Plan Benefit Materials | Health Net Medicare Advantage for Oregon and Washington

Plan Materials and Forms

 

Information about plan benefits, services, and drug costs can be found in your plan materials.

You can also look for plan materials based on the plan name and the county you live in.

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:

Plans CMS# County Annual Notice of Changes
Wellcare Assist (HMO)  H6815-037 Benton, Clackamas, Columbia, Coos, Crook, Deschutes, Douglas, Jackson, Jefferson, Josephine, Lane, Linn, Marion, Multnomah, Polk, Washington, Yamhill
Wellcare No Premium (HMO) H6815-038 Benton, Clackamas, Columbia, Coos, Crook, Deschutes, Douglas, Jackson, Jefferson, Josephine, Lane, Linn, Marion, Multnomah, Polk, Washington, Yamhill
Wellcare No Premium (HMO) H6815-039

Benton, Clackamas, Columbia, Crook, Deschutes, Jefferson, Lane, Linn, Marion, Multnomah, Polk, Washington, Yamhill

For HMO D-SNP Members:

Plans CMS# County Annual Notice of Changes
Wellcare Dual Select  (HMO D-SNP)  H2174-001 Lane
  • Summary of Benefits, H2174-001 - English (PDF) - Coming Soon

For PPO Members:

Plans CMS# County Annual Notice of Changes
Wellcare Premium Ultra Open (PPO) H5439-011 Benton, Clackamas, Douglas, Jackson, Josephine, Lane, Linn, Marion, Multnomah, Polk, Washington, Yamhill
Wellcare Giveback Open (PPO) H5439-015 Benton, Clackamas, Douglas, Jackson, Josephine, Lane, Linn, Marion, Multnomah, Polk, Washington, Yamhill
  • Summary of Benefits, H5439-015  - English (PDF) - Coming Soon
Wellcare No Premium Open (PPO) H5439-017 Benton, Clackamas, Douglas, Jackson, Josephine, Lane, Linn, Marion, Multnomah, Polk, Washington, Yamhill
Wellcare Low Premium Open (PPO) H5439-019 Benton, Clackamas, Douglas, Jackson, Josephine, Lane, Linn, Marion, Multnomah, Polk, Washington, Yamhill
  • Summary of Benefits, H5439-019 - English (PDF) - Coming Soon
Wellcare Patriot No Premium Open (PPO) H5439-010 Benton, Clackamas, Douglas, Jackson, Josephine, Lane, Linn, Marion, Multnomah, Polk, Washington, Yamhill

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:

Plans CMS# County Annual Notice of Changes
Wellcare Assist (HMO)  H6815-037 Benton, Clackamas, Columbia, Coos, Crook, Deschutes, Douglas, Jackson, Jefferson, Josephine, Lane, Linn, Marion, Multnomah, Polk, Washington, Yamhill
Wellcare No Premium (HMO) H6815-038 Benton, Clackamas, Columbia, Coos, Crook, Deschutes, Douglas, Jackson, Jefferson, Josephine, Lane, Linn, Marion, Multnomah, Polk, Washington, Yamhill

For HMO D-SNP Members:

Plans CMS# County Annual Notice of Changes
Wellcare Dual Select  (HMO D-SNP)  H2174-001 Lane

For PPO Members:

Plans CMS# County Annual Notice of Changes
Wellcare Premium Ultra Open (PPO) H5439-011 Benton, Clackamas, Douglas, Jackson, Josephine, Lane, Linn, Marion, Multnomah, Polk, Washington, Yamhill
Wellcare Giveback Open (PPO) H5439-015 Benton, Clackamas, Douglas, Jackson, Josephine, Lane, Linn, Marion, Multnomah, Polk, Washington, Yamhill
Wellcare No Premium Open (PPO) H5439-017 Benton, Clackamas, Douglas, Jackson, Josephine, Lane, Linn, Marion, Multnomah, Polk, Washington, Yamhill
Wellcare Low Premium Open (PPO) to Wellcare Low Premium Open (PPO) H5439-018 to H5439-019 Benton, Clackamas, Douglas, Jackson, Josephine, Lane, Linn, Marion, Multnomah, Polk, Washington, Yamhill
Wellcare Low Premium Open (PPO) H5439-019 Benton, Clackamas, Douglas, Jackson, Josephine, Lane, Linn, Marion, Multnomah, Polk, Washington, Yamhill
Wellcare Patriot No Premium Open (PPO) H5439-010 Benton, Clackamas, Douglas, Jackson, Josephine, Lane, Linn, Marion, Multnomah, Polk, Washington, Yamhill

  • Medicare Step Therapy Part B (PDF) - Coming soon