Notice of Change
- Annual Notice of Change - English (PDF)
- Annual Notice of Change - Spanish (PDF) - Coming Soon
Summary of Benefits
- Summary of Benefits - English (PDF)
- 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
Wellcare Giveback (HMO) H0351-064
Counties: Maricopa, Pima, Pinal
Annual Notice of Change
- Annual Notice of Change - English (PDF)
- Annual Notice of Change - Spanish (PDF) - Coming Soon
Summary of Benefits
- Summary of Benefits - English (PDF)
- 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
Wellcare Simple (HMO) H0351-053
Counties: Cochise, Coconino, Gila, Graham, Greenlee, La Paz, Mohave, Navajo, Santa Cruz, Yavapai, Yuma
Annual Notice of Change
- Annual Notice of Change - English (PDF)
- Annual Notice of Change - Spanish (PDF) - Coming Soon
Summary of Benefits
- Summary of Benefits - English (PDF)
- 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
Wellcare Simple (HMO) H0351-063
Counties: Maricopa, Pima, Pinal
Annual Notice of Change
- Annual Notice of Change - English (PDF)
- Annual Notice of Change - Spanish (PDF) - Coming Soon
Summary of Benefits
- Summary of Benefits - English (PDF)
- 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
Wellcare Simple Value (HMO) H0351-065
Counties: Maricopa, Pima, Pinal
Annual Notice of Change
- Annual Notice of Change - English (PDF)
- Annual Notice of Change - Spanish (PDF) - Coming Soon
Summary of Benefits
- Summary of Benefits - English (PDF)
- 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
Wellcare Specialty Simple (HMO C-SNP) H0351-038
Counties: Maricopa, Pima, Pinal
Annual Notice of Change
- Annual Notice of Change - English (PDF)
- Annual Notice of Change - Spanish (PDF) - Coming Soon
Summary of Benefits
- Summary of Benefits - English (PDF)
- 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
Wellcare Specialty Simple (HMO C-SNP) H0351-057
Counties: Cochise, Mohave, Santa Cruz, Yavapai, Yuma
Annual Notice of Change
- Annual Notice of Change - English (PDF)
- Annual Notice of Change - Spanish (PDF) - Coming Soon
Summary of Benefits
- Summary of Benefits - English (PDF)
- 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
Wellcare Dual Liberty Sync (HMO D-SNP) H5590-008
Counties: Apache, Cochise, Coconino, Gila, Graham, Greenlee, La Paz, Maricopa, Mohave, Navajo, Pima, Pinal, Santa Cruz, Yavapai, Yuma
Annual Notice of Change
- Annual Notice of Change - English (PDF)
- Annual Notice of Change: Wellcare Dual Liberty (HMO D-SNP) H5590-008 to Wellcare Dual Liberty Sync (HMO D-SNP) H5590-008 - Spanish (PDF) - Coming Soon
Summary of Benefits
- Summary of Benefits - English (PDF)
- 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
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