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Plan Benefit Materials | Health Net Medicare Advantage for California
2026 Plan Benefit Materials
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 Low Premium (HMO) H0562-012
Counties: Imperial, San Diego
Annual Notice of Change
- Annual Notice of Change: Wellcare Simple Focus (HMO) H0562-012 to Wellcare Low Premium (HMO) H0562-012 - English (PDF)
- Annual Notice of Change: Wellcare Simple Focus (HMO) H0562-012 to Wellcare Low Premium (HMO) H0562-012 - Spanish (PDF)
Summary of Benefits
Evidence of Coverage
Dental Benefit Details
Your OTC Highlight
Wellcare Low Premium (HMO) H0562-097
Counties: San Francisco
Annual Notice of Change
- Annual Notice of Change: Wellcare Simple Focus (HMO) H0562-097 to Wellcare Low Premium (HMO) H0562-097 - English (PDF)
- Annual Notice of Change: Wellcare Simple Focus (HMO) H0562-097 to Wellcare Low Premium (HMO) H0562-097 - Chinese (Traditional) (PDF)
Summary of Benefits
Evidence of Coverage
Dental Benefit Details
Your OTC Highlight
Wellcare Low Premium (HMO) H0562-133
Counties: Amador, Yolo
Annual Notice of Change
Summary of Benefits
Evidence of Coverage
Dental Benefit Details
Wellcare Low Premium (HMO) H0562-136
Counties: Los Angeles, Orange
Annual Notice of Change
Summary of Benefits
Evidence of Coverage
Dental Benefit Details
Wellcare Low Premium (HMO) H0562-137
Counties: Imperial, Riverside, San Bernardino, San Diego
Annual Notice of Change
Summary of Benefits
Evidence of Coverage
Dental Benefit Details
Wellcare Simple Focus (HMO) H0562-125
Counties: Los Angeles, Orange
Annual Notice of Change
Summary of Benefits
Evidence of Coverage
Dental Benefit Details
Wellcare Simple Focus (HMO) H0562-126
Counties: Riverside, San Bernardino
Annual Notice of Change
Summary of Benefits
Evidence of Coverage
Dental Benefit Details
Wellcare Specialty Simple (HMO C-SNP) H0562-092
Counties: Kern, Los Angeles, Orange, Riverside, San Bernardino, San Diego
Annual Notice of Change
Summary of Benefits
Evidence of Coverage
Dental Benefit Details
Your OTC Highlight
Wellcare Specialty Simple Focus (HMO C-SNP) H0562-138
Counties: San Francisco
Summary of Benefits
Evidence of Coverage
Your OTC Highlight
Wellcare CalViva Health Dual Align (HMO D-SNP) H3561-007
Counties: Fresno, Kings, Madera
Annual Notice of Change
- Annual Notice of Change - English (PDF)
- Annual Notice of Change - Hmong (PDF)
- Annual Notice of Change - Spanish (PDF)
Summary of Benefits
- Summary of Benefits - English (PDF)
- Summary of Benefits - Hmong (PDF)
- Summary of Benefits - Spanish (PDF)
Evidence of Coverage
Wellcare Dual Liberty (HMO D-SNP) H3561-009
Counties: Imperial, Kern, Orange, Placer, Riverside, San Bernardino, San Diego, San Francisco
Annual Notice of Change
- Annual Notice of Change: Wellcare Dual Liberty (HMO D-SNP) H3561-001 to Wellcare Dual Liberty (HMO D-SNP) H3561-009 - English (PDF)
- Annual Notice of Change: Wellcare Dual Liberty (HMO D-SNP) H3561-001 to Wellcare Dual Liberty (HMO D-SNP) H3561-009 - Chinese (Simplified) (PDF)
- Annual Notice of Change: Wellcare Dual Liberty (HMO D-SNP) H3561-001 to Wellcare Dual Liberty (HMO D-SNP) H3561-009 - Spanish (PDF)
- Annual Notice of Change: Wellcare Dual Liberty (HMO D-SNP) H3561-009 to Wellcare Dual Liberty (HMO D-SNP) H3561-009 - English (PDF)
- Annual Notice of Change: Wellcare Dual Liberty (HMO D-SNP) H3561-009 to Wellcare Dual Liberty (HMO D-SNP) H3561-009 - Chinese (Simplified) (PDF)
- Annual Notice of Change: Wellcare Dual Liberty (HMO D-SNP) H3561-009 to Wellcare Dual Liberty (HMO D-SNP) H3561-009 - Spanish (PDF)
Summary of Benefits
- Summary of Benefits - English (PDF)
- Summary of Benefits - Chinese (Simplified) (PDF)
- Summary of Benefits - Spanish (PDF)
Evidence of Coverage
- Evidence of Coverage - English (PDF)
- Evidence of Coverage - Chinese (Simplified) (PDF)
- Evidence of Coverage - Spanish (PDF)
Dental Benefit Details
- Dental Benefit Details - English (PDF)
- Dental Benefit Details - Chinese (Simplified) (PDF)
- Dental Benefit Details - Spanish (PDF) - Coming Soon
Your OTC Highlight
Wellcare Health Net Dual Align (HMO D-SNP) H3561-008
Counties: Amador, Calaveras, Inyo, Los Angeles, Mono, Sacramento, San Joaquin, Stanislaus, Tulare, Tuolumne
Annual Notice of Change
- Annual Notice of Change: Wellcare Dual Align (HMO D-SNP) H3561-008 to Wellcare Health Net Dual Align (HMO D-SNP) H3561-008 - English (PDF)
- Annual Notice of Change: Wellcare Dual Align (HMO D-SNP) H3561-008 to Wellcare Health Net Dual Align (HMO D-SNP) H3561-008 - Arabic (PDF)
- Annual Notice of Change: Wellcare Dual Align (HMO D-SNP) H3561-008 to Wellcare Health Net Dual Align (HMO D-SNP) H3561-008 - Armenian (PDF)
- Annual Notice of Change: Wellcare Dual Align (HMO D-SNP) H3561-008 to Wellcare Health Net Dual Align (HMO D-SNP) H3561-008 - Cambodian/Khmer (PDF)
- Annual Notice of Change: Wellcare Dual Align (HMO D-SNP) H3561-008 to Wellcare Health Net Dual Align (HMO D-SNP) H3561-008 - Chinese (Simplified) (PDF)
- Annual Notice of Change: Wellcare Dual Align (HMO D-SNP) H3561-008 to Wellcare Health Net Dual Align (HMO D-SNP) H3561-008 - Farsi (PDF)
- Annual Notice of Change: Wellcare Dual Align (HMO D-SNP) H3561-008 to Wellcare Health Net Dual Align (HMO D-SNP) H3561-008 - Hmong (PDF)
- Annual Notice of Change: Wellcare Dual Align (HMO D-SNP) H3561-008 to Wellcare Health Net Dual Align (HMO D-SNP) H3561-008 - Korean (PDF)
- Annual Notice of Change: Wellcare Dual Align (HMO D-SNP) H3561-008 to Wellcare Health Net Dual Align (HMO D-SNP) H3561-008 - Russian (PDF)
- Annual Notice of Change: Wellcare Dual Align (HMO D-SNP) H3561-008 to Wellcare Health Net Dual Align (HMO D-SNP) H3561-008 - Spanish (PDF)
- Annual Notice of Change: Wellcare Dual Align (HMO D-SNP) H3561-008 to Wellcare Health Net Dual Align (HMO D-SNP) H3561-008 - Tagalog (PDF)
- Annual Notice of Change: Wellcare Dual Align (HMO D-SNP) H3561-008 to Wellcare Health Net Dual Align (HMO D-SNP) H3561-008 - Vietnamese (PDF)
- Annual Notice of Change: Wellcare Dual Liberty (HMO D-SNP) H3561-001 to Wellcare Health Net Dual Align (HMO D-SNP) H3561-008 - English (PDF)
- Annual Notice of Change: Wellcare Dual Liberty (HMO D-SNP) H3561-001 to Wellcare Health Net Dual Align (HMO D-SNP) H3561-008 - Arabic (PDF)
- Annual Notice of Change: Wellcare Dual Liberty (HMO D-SNP) H3561-001 to Wellcare Health Net Dual Align (HMO D-SNP) H3561-008 - Armenian (PDF)
- Annual Notice of Change: Wellcare Dual Liberty (HMO D-SNP) H3561-001 to Wellcare Health Net Dual Align (HMO D-SNP) H3561-008 - Cambodian/Khmer (PDF)
- Annual Notice of Change: Wellcare Dual Liberty (HMO D-SNP) H3561-001 to Wellcare Health Net Dual Align (HMO D-SNP) H3561-008 - Chinese (Simplified) (PDF)
- Annual Notice of Change: Wellcare Dual Liberty (HMO D-SNP) H3561-001 to Wellcare Health Net Dual Align (HMO D-SNP) H3561-008 - Farsi (PDF)
- Annual Notice of Change: Wellcare Dual Liberty (HMO D-SNP) H3561-001 to Wellcare Health Net Dual Align (HMO D-SNP) H3561-008 - Hmong (PDF)
- Annual Notice of Change: Wellcare Dual Liberty (HMO D-SNP) H3561-001 to Wellcare Health Net Dual Align (HMO D-SNP) H3561-008 - Korean (PDF)
- Annual Notice of Change: Wellcare Dual Liberty (HMO D-SNP) H3561-001 to Wellcare Health Net Dual Align (HMO D-SNP) H3561-008 - Russian (PDF)
- Annual Notice of Change: Wellcare Dual Liberty (HMO D-SNP) H3561-001 to Wellcare Health Net Dual Align (HMO D-SNP) H3561-008 - Spanish (PDF)
- Annual Notice of Change: Wellcare Dual Liberty (HMO D-SNP) H3561-001 to Wellcare Health Net Dual Align (HMO D-SNP) H3561-008 - Tagalog (PDF)
- Annual Notice of Change: Wellcare Dual Align (HMO D-SNP) H3561-008 to Wellcare Health Net Dual Align (HMO D-SNP) H3561-008 - Vietnamese (PDF)
Summary of Benefits
- Summary of Benefits - English (PDF)
- Summary of Benefits - Arabic (PDF)
- Summary of Benefits - Armenian (PDF)
- Summary of Benefits - Cambodian/Khmer (PDF)
- Summary of Benefits - Chinese (Simplified) (PDF)
- Summary of Benefits - Farsi (PDF)
- Summary of Benefits - Hmong (PDF)
- Summary of Benefits - Korean (PDF)
- Summary of Benefits - Russian (PDF)
- Summary of Benefits - Spanish (PDF)
- Summary of Benefits - Tagalog (PDF)
- Summary of Benefits - Vietnamese (PDF)
Evidence of Coverage
- Evidence of Coverage - English (PDF)
- Evidence of Coverage - Arabic (PDF)
- Evidence of Coverage - Armenian (PDF)
- Evidence of Coverage - Cambodian/Khmer (PDF)
- Evidence of Coverage - Chinese (Simplified) (PDF)
- Evidence of Coverage - Farsi (PDF)
- Evidence of Coverage - Hmong (PDF)
- Evidence of Coverage - Korean (PDF)
- Evidence of Coverage - Russian (PDF)
- Evidence of Coverage - Spanish (PDF)
- Evidence of Coverage - Tagalog (PDF)
- Evidence of Coverage - Vietnamese (PDF)
Dental Benefit Details
- Dental Benefit Details - English (PDF)
- Dental Benefit Details - Arabic (PDF) - Coming Soon
- Dental Benefit Details - Armenian (PDF)
- Dental Benefit Details - Cambodian/Khmer (PDF)
- Dental Benefit Details - Chinese (Simplified) (PDF)
- Dental Benefit Details - Farsi (PDF)
- Dental Benefit Details - Hmong (PDF)
- Dental Benefit Details - Korean (PDF)
- Dental Benefit Details - Russian (PDF)
- Dental Benefit Details- Russian (PDF) - Coming Soon
- Dental Benefit Details - Spanish (PDF) - Coming Soon
- Dental Benefit Details - Tagalog (PDF) - Coming Soon
- Dental Benefit Details - Vietnamese (PDF)
Your OTC Highlight
- Your OTC Highlight - English (PDF)
- Your OTC Highlight - Arabic (PDF)
- Your OTC Highlight - Cambodian/Khmer (PDF)
- Your OTC Highlight - Chinese (Simplified) (PDF)
- Your OTC Highlight - Hmong (PDF)
- Your OTC Highlight - Korean (PDF)
- Your OTC Highlight - Russian (PDF)
- Your OTC Highlight - Spanish (PDF)
- Your OTC Highlight - Tagalog (PDF)
- Your OTC Highlight - Vietnamese (PDF)
Additional Forms
- 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