Plan Benefit Materials | Allwell from Buckeye Health Plan
Explore your plan and its benefits by reviewing important documents like 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.”
Wellcare
Wellcare Assist (HMO-POS) H0908-004
Counties: Adams, Allen, Ashland, Ashtabula, Athens, Auglaize, Belmont, Brown, Butler, Carroll, Champaign, Clark, Clermont, Clinton, Columbiana, Coshocton, Crawford, Cuyahoga, Darke, Defiance, Delaware, Erie, Fairfield, Fayette, Franklin, Fulton, Gallia, Geauga, Greene, Guernsey, Hamilton, Hancock, Hardin, Harrison, Henry, Highland, Hocking, Holmes, Huron, Jackson, Jefferson, Knox, Lake, Lawrence, Licking, Logan, Lorain, Lucas, Madison, Mahoning, Marion, Medina, Meigs, Mercer, Miami, Monroe, Montgomery, Morgan, Morrow, Muskingum, Noble, Ottawa, Paulding, Perry, Pickaway, Pike, Portage, Preble, Putnam, Richland, Ross, Sandusky, Scioto, Seneca, Shelby, Stark, Summit, Trumbull, Tuscarawas, Union, Van Wert, Vinton, Warren, Washington, Wayne, Williams, Wood, Wyandot
Annual Notice of Change
Summary of Benefits
Evidence of Coverage
- Evidence of Coverage - English (PDF) - Coming Soon
Dental Benefit Details
- Dental Benefit Details - English (PDF) - Coming Soon
Wellcare Simple (HMO-POS) H0908-003
Counties: Adams, Allen, Ashland, Ashtabula, Athens, Auglaize, Belmont, Brown, Butler, Carroll, Champaign, Clark, Clermont, Clinton, Columbiana, Coshocton, Crawford, Cuyahoga, Darke, Defiance, Delaware, Erie, Fairfield, Fayette, Franklin, Fulton, Gallia, Geauga, Greene, Guernsey, Hamilton, Hancock, Hardin, Harrison, Henry, Highland, Hocking, Holmes, Huron, Jackson, Jefferson, Knox, Lake, Lawrence, Licking, Logan, Lorain, Lucas, Madison, Mahoning, Marion, Medina, Meigs, Mercer, Miami, Monroe, Montgomery, Morgan, Morrow, Muskingum, Noble, Ottawa, Paulding, Perry, Pickaway, Pike, Portage, Preble, Putnam, Richland, Ross, Sandusky, Scioto, Seneca, Shelby, Stark, Summit, Trumbull, Tuscarawas, Union, Van Wert, Vinton, Warren, Washington, Wayne, Williams, Wood, Wyandot
Annual Notice of Change
Summary of Benefits
Evidence of Coverage
- Evidence of Coverage - English (PDF) - Coming Soon
Dental Benefit Details
- Dental Benefit Details - English (PDF) - Coming Soon
Wellcare Dual Access (HMO-POS D-SNP) H0908-001
Counties: Adams, Allen, Ashland, Ashtabula, Athens, Auglaize, Belmont, Brown, Butler, Carroll, Champaign, Clark, Clermont, Clinton, Columbiana, Coshocton, Crawford, Cuyahoga, Darke, Defiance, Delaware, Erie, Fairfield, Fayette, Franklin, Fulton, Gallia, Geauga, Greene, Guernsey, Hamilton, Hancock, Hardin, Harrison, Henry, Highland, Hocking, Holmes, Huron, Jackson, Jefferson, Knox, Lake, Lawrence, Licking, Logan, Lorain, Lucas, Madison, Mahoning, Marion, Medina, Meigs, Mercer, Miami, Monroe, Montgomery, Morgan, Morrow, Muskingum, Noble, Ottawa, Paulding, Perry, Pickaway, Pike, Portage, Preble, Putnam, Richland, Ross, Sandusky, Scioto, Seneca, Shelby, Stark, Summit, Trumbull, Tuscarawas, Union, Van Wert, Vinton, Warren, Washington, Wayne, Williams, Wood, Wyandot
Annual Notice of Change
Summary of Benefits
Evidence of Coverage
- Evidence of Coverage - English (PDF) - Coming Soon
Dental Benefit Details
- Dental Benefit Details - English (PDF) - Coming Soon
Wellcare Dual Liberty (HMO-POS D-SNP) H0908-007
Counties: Adams, Allen, Ashland, Athens, Auglaize, Brown, Carroll, Champaign, Coshocton, Crawford, Darke, Defiance, Erie, Fairfield, Fayette, Gallia, Guernsey, Hancock, Hardin, Harrison, Henry, Highland, Hocking, Holmes, Huron, Jackson, Jefferson, Knox, Lawrence, Licking, Logan, Marion, Meigs, Mercer, Miami, Monroe, Morgan, Morrow, Muskingum, Noble, Paulding, Perry, Pike, Preble, Putnam, Richland, Ross, Sandusky, Scioto, Seneca, Shelby, Tuscarawas, Van Wert, Vinton, Washington, Williams, Wyandot
Annual Notice of Change
Summary of Benefits
Evidence of Coverage
- Evidence of Coverage - English (PDF) - Coming Soon
Dental Benefit Details
- Dental Benefit Details - English (PDF) - Coming Soon
Wellcare Dual Liberty (HMO-POS D-SNP) H0908-008
Counties: Ashtabula, Belmont
Annual Notice of Change
- Annual Notice of Change - English (PDF) - Coming Soon
Summary of Benefits
Evidence of Coverage
- Evidence of Coverage - English (PDF) - Coming Soon
Dental Benefit Details
- Dental Benefit Details - English (PDF) - Coming Soon
Wellcare Dual Reserve (HMO-POS D-SNP) H0908-006
Counties: Adams, Allen, Ashland, Ashtabula, Athens, Auglaize, Belmont, Brown, Butler, Carroll, Champaign, Clark, Clermont, Clinton, Columbiana, Coshocton, Crawford, Cuyahoga, Darke, Defiance, Delaware, Erie, Fairfield, Fayette, Franklin, Fulton, Gallia, Geauga, Greene, Guernsey, Hamilton, Hancock, Hardin, Harrison, Henry, Highland, Hocking, Holmes, Huron, Jackson, Jefferson, Knox, Lake, Lawrence, Licking, Logan, Lorain, Lucas, Madison, Mahoning, Marion, Medina, Meigs, Mercer, Miami, Monroe, Montgomery, Morgan, Morrow, Muskingum, Noble, Ottawa, Paulding, Perry, Pickaway, Pike, Portage, Preble, Putnam, Richland, Ross, Sandusky, Scioto, Seneca, Shelby, Stark, Summit, Trumbull, Tuscarawas, Union, Van Wert, Vinton, Warren, Washington, Wayne, Williams, Wood, Wyandot
Annual Notice of Change
Summary of Benefits
Evidence of Coverage
- Evidence of Coverage - English (PDF) - Coming Soon
Dental Benefit Details
- Dental Benefit Details - English (PDF) - Coming Soon
HMO D-SNP Plans
Wellcare Buckeye MyCare Ohio Dual Align (HMO D-SNP) H4158-001
Counties: Adams, Allen, Ashland, Athens, Auglaize, Brown, Butler, Carroll, Champaign, Clark, Clermont, Clinton, Columbiana, Coshocton, Crawford, Cuyahoga, Darke, Defiance, Delaware, Erie, Fairfield, Fayette, Franklin, Fulton, Gallia, Geauga, Greene, Guernsey, Hamilton, Hancock, Hardin, Harrison, Henry, Highland, Hocking, Holmes, Huron, Jackson, Jefferson, Knox, Lake, Lawrence, Licking, Logan, Lorain, Lucas, Madison, Mahoning, Marion, Medina, Meigs, Mercer, Miami, Monroe, Montgomery, Morgan, Morrow, Muskingum, Noble, Ottawa, Paulding, Perry, Pickaway, Pike, Portage, Preble, Putnam, Richland, Ross, Sandusky, Scioto, Seneca, Shelby, Stark, Summit, Trumbull, Tuscarawas, Union, Van Wert, Vinton, Warren, Washington, Wayne, Williams, Wood, Wyandot
Annual Notice of Change
- Annual Notice of Change: Buckeye Health Plan - MyCare Ohio (Medicare-Medicaid Plan) H0022-001 to Wellcare Buckeye MyCare Ohio Dual Align (HMO D-SNP) H4158-001 - English (PDF) - Coming Soon
- Annual Notice of Change: Buckeye Health Plan - MyCare Ohio (Medicare-Medicaid Plan) H0022-001 to Wellcare Buckeye MyCare Ohio Dual Align (HMO D-SNP) H4158-001 - Spanish (PDF) - Coming Soon
- Annual Notice of Change: Wellcare Dual Access (HMO-POS D-SNP) H0908-001 to Wellcare Buckeye MyCare Ohio Dual Align (HMO D-SNP) H4158-001 - English (PDF) - Coming Soon
- Annual Notice of Change: Wellcare Dual Access (HMO-POS D-SNP) H0908-001 to Wellcare Buckeye MyCare Ohio Dual Align (HMO D-SNP) H4158-001 - Spanish (PDF) - Coming Soon
Summary of Benefits
- Summary of Benefits - English (PDF) - Coming Soon
- Summary of Benefits - Spanish (PDF) - Coming Soon
Member Handbook
- Member Handbook - English (PDF) - Coming Soon
- Member Handbook - Spanish (PDF) - Coming Soon
Dental Benefit Details
- Dental Benefit Details - English (PDF) - Coming Soon
- Dental Benefit Details - Spanish (PDF) - Coming Soon
Additional Forms
- Over-the-Counter Catalog (PDF) - Coming Soon
- Over-the-Counter Catalog and Healthy Food (PDF) - Coming Soon
- Medicare Step Therapy Part B (PDF) - Coming Soon
- 2026 Medicare Parts A & B Premiums and Deductibles (PDF) - Coming Soon
- Member Secure Portal Guide (PDF) - Coming Soon