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- Shop for Plans show Shop for Plans menu
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Pharmacy Benefits
show Pharmacy Benefits menu
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- Find a Doctor or Pharmacy
- List of Drugs (Formulary)
- Medication Therapy Management (MTMP)
- Mail Order Service
- Specialty Pharmacy
- Coverage Determinations and Redeterminations
- Prior Authorization, Step Therapy & Quantity Limitations
- Out-of-Network Pharmacies
- Medication (Drug) Management and Safety
- Drug Transition Policy
- Pharmacy Forms
- Medicare Prescription Payment Plan
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Plan Benefit Materials | Health Net Medicare Advantage for Oregon and Washington
Plan Benefit Materials
Learn about your plan and all that it has to offer by reviewing helpful plan documents such as the Annual Notice of Change (ANOC), Summary of Benefits, and Evidence of Coverage.
To get started, locate your plan in the list of plans below and select “Plan Benefits.”
HMO
Additional Forms
Plan Benefit Materials
Learn about your plan and all that it has to offer by reviewing helpful plan documents such as the Annual Notice of Change (ANOC), Summary of Benefits, and Evidence of Coverage.
To get started, locate your plan in the list of plans below and select “Plan Benefits.”
HMO
Wellcare Simple Value (HMO-POS) H6815-038
Counties: Benton, Clackamas, Columbia, Coos, Douglas, Jackson, Josephine, Lane, Linn, Marion, Multnomah, Polk, Washington, Yamhill
Annual Notice of Changes
- Annual Notice of Change: Wellcare Assist (HMO) to Wellcare Simple Value (HMO-POS) - English (PDF)
- Annual Notice of Change: Wellcare No Premium (HMO) to Wellcare Simple Value (HMO-POS) - English (PDF)
Summary of Benefits
Evidence of Coverage
Wellcare Simple (HMO-POS) H6815-039
Counties: Benton, Clackamas, Columbia, Linn, Marion, Multnomah, Polk, Washington, Yamhill
Annual Notice of Changes
Summary of Benefits
Evidence of Coverage
Wellcare PeaceHealth Simple (HMO-POS) H6815-040
Counties: Lane
Summary of Benefits
Evidence of Coverage
PPO
Wellcare Patriot Giveback Open (PPO) H5439-010
Counties: Benton, Clackamas, Douglas, Jackson, Josephine, Lane, Linn, Marion, Multnomah, Polk, Washington, Yamhill
Annual Notice of Changes
Summary of Benefits
Evidence of Coverage - coming soon
Wellcare Premium Ultra Open (PPO) H5439-011
Counties: Benton, Clackamas, Douglas, Jackson, Josephine, Lane, Linn, Marion, Multnomah, Polk, Washington, Yamhill
Annual Notice of Changes
Summary of Benefits
Evidence of Coverage
Wellcare Giveback Open (PPO) H5439-015
Counties: Benton, Clackamas, Clark, Douglas, Jackson, Josephine, Lane, Linn, Marion, Multnomah, Polk, Washington, Yamhill
Annual Notice of Changes
Summary of Benefits
Evidence of Coverage
Wellcare Simple Open (PPO) H5439-017
Counties: Benton, Clackamas, Douglas, Jackson, Josephine, Lane, Linn, Marion, Multnomah, Polk, Washington, Yamhill
Annual Notice of Changes
Summary of Benefits
Evidence of Coverage
Wellcare Low Premium Open (PPO) H5439-019
Counties: Benton, Clackamas, Clark, Douglas, Jackson, Josephine, Lane, Linn, Marion, Multnomah, Polk, Washington, Yamhill
Annual Notice of Changes
Summary of Benefits
Evidence of Coverage
Additional Forms
If you have questions please, contact Member Services.
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