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 (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)

For HMO D-SNP Members:

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)

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 (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)

For HMO D-SNP Members:

2020 Medicare Defined Cost Sharing Amounts Notice (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)

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
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)

For HMO D-SNP Members:

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)

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.

Over-the-Counter Catalog - English / Spanish (PDF)

Don’t want to wait? You may be able to pick up your OTC products from a CVS 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

Acupuncture National Coverage (PDF)

Spotlight on Health newsletters
Healthy Moves newsletters

Take Charge of Your Mental Health

We all have our struggles.

Finding support to focus on your emotional health is important.

Now you can use web and mobile tools to help you get better and stay mentally strong.

myStrength is a free online tool to help you live your best life. myStrength is available 24/7 from your computer or mobile device. It offers personalized resources to improve your mood. Learning to use myStrength’s tools can help you overcome the challenges you face.

On myStrength you will find:

Hundreds of wellness resources
Self-help tools
Online health trackers
Personalized activities
Uplifting daily quotes

Safe, secure, effective.

Your privacy is our top priority. myStrength is a confidential and safe place for you.

1. Visit the myStrength website.

2. Complete the myStrength sign-up process and personal profile.

Y0020_19_12664WEB_C_06042019

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)

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)

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)

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)

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)

Plan Benefit Materials | Allwell from Superior HealthPlan

Plan Materials and Forms

For HMO Members:

For HMO D-SNP Members:

For HMO Members:

For HMO D-SNP Members:

For HMO Members:

For HMO D-SNP Members:

Take Charge of Your Mental Health

Plan Benefit Materials

For HMO Members:

For HMO D-SNP Members:

For HMO Members:

For HMO D-SNP Members:

For HMO Members:

For HMO D-SNP Members:

Take Charge of Your Mental Health

Plan Benefit Materials | Allwell from Superior HealthPlan

Plan Materials and Forms

Summary of Benefits (SB)

For HMO Members:

For HMO D-SNP Members:

Evidence Of Coverage (EOC)

For HMO Members:

For HMO D-SNP Members:

Annual Notice of Changes (ANOC)

For HMO Members:

For HMO D-SNP Members:

Over-the-Counter Benefits

Acupuncture National Coverage

Member Newsletters

myStrength

Take Charge of Your Mental Health

Plan Benefit Materials

Summary of Benefits (SB)

For HMO Members:

For HMO D-SNP Members:

Evidence Of Coverage (EOC)

For HMO Members:

For HMO D-SNP Members:

Annual Notice of Changes (ANOC)

For HMO Members:

For HMO D-SNP Members:

Acupuncture National Coverage

Member Newsletters

myStrength

Take Charge of Your Mental Health

Spotlight on Health Newsletter 2021

Over-The-Counter Benefits