Plan Benefit Materials | Allwell from PA Health and Wellness
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 Assist (HMO-POS) H2915-011
Counties: Adams, Allegheny, Armstrong, Beaver, Bedford, Berks, Blair, Bradford, Bucks, Butler, Cambria, Cameron, Carbon, Centre, Chester, Clarion, Clearfield, Clinton, Crawford, Cumberland, Dauphin, Delaware, Elk, Erie, Fayette, Forest, Fulton, Greene, Huntingdon, Indiana, Jefferson, Juniata, Lackawanna, Lancaster, Lawrence, Lebanon, Lehigh, Luzerne, Lycoming, Mckean, Mercer, Mifflin, Monroe, Montgomery, Montour, Northampton, Perry, Philadelphia, Potter, Schuylkill, Snyder, Somerset, Sullivan, Susquehanna, Tioga, Union, Venango, Warren, Washington, Wayne, Westmoreland, Wyoming, York
Annual Notice of Change
Summary of Benefits
Evidence of Coverage
Dental Benefit Details
Your OTC Highlight
Wellcare Patriot Giveback (HMO-POS) H2915-013
Counties: Adams, Allegheny, Armstrong, Beaver, Bedford, Berks, Blair, Bradford, Bucks, Butler, Cambria, Cameron, Carbon, Centre, Chester, Clarion, Clearfield, Clinton, Crawford, Cumberland, Dauphin, Delaware, Elk, Erie, Fayette, Forest, Fulton, Greene, Huntingdon, Indiana, Jefferson, Juniata, Lackawanna, Lancaster, Lawrence, Lebanon, Lehigh, Luzerne, Lycoming, Mckean, Mercer, Mifflin, Monroe, Montgomery, Montour, Northampton, Perry, Philadelphia, Potter, Schuylkill, Snyder, Somerset, Sullivan, Susquehanna, Tioga, Union, Venango, Warren, Washington, Wayne, Westmoreland, Wyoming, York
Annual Notice of Change
Summary of Benefits
Evidence of Coverage
Dental Benefit Details
Your OTC Highlight
Wellcare Simple (HMO-POS) H2915-003
Counties: Adams, Allegheny, Armstrong, Beaver, Bedford, Berks, Blair, Bradford, Bucks, Butler, Cambria, Cameron, Carbon, Centre, Chester, Clarion, Clearfield, Clinton, Crawford, Cumberland, Dauphin, Delaware, Elk, Erie, Fayette, Forest, Fulton, Greene, Huntingdon, Indiana, Jefferson, Juniata, Lackawanna, Lancaster, Lawrence, Lebanon, Lehigh, Luzerne, Lycoming, Mckean, Mercer, Mifflin, Monroe, Montgomery, Montour, Northampton, Perry, Philadelphia, Potter, Schuylkill, Snyder, Somerset, Sullivan, Susquehanna, Tioga, Union, Venango, Warren, Washington, Wayne, Westmoreland, Wyoming, York
Annual Notice of Change
- Annual Notice of Change: Wellcare Simple (HMO) H2915-003 to Wellcare Simple (HMO-POS) H2915-003 - English (PDF)
- Annual Notice of Change: Wellcare Simple (HMO) H2915-016 to Wellcare Simple (HMO-POS) H2915-003 - English (PDF)
Summary of Benefits
Evidence of Coverage
Dental Benefit Details
Your OTC Highlight
Wellcare Dual Liberty Sync (HMO-POS D-SNP) H2915-002
Counties: Adams, Allegheny, Armstrong, Beaver, Bedford, Berks, Blair, Bradford, Bucks, Butler, Cambria, Cameron, Carbon, Centre, Chester, Clarion, Clearfield, Clinton, Crawford, Cumberland, Dauphin, Delaware, Elk, Erie, Fayette, Forest, Franklin, Fulton, Greene, Huntingdon, Indiana, Jefferson, Juniata, Lackawanna, Lancaster, Lawrence, Lebanon, Lehigh, Luzerne, Lycoming, Mckean, Mercer, Mifflin, Monroe, Montgomery, Montour, Northampton, Perry, Philadelphia, Pike, Potter, Schuylkill, Snyder, Somerset, Sullivan, Susquehanna, Tioga, Union, Venango, Warren, Washington, Wayne, Westmoreland, Wyoming, York
Annual Notice of Change
- Annual Notice of Change: Wellcare Dual Access (HMO D-SNP) H2915-002 to Wellcare Dual Liberty Sync (HMO-POS D-SNP) H2915-002 - English (PDF)
- Annual Notice of Change: Wellcare Dual Access (HMO D-SNP) H2915-007 to Wellcare Dual Liberty Sync (HMO-POS D-SNP) H2915-002 - English (PDF)
Summary of Benefits
Evidence of Coverage
Dental Benefit Details
Your OTC Highlight
Wellcare Dual Select (HMO-POS D-SNP) H2915-018
Counties: Adams, Allegheny, Armstrong, Beaver, Bedford, Berks, Blair, Bradford, Bucks, Butler, Cambria, Cameron, Carbon, Centre, Chester, Clarion, Clearfield, Clinton, Crawford, Cumberland, Dauphin, Delaware, Elk, Erie, Fayette, Forest, Franklin, Fulton, Greene, Huntingdon, Indiana, Jefferson, Juniata, Lackawanna, Lancaster, Lawrence, Lebanon, Lehigh, Luzerne, Lycoming, Mckean, Mercer, Mifflin, Monroe, Montgomery, Montour, Northampton, Perry, Philadelphia, Pike, Potter, Schuylkill, Snyder, Somerset, Sullivan, Susquehanna, Tioga, Union, Venango, Warren, Washington, Wayne, Westmoreland, Wyoming, York
Summary of Benefits
- Summary of Benefits - English (PDF)
- Summary of Benefits - Arabic (PDF)
- Summary of Benefits - Bengali (PDF)
- Summary of Benefits - Chinese (Traditional) (PDF)
- Summary of Benefits - Creole/Haitian (PDF)
- Summary of Benefits - Nepali (PDF)
- Summary of Benefits - Russian (PDF)
- Summary of Benefits - Spanish (PDF)
- Summary of Benefits - Swahili (PDF)
- Summary of Benefits - Tamil (PDF)
- Summary of Benefits - Vietnamese (PDF)
Evidence of Coverage
- Evidence of Coverage - English (PDF)
- Evidence of Coverage - Arabic (PDF)
- Evidence of Coverage - Bengali (PDF)
- Evidence of Coverage - Chinese (Traditional) (PDF)
- Evidence of Coverage - Creole/Haitian (PDF)
- Evidence of Coverage - Nepali (PDF)
- Evidence of Coverage - Russian (PDF)
- Evidence of Coverage - Spanish (PDF)
- Evidence of Coverage - Swahili (PDF)
- Evidence of Coverage - Tamil (PDF)
- Evidence of Coverage - Vietnamese (PDF)
Dental Benefit Details
- Dental Benefit Details - English (PDF)
- Dental Benefit Details - Arabic (PDF)
- Dental Benefit Details - Bengali (PDF)
- Dental Benefit Details - Chinese (Traditional) (PDF)
- Dental Benefit Details - Creole/Haitian (PDF)
- Dental Benefit Details - Nepali (PDF)
- Dental Benefit Details - Russian (PDF)
- Dental Benefit Details - Spanish (PDF)
- Dental Benefit Details - Swahili (PDF)
- Dental Benefit Details - Tamil (PDF)
- Dental Benefit Details - Vietnamese (PDF)
Your OTC Highlight