Plan Benefit Materials |

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 from Sunflower Health Plan member ID card for your plan number and type to view materials for your plan. 

  • View a sample of an Wellcare By Allwell Member ID Card to see where this information is located.

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 from Sunflower Health Plan 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 (HMO) H6550-003 Allen, Bourbon, Butler, Cherokee, Cowley, Crawford, Douglas, Harvey, Jackson, Jefferson, Johnson, Kingman, Labette, Leavenworth, Linn, McPherson, Miami, Sedgwick, Shawnee, Sumner, Woodson, Wyandotte
Wellcare Assist (HMO) H6550-006 Allen, Bourbon, Butler, Cherokee, Cowley, Crawford, Douglas, Harvey, Jackson, Jefferson, Johnson, Kingman, Labette, Leavenworth, Linn, McPherson, Miami, Sedgwick, Shawnee, Sumner, Woodson, Wyandotte
Wellcare Giveback (HMO) H6550-007 Allen, Bourbon, Butler, Cherokee, Cowley, Crawford, Douglas, Harvey, Jackson, Jefferson, Johnson, Kingman, Labette, Leavenworth, Linn, McPherson, Miami, Sedgwick, Shawnee, Sumner, Woodson, Wyandotte


For HMO D-SNP Members:

Plan Name  CMS# County Summary of Benefits
Wellcare Dual Access (HMO D-SNP) H6550-004 Allen, Bourbon, Butler, Cherokee, Cowley, Crawford, Douglas, Harvey, Jackson, Jefferson, Johnson, Kingman, Labette, Leavenworth, Linn, McPherson, Miami, Sedgwick, Shawnee, Sumner, Woodson, Wyandotte
Wellcare Dual Liberty (HMO D-SNP) H6550-009 Allen, Bourbon, Butler, Cherokee, Cowley, Crawford, Douglas, Harvey, Jackson, Jefferson, Johnson, Kingman, Labette, Leavenworth, Linn, McPherson, Miami, Sedgwick, Shawnee, Sumner, Woodson, Wyandotte

For PPO Members:

Plan Name  CMS# County Summary of Benefits
Wellcare No Premium Open (PPO) H9387-001 Allen, Bourbon, Butler, Cherokee, Cowley, Crawford, Douglas, Harvey, Jackson, Jefferson, Johnson, Kingman, Labette, Leavenworth, Linn, McPherson, Miami, Sedgwick, Shawnee, Sumner, Woodson, Wyandotte
Wellcare Patriot Giveback Open (PPO) H9387-002 Allen, Bourbon, Butler, Cherokee, Cowley, Crawford, Douglas, Harvey, Jackson, Jefferson, Johnson, Kingman, Labette, Leavenworth, Linn, McPherson, Miami, Sedgwick, Shawnee, Sumner, Woodson, Wyandotte
Wellcare Premium Hybrid Open (PPO) H9387-003 Allen, Bourbon, Butler, Cherokee, Cowley, Crawford, Douglas, Harvey, Jackson, Jefferson, Johnson, Kingman, Labette, Leavenworth, Linn, McPherson, Miami, Sedgwick, Shawnee, Sumner, Woodson, Wyandotte

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 (HMO) H6550-003 Allen, Bourbon, Butler, Cherokee, Cowley, Crawford, Douglas, Harvey, Jackson, Jefferson, Johnson, Kingman, Labette, Leavenworth, Linn, McPherson, Miami, Sedgwick, Shawnee, Sumner, Woodson, Wyandotte
Wellcare Assist (HMO) H6550-006 Allen, Bourbon, Butler, Cherokee, Cowley, Crawford, Douglas, Harvey, Jackson, Jefferson, Johnson, Kingman, Labette, Leavenworth, Linn, McPherson, Miami, Sedgwick, Shawnee, Sumner, Woodson, Wyandotte
Wellcare Giveback (HMO) H6550-007 Allen, Bourbon, Butler, Cherokee, Cowley, Crawford, Douglas, Harvey, Jackson, Jefferson, Johnson, Kingman, Labette, Leavenworth, Linn, McPherson, Miami, Sedgwick, Shawnee, Sumner, Woodson, Wyandotte


For HMO D-SNP Members:

Plan Name  CMS# County Evidence of Coverage
Wellcare Dual Access (HMO D-SNP) H6550-004 Allen, Bourbon, Butler, Cherokee, Cowley, Crawford, Douglas, Harvey, Jackson, Jefferson, Johnson, Kingman, Labette, Leavenworth, Linn, McPherson, Miami, Sedgwick, Shawnee, Sumner, Woodson, Wyandotte
Wellcare Dual Liberty (HMO D-SNP) H6550-009 Allen, Bourbon, Butler, Cherokee, Cowley, Crawford, Douglas, Harvey, Jackson, Jefferson, Johnson, Kingman, Labette, Leavenworth, Linn, McPherson, Miami, Sedgwick, Shawnee, Sumner, Woodson, Wyandotte

For PPO Members:

Plan Name  CMS# County Evidence of Coverage
Wellcare No Premium Open (PPO) H9387-001 Allen, Bourbon, Butler, Cherokee, Cowley, Crawford, Douglas, Harvey, Jackson, Jefferson, Johnson, Kingman, Labette, Leavenworth, Linn, McPherson, Miami, Sedgwick, Shawnee, Sumner, Woodson, Wyandotte
Wellcare Patriot Giveback Open (PPO) H9387-002 Allen, Bourbon, Butler, Cherokee, Cowley, Crawford, Douglas, Harvey, Jackson, Jefferson, Johnson, Kingman, Labette, Leavenworth, Linn, McPherson, Miami, Sedgwick, Shawnee, Sumner, Woodson, Wyandotte
Wellcare Premium Hybrid Open (PPO) H9387-003 Allen, Bourbon, Butler, Cherokee, Cowley, Crawford, Douglas, Harvey, Jackson, Jefferson, Johnson, Kingman, Labette, Leavenworth, Linn, McPherson, Miami, Sedgwick, Shawnee, Sumner, Woodson, Wyandotte

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 Change
Wellcare No Premium (HMO) H6550-003 Allen, Bourbon, Butler, Cherokee, Cowley, Crawford, Douglas, Harvey, Jackson, Jefferson, Johnson, Kingman, Labette, Leavenworth, Linn, McPherson, Miami, Sedgwick, Shawnee, Sumner, Woodson, Wyandotte
Wellcare Assist (HMO) H6550-006 Allen, Bourbon, Butler, Cherokee, Cowley, Crawford, Douglas, Harvey, Jackson, Jefferson, Johnson, Kingman, Labette, Leavenworth, Linn, McPherson, Miami, Sedgwick, Shawnee, Sumner, Woodson, Wyandotte
Wellcare Giveback (HMO) H6550-007 Allen, Bourbon, Butler, Cherokee, Cowley, Crawford, Douglas, Harvey, Jackson, Jefferson, Johnson, Kingman, Labette, Leavenworth, Linn, McPherson, Miami, Sedgwick, Shawnee, Sumner, Woodson, Wyandotte


For HMO D-SNP Members:

Plan Name  CMS# County Annual Notice of Change
Wellcare Dual Access (HMO D-SNP) H6550-004 Allen, Bourbon, Butler, Cherokee, Cowley, Crawford, Douglas, Harvey, Jackson, Jefferson, Johnson, Kingman, Labette, Leavenworth, Linn, McPherson, Miami, Sedgwick, Shawnee, Sumner, Woodson, Wyandotte

For PPO Members:

Plan Name  CMS# County Annual Notice of Change
Wellcare No Premium Open (PPO) H9387-001 Allen, Bourbon, Butler, Cherokee, Cowley, Crawford, Douglas, Harvey, Jackson, Jefferson, Johnson, Kingman, Labette, Leavenworth, Linn, McPherson, Miami, Sedgwick, Shawnee, Sumner, Woodson, Wyandotte
Wellcare Patriot Giveback Open (PPO) H9387-002 Allen, Bourbon, Butler, Cherokee, Cowley, Crawford, Douglas, Harvey, Jackson, Jefferson, Johnson, Kingman, Labette, Leavenworth, Linn, McPherson, Miami, Sedgwick, Shawnee, Sumner, Woodson, Wyandotte