Plan Benefit Materials | Allwell from Sunshine Health

Plan Materials and Forms

 

Listed below are some documents that may be helpful at different times during your membership. 

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
Allwell Medicare Premier (HMO) H9276 - 002

Duval

Allwell Medicare (HMO)
H9276 - 004 Miami-Dade
Allwell Medicare (HMO)
H9276 - 0012 Broward
Allwell Medicare (HMO)
H9276 - 021

Palm Beach

 

For HMO D-SNP Members:

Plan Name   CMS#  County Summary of Benefits
Allwell Dual Medicare (HMO D-SNP) H5190 - 001

Duval | Volusia

 

Allwell Dual Medicare (HMO D-SNP) H5190 - 002 Hillsborough | Orange | Osceola | Palm Beach | Pasco | Pinellas | Polk | Seminole
Allwell Dual Medicare (HMO D-SNP) H5190 - 003 Broward
Allwell Dual Medicare (HMO D-SNP) H5190 - 004

Miami - Dade

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
Allwell Medicare Premier (HMO) H9276 - 002

Duval

Allwell Medicare (HMO)
H9276 - 004 Miami-Dade
Allwell Medicare (HMO)
H9276 - 012 Broward
Allwell Medicare (HMO)

H9276 - 021

Palm Beach


For HMO D-SNP Members:

Plan Name   CMS#  County Evidence of Coverage
Allwell Dual Medicare (HMO D-SNP) H5190 - 001

Duval | Volusia

 

Allwell Dual Medicare (HMO D-SNP) H5190 - 002 Hillsborough | Orange | Osceola | Palm Beach | Pasco | Pinellas | Polk | Seminole
Allwell Dual Medicare (HMO D-SNP) H5190 - 003 Broward
Allwell Dual Medicare (HMO D-SNP) H5190 - 004

Miami - Dade

 

If you were enrolled in Allwell from Sunshine Health last year, 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 Changes
Allwell Medicare (HMO) H9276-002 Duval
Allwell Medicare (HMO)
H9276 - 004 Miami-Dade
Allwell Medicare (HMO)
H9276 - 021 Palm Beach
Allwell Medicare (HMO)
H9276 - 0012 Broward

 

For HMO D-SNP Members:

Plan Name   CMS#  County Annual Notice Of Changes
Allwell Dual Medicare (HMO D-SNP) H5190 - 001

Baker | Duval | Hardee | Hernando | Lake | Manatee |Marion | Martin | Volusia

 

Allwell Dual Medicare (HMO D-SNP) H5190 - 002 Hillsborough | Orange | Osceola | Palm Beach | Pasco | Pinellas | Polk | Seminole | St.Lucie
Allwell Dual Medicare (HMO D-SNP) H5190 - 003 Broward
Allwell Dual Medicare (HMO D-SNP) H5190 - 004

Miami - Dade

Your current plan may have an over-the-counter (OTC) benefit that lets you buy OTC health and wellness products. This catalog includes a list of OTC items that you can order to be mailed to your home. Check the catalog for item limits.

Ordering is easy. Just follow the steps in your plan's catalog.

Don’t want to wait? You may pick up your OTC products from a CVS or Navarro Discount Pharmacy store near you. Please note: this does not include CVS locations inside of Target stores.

Connect to the CVS OTC website to view available products and store information.

 

Material ID: Y0020_20_17590WEB_C_03192020