Plan Benefit Materials

Plan Name	CMS #	County	Summary of Benefits
Allwell Medicare (HMO)	H0062-001	Aransas, Bexar, Comal, El Paso, Guadalupe, Jim Wells, Nueces and Wilson counties	Summary of Benefits, H0062-001 - English (PDF) Summary of Benefits, H0062-001- Spanish (PDF)
Allwell Medicare (HMO)	H0062-002	Collin, Dallas, Denton, Rockwall and Tarrant counties	Summary of Benefits, H0062-002 - English (PDF) Summary of Benefits, H0062-002- Spanish (PDF)
Allwell Medicare (HMO)	H0062-003	Cameron, Hidalgo and Starr counties	Summary of Benefits, H0062-003 - English (PDF) Summary of Benefits H0062-003- Spanish (PDF)
Allwell Medicare (HMO)	H0062 - 009	Fort Bend and Montgomery counties	Summary of Benefits, H0062-009 - English (PDF) Summary of Benefits, H0062-009 - Spanish (PDF)

Plan Name	CMS #	County	Summary of Benefits
Allwell Dual Medicare (HMO D-SNP)	H5294-002-002	Cameron, Hidalgo and Starr counties	Summary of Benefits, H5294-002-002 - English (PDF) Summary of Benefits, H5294-002-002 - Spanish (PDF)
Allwell Dual Medicare (HMO D-SNP)	H5294-002-003	Collin, Dallas, Denton, Rockwall and Tarrant counties	Summary of Benefits, H5294-002-003 - English (PDF) Summary of Benefits, H5294-002-003 - Spanish (PDF)
Allwell Dual Medicare (HMO D-SNP)	H5294-002-004	Aransas, Bexar, Comal, El Paso, Guadalupe, Jim Wells, Nueces and Wilson counties	Summary of Benefits, H5294-002-004 - English (PDF) Summary of Benefits, H5294-002-004 - Spanish (PDF)
Allwell Dual Medicare (HMO D-SNP)	H5294-007	Fort Bend and Montgomery counties	Summary of Benefits, H5294-007 - English (PDF) Summary of Benefits, H5294-007 - Spanish (PDF)
Allwell Dual Medicare (HMO D-SNP)	H5294-009	Lubbock	Summary of Benefits, H5294-009 - English (PDF) Summary of Benefits, H5294-009 - Spanish (PDF)

Plan Name	CMS #	County	Evidence of Coverage
Allwell Medicare (HMO)	H0062-001	Aransas, Bexar, Comal, El Paso, Guadalupe, Jim Wells, Nueces and Wilson counties	Evidence of Coverage, H0062-001 - English (PDF) Evidence of Coverage, H0062-001 - Spanish (PDF)
Allwell Medicare (HMO)	H0062-002	Collin, Dallas, Denton, Rockwall and Tarrant counties	Evidence of Coverage, H0062-002 - English (PDF) Evidence of Coverage, H0062-002 - Spanish (PDF)
Allwell Medicare (HMO)	H0062-003	Cameron, Hidalgo and Starr counties	Evidence of Coverage, H0062-003 - English (PDF) Evidence of Coverage, H0062-003 - Spanish (PDF)
Allwell Medicare (HMO)	H0062-009	Fort Bend and Montgomery counties	Evidence of Coverage, H0062-009 - English (PDF) Evidence of Coverage, H0062-009 - Spanish (PDF)

Plan Name	CMS #	County	Evidence of Coverage
Allwell Dual Medicare (HMO D-SNP)	H5294-002-002	Cameron, Hidalgo and Starr counties	Evidence of Coverage, H5294-002-002 - English (PDF) Evidence of Coverage, H5294-002-002 - Spanish (PDF)
Allwell Dual Medicare (HMO D-SNP)	H5294-002-003	Collin, Dallas, Denton, Rockwall and Tarrant counties	Evidence of Coverage, H5294-002-003 - English (PDF) Evidence of Coverage, H5294-002-003 - Spanish (PDF)
Allwell Dual Medicare (HMO D-SNP)	H5294-002-004	Aransas, Bexar, Comal, El Paso, Guadalupe, Jim Wells, Nueces and Wilson counties	Evidence of Coverage, H5294-002-004 - English (PDF) Evidence of Coverage, H5294-002-004 - Spanish (PDF)
Allwell Dual Medicare (HMO D-SNP)	H5294-007	Fort Bend and Montgomery counties	Evidence of Coverage, H5294-007 - English (PDF) Evidence of Coverage, H5294-007 - Spanish (PDF)
Allwell Dual Medicare (HMO D-SNP)	H5294-009	Lubbock	Evidence of Coverage, H5294-009 - English (PDF)

Plan Name	CMS #	County	Annual Notice of Changes
Allwell Medicare (HMO)	H0062-001	Aransas, Bexar, Comal, El Paso, Guadalupe, Jim Wells, Nueces and Wilson counties	Annual Notice of Changes, H0062-001 - English (PDF) Annual Notice of Changes, H0062-001 - Spanish (PDF) Annual Notice of Changes, H0062-004-001 - English (PDF) Annual Notice of Changes, H0062-004-001 - Spanish (PDF) Annual Notice of Changes, H0062-005-001 - English (PDF) Annual Notice of Changes, H0062-005-001 - Spanish (PDF)
Allwell Medicare (HMO)	H0062-002	Collin, Dallas, Denton, Rockwall and Tarrant counties	Annual Notice of Changes, H0062-002 - English (PDF) Annual Notice of Changes, H0062-002 - Spanish (PDF)
Allwell Medicare (HMO)	H0062-003	Cameron, Hidalgo and Starr counties	Annual Notice of Changes, H0062-003 - English (PDF) Annual Notice of Changes H0062-003 - Spanish (PDF)
Allwell Medicare (HMO)	H0062 - 009	Fort Bend and Montgomery counties	Annual Notice of Changes, H0062-009 - English (PDF) Annual Notice of Changes H0062-009 - Spanish (PDF)

Plan Name	CMS #	County	Annual Notice of Changes
Allwell Dual Medicare (HMO D-SNP)	H5294-002-002	Cameron, Hidalgo and Starr counties	Annual Notice of Changes, H5294-002-002 - English (PDF) Annual Notice of Changes, H5294-002-002 - Spanish (PDF)
Allwell Dual Medicare (HMO D-SNP)	H5294-002-003	Collin, Dallas, Denton, Rockwall and Tarrant counties	Annual Notice of Changes, H5294-002-001-002-003- English (PDF) Annual Notice of Changes, H5294-002-001-002-003- Spanish (PDF) Annual Notice of Changes, H5294-002-003 - English (PDF) Annual Notice of Changes, H5294-002-003 - Spanish (PDF)
Allwell Dual Medicare (HMO D-SNP)	H5294-002-004	Aransas, Bexar, Comal, El Paso, Guadalupe, Jim Wells, Nueces and Wilson counties	Annual Notice of Changes, H5294-002-004 - English (PDF) Annual Notice of Changes, H5294-002-004 - Spanish (PDF) Annual Notice of Changes, H5294-006-002-004 - English (PDF) Annual Notice of Changes, H5294-006-002-004 - Spanish (PDF)
Allwell Dual Medicare (HMO D-SNP)	H5294-007	Fort Bend and Montgomery counties	Annual Notice of Changes, H5294-007 - English (PDF) Annual Notice of Changes, H5294-007 - Spanish (PDF)

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 (HMO)	H0062-001	Aransas, Bexar, Comal, El Paso, Guadalupe, Jim Wells, Nueces and Wilson counties	Summary of Benefits, H0062-001 - English (PDF) Summary of Benefits, H0062-001 - Spanish (PDF)
Allwell Medicare (HMO)	H0062-002	Collin, Dallas, Denton, Rockwall and Tarrant counties	Summary of Benefits, H0062-002 - English (PDF) Summary of Benefits, H0062-002 - Spanish (PDF)
Allwell Medicare (HMO)	H0062-003	Cameron, Hidalgo and Starr counties	Summary of Benefits, H0062-003 - English (PDF) Summary of Benefits, H0062-003 - Spanish (PDF)
Allwell Medicare (HMO)	H5294 - 011	Aransas, Bee, Brooks, Cameron, Goliad, Hidalgo, Jim Hogg, Jim Wells, Kenedy, Kleberg, Nueces, Refugio, Starr, Willacy and Zapata counties	Summary of Benefits, H5294-011 - English (PDF) Summary of Benefits, H5294-011 - Spanish (PDF)
Allwell Medicare Boost (HMO)	H5294 - 012	Aransas, Bee, Brooks, Cameron, Goliad, Hidalgo, Jim Hogg, Jim Wells, Kenedy, Kleberg, Nueces, Refugio, Starr, Willacy and Zapata counties	Summary of Benefits, H5294-012 - English (PDF) Summary of Benefits, H5294-012 - Spanish (PDF)
Allwell Medicare Complement (HMO)	H5294 - 013	Aransas, Bee, Brooks, Cameron, Goliad, Hidalgo, Jim Hogg, Jim Wells, Kenedy, Kleberg, Nueces, Refugio, Starr, Willacy and Zapata counties	Summary of Benefits, H5294-013 - English (PDF) Summary of Benefits, H5294-013 - Spanish (PDF)
Allwell Medicare Simple (HMO)	H5294 - 014	Aransas, Armstrong, Atascosa, Bailey, Bandera, Bastrop, Bee, Bexar, Blanco, Borden, Bosque, Briscoe, Brooks, Burnet, Caldwell, Calhoun, Cameron, Castro, Cochran, Coke, Collin, Colorado, Comal, Crosby, Dallas, Denton, DeWitt, Dickens, Dimmit, Donley, Duval, El Paso, Erath, Fayette, Fisher, Floyd, Garza, Gillespie, Glasscock, Goliad, Gonzales, Grimes, Guadalupe, Hale, Hamilton, Hays, Hidalgo, Hill, Hockley, Hunt, Irion, Jack, Jim Hogg, Jim Wells, Karnes, Kendall, Kenedy, Kent, Kimble, Kleberg, La Salle, Lamb, Lee, Leon, Limestone, Lubbock, Lynn, Martin, Mason, Maverick, McCulloch, McMullen, Medina, Milam, Mills, Mitchell, Navarro, Nolan, Nueces, Palo Pinto, Real, Refugio, Rockwall, San Saba, Shackelford, Somervell, Starr, Sterling, Swisher, Tarrant, Terry, Throckmorton, Uvalde, Willacy, Williamson, Wilson, Zapata and Zavala counties	Summary of Benefits, H5294-014 - English (PDF) Summary of Benefits, H5294-014 - Spanish (PDF)
Allwell Medicare Complement (HMO)	H5294 - 016	Armstrong, Atascosa, Bailey, Bandera, Bastrop, Bexar, Blanco, Borden, Bosque, Briscoe, Burnet, Caldwell, Calhoun, Castro, Cochran, Coke, Collin, Colorado, Comal, Crosby, Dallas, Denton, DeWitt, Dickens, Dimmit, Donley, Duval, El Paso, Erath, Fayette, Fisher, Floyd, Garza, Gillespie, Glasscock, Gonzales, Grimes, Guadalupe, Hale, Hamilton, Hays, Hill, Hockley, Hunt, Irion, Jack, Karnes, Kendall, Kent, Kimble, La Salle, Lamb, Lee, Leon, Limestone, Lubbock, Lynn, Martin, Mason, Maverick, McCulloch, McMullen, Medina, Milam, Mills, Mitchell, Navarro, Nolan, Palo Pinto, Real, Rockwall, San Saba, Shackelford, Somervell, Sterling, Swisher, Tarrant, Terry, Throckmorton, Uvalde, Williamson, Wilson and Zavala counties	Summary of Benefits, H5294-016 - English (PDF) Summary of Benefits, H5294-016 - Spanish (PDF)
Allwell Medicare (HMO)	H5294 - 017	Atascosa, Bandera, Bexar, Comal, Guadalupe, Karnes, Kendall, Medina and Wilson counties	Summary of Benefits, H5294-017 - English (PDF) Summary of Benefits, H5294-017 - Spanish (PDF)
Allwell Medicare (HMO)	H5294 - 018	Lubbock county	Summary of Benefits, H5294-018- English (PDF) Summary of Benefits, H5294-018- Spanish (PDF)

For HMO D-SNP Members:

Plan Name	CMS #	County	Summary of Benefits (SB)
Allwell Medicare Nurture (HMO D-SNP)	H5294 - 010	Aransas, Armstrong, Atascosa, Bailey, Bandera, Bee, Bexar, Borden, Bosque, Briscoe, Brooks, Calhoun, Cameron, Castro, Cochran, Coke, Collin, Colorado, Comal, Crosby, Dallas, Denton, DeWitt, Dickens, Dimmit, Donley, Duval, El Paso, Erath, Fayette, Fisher, Floyd, Garza, Gillespie, Glasscock, Goliad, Gonzales, Grimes, Guadalupe, Hale, Hamilton, Hidalgo, Hill, Hockley, Hunt, Irion, Jack, Jim Hogg, Jim Wells, Karnes, Kendall, Kenedy, Kent, Kimble, Kleberg, La Salle, Lamb, Leon, Limestone, Lubbock, Lynn, Martin, Mason, Maverick, McCulloch, McMullen, Medina, Mills, Mitchell, Navarro, Nolan, Nueces, Palo Pinto, Real, Refugio, Rockwall, San Saba, Shackelford, Somervell, Starr, Sterling, Swisher, Tarrant, Terry, Throckmorton, Uvalde, Willacy, Wilson, Zapata and Zavala counties	Summary of Benefits, H5294-010 - English (PDF) Summary of Benefits, H5294-010 - Spanish (PDF)
Allwell Dual Medicare Harmony (HMO D-SNP)	H5294 - 015	Aransas, Armstrong, Atascosa, Bailey, Bandera, Bastrop, Bee, Bexar, Blanco, Borden, Bosque, Briscoe, Brooks, Burnet, Caldwell, Calhoun, Cameron, Castro, Cochran, Coke, Collin, Colorado, Comal, Crosby, Dallas, Denton, DeWitt, Dickens, Dimmit, Donley, Duval, El Paso, Erath, Fayette, Fisher, Floyd, Garza, Gillespie, Glasscock, Goliad, Gonzales, Grimes, Guadalupe, Hale, Hamilton, Hays, Hidalgo, Hill, Hockley, Hunt, Irion, Jack, Jim Hogg, Jim Wells, Karnes, Kendall, Kenedy, Kent, Kimble, Kleberg, La Salle, Lamb, Lee, Leon, Limestone, Lubbock, Lynn, Martin, Mason, Maverick, McCulloch, McMullen, Medina, Milam, Mills, Mitchell, Navarro, Nolan, Nueces, Palo Pinto, Real, Refugio, Rockwall, San Saba, Shackelford, Somervell, Starr, Sterling, Swisher, Tarrant, Terry, Throckmorton, Uvalde, Willacy, Williamson, Wilson, Zapata and Zavala counties	Summary of Benefits, H5294-015 - English (PDF) Summary of Benefits, H5294-015 - Spanish (PDF)

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 (EOC)
Allwell Medicare (HMO)	H0062-001	Aransas, Bexar, Comal, El Paso, Guadalupe, Jim Wells, Nueces and Wilson counties	EOC, H0062-001 - English (PDF) EOC, H0062-001 - Spanish (PDF)
Allwell Medicare (HMO)	H0062-002	Collin, Dallas, Denton, Rockwall and Tarrant counties	EOC, H0062-002 - English (PDF) EOC, H0062-002 - Spanish (PDF)
Allwell Medicare (HMO)	H0062-003	Cameron, Hidalgo and Starr counties	EOC, H0062-003 - English (PDF) EOC, H0062-003 - Spanish (PDF)
Allwell Medicare (HMO)	H5294 - 011	Aransas, Bee, Brooks, Cameron, Goliad, Hidalgo, Jim Hogg, Jim Wells, Kenedy, Kleberg, Nueces, Refugio, Starr, Willacy and Zapata counties	EOC, H5294-011 - English (PDF) EOC, H5294-011 - Spanish (PDF)
Allwell Medicare Boost (HMO)	H5294 - 012	Aransas, Bee, Brooks, Cameron, Goliad, Hidalgo, Jim Hogg, Jim Wells, Kenedy, Kleberg, Nueces, Refugio, Starr, Willacy and Zapata counties	EOC, H5294-012 - English (PDF) EOC, H5294-012 - Spanish (PDF)
Allwell Medicare Complement (HMO)	H5294 - 013	Aransas, Bee, Brooks, Cameron, Goliad, Hidalgo, Jim Hogg, Jim Wells, Kenedy, Kleberg, Nueces, Refugio, Starr, Willacy and Zapata counties	EOC, H5294-013 - English (PDF) EOC, H5294-013 - Spanish (PDF)
Allwell Medicare Simple (HMO)	H5294 - 014	Aransas, Armstrong, Atascosa, Bailey, Bandera, Bastrop, Bee, Bexar, Blanco, Borden, Bosque, Briscoe, Brooks, Burnet, Caldwell, Calhoun, Cameron, Castro, Cochran, Coke, Collin, Colorado, Comal, Crosby, Dallas, Denton, DeWitt, Dickens, Dimmit, Donley, Duval, El Paso, Erath, Fayette, Fisher, Floyd, Garza, Gillespie, Glasscock, Goliad, Gonzales, Grimes, Guadalupe, Hale, Hamilton, Hays, Hidalgo, Hill, Hockley, Hunt, Irion, Jack, Jim Hogg, Jim Wells, Karnes, Kendall, Kenedy, Kent, Kimble, Kleberg, La Salle, Lamb, Lee, Leon, Limestone, Lubbock, Lynn, Martin, Mason, Maverick, McCulloch, McMullen, Medina, Milam, Mills, Mitchell, Navarro, Nolan, Nueces, Palo Pinto, Real, Refugio, Rockwall, San Saba, Shackelford, Somervell, Starr, Sterling, Swisher, Tarrant, Terry, Throckmorton, Uvalde, Willacy, Williamson, Wilson, Zapata and Zavala counties	EOC, H5294-014 - English (PDF) EOC, H5294-014 - Spanish (PDF)
Allwell Medicare Complement (HMO)	H5294 - 016	Armstrong, Atascosa, Bailey, Bandera, Bastrop, Bexar, Blanco, Borden, Bosque, Briscoe, Burnet, Caldwell, Calhoun, Castro, Cochran, Coke, Collin, Colorado, Comal, Crosby, Dallas, Denton, DeWitt, Dickens, Dimmit, Donley, Duval, El Paso, Erath, Fayette, Fisher, Floyd, Garza, Gillespie, Glasscock, Gonzales, Grimes, Guadalupe, Hale, Hamilton, Hays, Hill, Hockley, Hunt, Irion, Jack, Karnes, Kendall, Kent, Kimble, La Salle, Lamb, Lee, Leon, Limestone, Lubbock, Lynn, Martin, Mason, Maverick, McCulloch, McMullen, Medina, Milam, Mills, Mitchell, Navarro, Nolan, Palo Pinto, Real, Rockwall, San Saba, Shackelford, Somervell, Sterling, Swisher, Tarrant, Terry, Throckmorton, Uvalde, Williamson, Wilson and Zavala counties	EOC, H5294-016 - English (PDF) EOC, H5294-016 - Spanish (PDF)
Allwell Medicare (HMO)	H5294 - 017	Atascosa, Bandera, Bexar, Comal, Guadalupe, Karnes, Kendall, Medina and Wilson counties	EOC, H5294-017 - English (PDF) EOC, H5294-017 - Spanish (PDF)
Allwell Medicare (HMO)	H5294 - 018	Lubbock county	EOC, H5294-018- English (PDF)

For HMO D-SNP Members:

2021 Medicare Defined Cost-Sharing Amounts Notice (PDF)

Plan Name	CMS #	County	Evidence of Coverage (EOC)
Allwell Medicare Nurture (HMO D-SNP)	H5294 - 010	Aransas, Armstrong, Atascosa, Bailey, Bandera, Bee, Bexar, Borden, Bosque, Briscoe, Brooks, Calhoun, Cameron, Castro, Cochran, Coke, Collin, Colorado, Comal, Crosby, Dallas, Denton, DeWitt, Dickens, Dimmit, Donley, Duval, El Paso, Erath, Fayette, Fisher, Floyd, Garza, Gillespie, Glasscock, Goliad, Gonzales, Grimes, Guadalupe, Hale, Hamilton, Hidalgo, Hill, Hockley, Hunt, Irion, Jack, Jim Hogg, Jim Wells, Karnes, Kendall, Kenedy, Kent, Kimble, Kleberg, La Salle, Lamb, Leon, Limestone, Lubbock, Lynn, Martin, Mason, Maverick, McCulloch, McMullen, Medina, Mills, Mitchell, Navarro, Nolan, Nueces, Palo Pinto, Real, Refugio, Rockwall, San Saba, Shackelford, Somervell, Starr, Sterling, Swisher, Tarrant, Terry, Throckmorton, Uvalde, Willacy, Wilson, Zapata and Zavala counties	EOC, H5294-010 - English (PDF) EOC, H5294-010 - Spanish (PDF)
Allwell Dual Medicare Harmony (HMO D-SNP)	H5294 - 015	Aransas, Armstrong, Atascosa, Bailey, Bandera, Bastrop, Bee, Bexar, Blanco, Borden, Bosque, Briscoe, Brooks, Burnet, Caldwell, Calhoun, Cameron, Castro, Cochran, Coke, Collin, Colorado, Comal, Crosby, Dallas, Denton, DeWitt, Dickens, Dimmit, Donley, Duval, El Paso, Erath, Fayette, Fisher, Floyd, Garza, Gillespie, Glasscock, Goliad, Gonzales, Grimes, Guadalupe, Hale, Hamilton, Hays, Hidalgo, Hill, Hockley, Hunt, Irion, Jack, Jim Hogg, Jim Wells, Karnes, Kendall, Kenedy, Kent, Kimble, Kleberg, La Salle, Lamb, Lee, Leon, Limestone, Lubbock, Lynn, Martin, Mason, Maverick, McCulloch, McMullen, Medina, Milam, Mills, Mitchell, Navarro, Nolan, Nueces, Palo Pinto, Real, Refugio, Rockwall, San Saba, Shackelford, Somervell, Starr, Sterling, Swisher, Tarrant, Terry, Throckmorton, Uvalde, Willacy, Williamson, Wilson, Zapata and Zavala counties	EOC, H5294-015 - English (PDF) EOC, H5294-015 - Spanish (PDF)

If you were enrolled in Superior HealthPlan Medicare Advantage 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 (ANOC)
Allwell Medicare (HMO)	H0062-001	Aransas, Bexar, Comal, El Paso, Guadalupe, Jim Wells, Nueces and Wilson counties	ANOC, H0062-001 - English (PDF) ANOC, H0062-001 - Spanish (PDF)
Allwell Medicare (HMO)	H0062-002	Collin, Dallas, Denton, Rockwall and Tarrant counties	ANOC, H0062-002 - English (PDF) ANOC, H0062-002 - Spanish (PDF)
Allwell Medicare (HMO)	H0062-003	Cameron, Hidalgo and Starr counties	ANOC, H0062-003 - English (PDF) ANOC H0062-003 - Spanish (PDF)

For HMO D-SNP Members:

Plan Name	CMS #	County	Annual Notice of Changes (ANOC)
Allwell Medicare Nurture (HMO D-SNP)	H5294-002-002-010	Aransas, Armstrong, Atascosa, Bailey, Bandera, Bee, Bexar, Borden, Bosque, Briscoe, Brooks, Calhoun, Cameron, Castro, Cochran, Coke, Collin, Colorado, Comal, Crosby, Dallas, Denton, DeWitt, Dickens, Dimmit, Donley, Duval, El Paso, Erath, Fayette, Fisher, Floyd, Garza, Gillespie, Glasscock, Goliad, Gonzales, Grimes, Guadalupe, Hale, Hamilton, Hidalgo, Hill, Hockley, Hunt, Irion, Jack, Jim Hogg, Jim Wells, Karnes, Kendall, Kenedy, Kent, Kimble, Kleberg, La Salle, Lamb, Leon, Limestone, Lubbock, Lynn, Martin, Mason, Maverick, McCulloch, McMullen, Medina, Mills, Mitchell, Navarro, Nolan, Nueces, Palo Pinto, Real, Refugio, Rockwall, San Saba, Shackelford, Somervell, Starr, Sterling, Swisher, Tarrant, Terry, Throckmorton, Uvalde, Willacy, Wilson, Zapata and Zavala counties	ANOC, H5294-002-002-010 - English (PDF) ANOC, H5294-002-002-010 - Spanish (PDF)
Allwell Medicare Nurture (HMO D-SNP)	H5294-002-003-010	Aransas, Armstrong, Atascosa, Bailey, Bandera, Bee, Bexar, Borden, Bosque, Briscoe, Brooks, Calhoun, Cameron, Castro, Cochran, Coke, Collin, Colorado, Comal, Crosby, Dallas, Denton, DeWitt, Dickens, Dimmit, Donley, Duval, El Paso, Erath, Fayette, Fisher, Floyd, Garza, Gillespie, Glasscock, Goliad, Gonzales, Grimes, Guadalupe, Hale, Hamilton, Hidalgo, Hill, Hockley, Hunt, Irion, Jack, Jim Hogg, Jim Wells, Karnes, Kendall, Kenedy, Kent, Kimble, Kleberg, La Salle, Lamb, Leon, Limestone, Lubbock, Lynn, Martin, Mason, Maverick, McCulloch, McMullen, Medina, Mills, Mitchell, Navarro, Nolan, Nueces, Palo Pinto, Real, Refugio, Rockwall, San Saba, Shackelford, Somervell, Starr, Sterling, Swisher, Tarrant, Terry, Throckmorton, Uvalde, Willacy, Wilson, Zapata and Zavala counties	ANOC, H5294-002-003-010 - English (PDF) ANOC, H5294-002-003-010 - Spanish (PDF)
Allwell Medicare Nurture (HMO D-SNP)	H5294-002-004-010	Aransas, Armstrong, Atascosa, Bailey, Bandera, Bee, Bexar, Borden, Bosque, Briscoe, Brooks, Calhoun, Cameron, Castro, Cochran, Coke, Collin, Colorado, Comal, Crosby, Dallas, Denton, DeWitt, Dickens, Dimmit, Donley, Duval, El Paso, Erath, Fayette, Fisher, Floyd, Garza, Gillespie, Glasscock, Goliad, Gonzales, Grimes, Guadalupe, Hale, Hamilton, Hidalgo, Hill, Hockley, Hunt, Irion, Jack, Jim Hogg, Jim Wells, Karnes, Kendall, Kenedy, Kent, Kimble, Kleberg, La Salle, Lamb, Leon, Limestone, Lubbock, Lynn, Martin, Mason, Maverick, McCulloch, McMullen, Medina, Mills, Mitchell, Navarro, Nolan, Nueces, Palo Pinto, Real, Refugio, Rockwall, San Saba, Shackelford, Somervell, Starr, Sterling, Swisher, Tarrant, Terry, Throckmorton, Uvalde, Willacy, Wilson, Zapata and Zavala counties	ANOC, H5294-002-004-010 - English (PDF) ANOC, H5294-002-004-010 - Spanish (PDF)
Allwell Medicare Nurture (HMO D-SNP)	H5294-002-009-010	Aransas, Armstrong, Atascosa, Bailey, Bandera, Bee, Bexar, Borden, Bosque, Briscoe, Brooks, Calhoun, Cameron, Castro, Cochran, Coke, Collin, Colorado, Comal, Crosby, Dallas, Denton, DeWitt, Dickens, Dimmit, Donley, Duval, El Paso, Erath, Fayette, Fisher, Floyd, Garza, Gillespie, Glasscock, Goliad, Gonzales, Grimes, Guadalupe, Hale, Hamilton, Hidalgo, Hill, Hockley, Hunt, Irion, Jack, Jim Hogg, Jim Wells, Karnes, Kendall, Kenedy, Kent, Kimble, Kleberg, La Salle, Lamb, Leon, Limestone, Lubbock, Lynn, Martin, Mason, Maverick, McCulloch, McMullen, Medina, Mills, Mitchell, Navarro, Nolan, Nueces, Palo Pinto, Real, Refugio, Rockwall, San Saba, Shackelford, Somervell, Starr, Sterling, Swisher, Tarrant, Terry, Throckmorton, Uvalde, Willacy, Wilson, Zapata and Zavala counties	ANOC, H5294-002-009-010 - English (PDF) ANOC, H5294-002-009-010 - Spanish (PDF)

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