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Plan Materials and Forms

For HMO Members

Plans CMS# County Summary of Benefits
Allwell Medicare (HMO) H0351 - 044-001
  • Pima
Allwell Medicare (HMO) H0351 - 044-002
  • Cochise
Allwell Medicare (HMO)

H0351 - 044-003

  • Santa Cruz
Allwell Medicare Premier (HMO) 

H9287 - 001

  • Pima
Allwell Medicare Complement (HMO)  H0351 - 030
  • Cochise, Maricopa, Pinal and Santa Cruz
Allwell Medicare Essentials II (HMO) H0351 - 050
  • Maricopa and Pinal
Allwell Medicare Premier (HMO) H0351 - 051
  • Maricopa and Pinal
Allwell Medicare Essentials (HMO) H5590 - 005
  • Maricopa and Pinal
Allwell Medicare
H5590 - 004
  • Yuma


For HMO SNP Members

Plans  CMS# County Summary of Benefits
Allwell Dual Medicare  (HMO SNP)  H5590 - 006 - 001
  • Maricopa, Pima and Yuma
Allwell Dual Medicare  (HMO SNP)  H5590 - 006 - 002
  • Cochise, Gila, Graham, Greenlee, La Paz,
    Pinal and Santa Cruz
Allwell CHF/Diabetes Medicare (HMO SNP)  H0351 - 038
  • Maricopa and Pinal

For HMO Members

Plans CMS# County Evidence Of Coverage
Allwell Medicare Complement (HMO) H0351 - 030
  • Cochise, Maricopa, Pinal, Santa Cruz
Allwell Medicare (HMO) H0351 - 044-001
  • Pima
Allwell Medicare (HMO) H0351 - 044-002
  • Cochise
Allwell Medicare (HMO)

H0351 - 044-003

  • Santa Cruz
Allwell Medicare Essentials II (HMO)  H0351 - 050
  • Maricopa, Pinal
Allwell Medicare Premier (HMO)  H0351 - 051
  • Maricopa, Pinal
Allwell Medicare Premier (HMO) 

H9287 - 001

  • Pima
Allwell Medicare (HMO) H5590 - 004
  • Yuma
Allwell Medicare Essentials (HMO)

H5590 - 005

  • Maricopa, Pinal  

 

For HMO SNP Members

Plans  CMS# County Evidence Of Coverage
Allwell Dual Medicare (HMO SNP) H5590 - 006 - 001
  • Maricopa, Pima, Yuma
Allwell Dual Medicare (HMO SNP) H5590 - 006 - 002
  • Cochise, Gila, Graham, Greenlee, La Paz, Pinal, Santa Cruz
Allwell CHF/Diabetes Medicare (HMO SNP)  H0351 - 038
  • Maricopa, Pinal

For HMO Members

Plans CMS# County Annual Notice Of Changes
Allwell Medicare Complement (HMO) H0351-030
  • Cochise, Maricopa, Pinal, Santa Cruz
Allwell Medicare (HMO)

H0351 - 044-001

 

  • Pima
Allwell Medicare (HMO) H0351 - 044-002
  • Cochise
Allwell Medicare (HMO)

H0351 - 044-003

  • Santa Cruz 
Allwell Medicare Premier (HMO)  H0351 - 051
  • Maricopa
Allwell Medicare Premier (HMO)  H0351 - 051
  • Pinal
Allwell Medicare Premier (HMO) 

H9287 - 001

  • Pima
Allwell Medicare Essentials II (HMO) H0351 - 050
  • Maricopa
Allwell Medicare Essentials II (HMO)

H0351 - 050

  • Pinal


For HMO SNP Members

Plans  CMS# County Annual Notice Of Changes
Allwell CHF/Diabetes Medicare (HMO SNP)  H0351 - 038
  • Maricopa, Pinal
Allwell Dual Medicare (HMO SNP) H5590-006-001
  • Maricopa, Pima, Yuma

For HMO Members

Plans CMS# County Low Income Subsidy
Allwell Medicare
(HMO)
H0351 - 044-001
  • Pima
Allwell Medicare
(HMO)
H0351 - 044-002
  • Cochise
Allwell Medicare
(HMO)

H0351 - 044-003

  • Santa Cruz
Allwell Medicare Premier
(HMO) 

H9287 - 001

  • Pima
Allwell Medicare Premier
(HMO)
H0351 - 050
  • Maricopa, Pima
Allwell Medicare Premier
(HMO)
H0351 - 051
  • Maricopa, Pima

For HMO SNP Members

Plans  CMS# County Low Income Subsidy
Allwell Dual Medicare
(HMO SNP) 
H5590 - 004
  • Maricopa
Allwell Dual Medicare
(HMO SNP) 

H5590 - 005
  • Maricopa, Pinal
Allwell Dual Medicare
(HMO SNP) 

H5590 - 006 - 001
  • Maricopa, Pima,
    Yuma
Allwell Dual Medicare
(HMO SNP)
H5590 - 006 - 002
  • Cochise, Gila,
    Graham, Greenlee,
    La Paz, Pinal,
    Santa Cruz
Allwell CHF/Diabetes
(HMO SNP)
H0351 - 038
  • Maricopa, Pinal

Your current plan may have an over-the-counter benefit that allows you to purchase over-the-counter (OTC) health and wellness products. This catalog includes a list of over-the-counter items that you can order to be directly mailed to your home.

Ordering is easy! Just follow the steps listed on your plan's catalog.

 

medicare phone number

 

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