Plan Benefit Materials and Forms | Wellcare Nebraska
2027 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
Wellcare Giveback (HMO-POS) H1215-003
Counties: Adams, Antelope, Banner, Blaine, Boone, Buffalo, Burt, Butler, Cass, Clay, Colfax, Cuming, Custer, Dawson, Dodge, Douglas, Fillmore, Franklin, Frontier, Furnas, Gage, Garfield, Gosper, Greeley, Hall, Hamilton, Harlan, Howard, Johnson, Kearney, Knox, Lancaster, Madison, Merrick, Nance, Nemaha, Otoe, Phelps, Pierce, Polk, Saline, Sarpy, Saunders, Scotts Bluff, Seward, Sherman, Stanton, Thayer, Valley, Washington, Wayne, Webster, Wheeler, York
Annual Notice of Change
Summary of Benefits
Evidence of Coverage
Dental Benefit Details
Wellcare Simple (HMO-POS) H1215-005
Counties: Adams, Antelope, Banner, Blaine, Boone, Buffalo, Burt, Butler, Cass, Clay, Colfax, Cuming, Custer, Dawson, Dodge, Douglas, Fillmore, Franklin, Frontier, Furnas, Gage, Garfield, Gosper, Greeley, Hall, Hamilton, Harlan, Howard, Johnson, Kearney, Knox, Lancaster, Madison, Merrick, Nance, Nemaha, Otoe, Phelps, Pierce, Polk, Saline, Sarpy, Saunders, Scotts Bluff, Seward, Sherman, Stanton, Thayer, Valley, Washington, Wayne, Webster, Wheeler, York
Annual Notice of Change
Summary of Benefits
Evidence of Coverage
Dental Benefit Details
HMO D-SNP Plans
Wellcare Nebraska Total Care Dual Liberty Sync (HMO-POS D-SNP) H1215-001
Counties: Adams, Antelope, Banner, Blaine, Boone, Boyd, Buffalo, Burt, Butler, Cass, Cedar, Clay, Colfax, Cuming, Custer, Dawson, Dixon, Dodge, Douglas, Fillmore, Franklin, Frontier, Furnas, Gage, Garfield, Gosper, Greeley, Hall, Hamilton, Harlan, Hayes, Hitchcock, Holt, Howard, Jefferson, Johnson, Kearney, Keith, Knox, Lancaster, Lincoln, Logan, Madison, Merrick, Nance, Nemaha, Otoe, Pawnee, Perkins, Phelps, Pierce, Polk, Saline, Sarpy, Saunders, Scotts Bluff, Seward, Sherman, Stanton, Thayer, Valley, Washington, Wayne, Webster, Wheeler, York
Annual Notice of Change
- Annual Notice of Change: Wellcare Dual Liberty Sync (HMO-POS D-SNP) H1215-001 to Wellcare Nebraska Total Care Dual Liberty Sync (HMO-POS D-SNP) H1215-001 - English (PDF)
- Annual Notice of Change: Wellcare Dual Liberty Sync (HMO-POS D-SNP) H1215-001 to Wellcare Nebraska Total Care Dual Liberty Sync (HMO-POS D-SNP) H1215-001 - Spanish (PDF)
Summary of Benefits
Evidence of Coverage
Dental Benefit Details
Your OTC Highlight
Additional Forms
- Medicare Step Therapy Part B (PDF) - Coming Soon
- 2027 Medicare Parts A & B Premiums and Deductibles (PDF) - Coming Soon
- Member Secure Portal Guide (PDF) - Coming Soon
If you have questions please, contact Member Services.