Plan Benefit Materials | Health Net Medicare Advantage for California
2027 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) H0562-136
Counties: Los Angeles, Orange
Annual Notice of Change
Summary of Benefits
Evidence of Coverage
Dental Benefit Details
- Dental Benefit Details - English (PDF)
- Dental Benefit Details - Spanish (PDF) - Coming Soon
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
- Dental Benefit Details - English (PDF)
- Dental Benefit Details - Spanish (PDF) - Coming Soon
Wellcare Low Premium Focus (HMO) H0562-012
Counties: Imperial, San Diego
Annual Notice of Change
- Annual Notice of Change: Wellcare Low Premium (HMO) H0562-012 to Wellcare Low Premium Focus (HMO) H0562-012 - English (PDF)
- Annual Notice of Change: Wellcare Low Premium (HMO) H0562-012 to Wellcare Low Premium Focus (HMO) H0562-012 - Spanish (PDF)
Summary of Benefits
Evidence of Coverage
Dental Benefit Details
- Dental Benefit Details - English (PDF)
- Dental Benefit Details - Spanish (PDF) - Coming Soon
Wellcare Low Premium Focus (HMO) H0562-097
Counties: San Francisco
Annual Notice of Change
- Annual Notice of Change: Wellcare Low Premium (HMO) H0562-097 to Wellcare Low Premium Focus (HMO) H0562-097 - English (PDF)
- Annual Notice of Change: Wellcare Low Premium (HMO) H0562-097 to Wellcare Low Premium Focus (HMO) H0562-097 - Chinese (PDF)
Summary of Benefits
Evidence of Coverage
- Evidence of Coverage - English (PDF)
- Evidence of Coverage - Chinese (PDF) - Coming Soon
Dental Benefit Details
- Dental Benefit Details - English (PDF)
- Dental Benefit Details - Chinese (PDF) - Coming Soon
Wellcare Simple Focus (HMO) H0562-125
Counties: Los Angeles, Orange
Annual Notice of Change
Summary of Benefits
Evidence of Coverage
Dental Benefit Details
- Dental Benefit Details - English (PDF)
- Dental Benefit Details - Spanish (PDF) - Coming Soon
Wellcare Simple Focus (HMO) H0562-126
Counties: Riverside, San Bernardino
Annual Notice of Change
Summary of Benefits
Evidence of Coverage
Dental Benefit Details
- Dental Benefit Details - English (PDF)
- Dental Benefit Details - Spanish (PDF) - Coming Soon
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
- Dental Benefit Details - English (PDF)
- Dental Benefit Details - Spanish (PDF) - Coming Soon
Your OTC Highlight
Wellcare Specialty Simple Focus (HMO C-SNP) H0562-138
Counties: San Francisco
Annual Notice of Change
Summary of Benefits
Evidence of Coverage
- Evidence of Coverage - English (PDF)
- Evidence of Coverage - Chinese (PDF) - Coming Soon
Dental Benefit Details
- Dental Benefit Details - English (PDF)
- Dental Benefit Details - Chinese (PDF) - Coming Soon
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
- Evidence of Coverage - English (PDF)
- Evidence of Coverage - Hmong (PDF)
- Evidence of Coverage - Spanish (PDF)
Your OTC Highlight
Wellcare Health Net Dual Align (HMO D-SNP) H3561-010-001
Counties: Los Angeles
Annual Notice of Change
- Annual Notice of Change: Wellcare Health Net Dual Align (HMO D-SNP) H3561-008-000 to Wellcare Health Net Dual Align (HMO D-SNP) H3561-010-001 - English (PDF)
- Annual Notice of Change: Wellcare Health Net Dual Align (HMO D-SNP) H3561-008-000 to Wellcare Health Net Dual Align (HMO D-SNP) H3561-010-001 - Arabic (PDF)
- Annual Notice of Change: Wellcare Health Net Dual Align (HMO D-SNP) H3561-008-000 to Wellcare Health Net Dual Align (HMO D-SNP) H3561-010-001 - Armenian (PDF)
- Annual Notice of Change: Wellcare Health Net Dual Align (HMO D-SNP) H3561-008-000 to Wellcare Health Net Dual Align (HMO D-SNP) H3561-010-001 - Cambodian (PDF)
- Annual Notice of Change: Wellcare Health Net Dual Align (HMO D-SNP) H3561-008-000 to Wellcare Health Net Dual Align (HMO D-SNP) H3561-010-001 - Simplified Chinese (PDF)
- Annual Notice of Change: Wellcare Health Net Dual Align (HMO D-SNP) H3561-008-000 to Wellcare Health Net Dual Align (HMO D-SNP) H3561-010-001 - Farsi (PDF)
- Annual Notice of Change: Wellcare Health Net Dual Align (HMO D-SNP) H3561-008-000 to Wellcare Health Net Dual Align (HMO D-SNP) H3561-010-001 - Korean (PDF)
- Annual Notice of Change: Wellcare Health Net Dual Align (HMO D-SNP) H3561-008-000 to Wellcare Health Net Dual Align (HMO D-SNP) H3561-010-001 - Russian (PDF)
- Annual Notice of Change: Wellcare Health Net Dual Align (HMO D-SNP) H3561-008-000 to Wellcare Health Net Dual Align (HMO D-SNP) H3561-010-001 - Spanish (PDF)
- Annual Notice of Change: Wellcare Health Net Dual Align (HMO D-SNP) H3561-008-000 to Wellcare Health Net Dual Align (HMO D-SNP) H3561-010-001 - Tagalog (PDF)
- Annual Notice of Change: Wellcare Health Net Dual Align (HMO D-SNP) H3561-008-000 to Wellcare Health Net Dual Align (HMO D-SNP) H3561-010-001 - Vietnamese (PDF)
Summary of Benefits
- Summary of Benefits - English (PDF)
- Summary of Benefits - Arabic (PDF)
- Summary of Benefits - Armenian (PDF)
- Summary of Benefits - Cambodian (PDF)
- Summary of Benefits - Simplified Chinese (PDF)
- Summary of Benefits - Farsi (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) - Coming Soon
- Evidence of Coverage - Armenian (PDF) - Coming Soon
- Evidence of Coverage - Cambodian (PDF) - Coming Soon
- Evidence of Coverage - Simplified Chinese (PDF) - Coming Soon
- Evidence of Coverage - Farsi (PDF) - Coming Soon
- Evidence of Coverage - Korean (PDF)
- Evidence of Coverage - Russian (PDF) - Coming Soon
- Evidence of Coverage - Spanish (PDF)
- Evidence of Coverage - Tagalog (PDF) - Coming Soon
- Evidence of Coverage - Vietnamese (PDF) - Coming Soon
Dental Benefit Details
- Dental Benefit Details - English (PDF)
- Dental Benefit Details - Arabic (PDF) - Coming Soon
- Dental Benefit Details - Armenian (PDF) - Coming Soon
- Dental Benefit Details- Cambodian (PDF) - Coming Soon
- Dental Benefit Details - Simplified Chinese (PDF) - Coming Soon
- Dental Benefit Details - Farsi (PDF) - Coming Soon
- Dental Benefit Details - Korean (PDF) - Coming Soon
- 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) - Coming Soon
Your OTC Highlight
Wellcare Health Net Dual Align (HMO D-SNP) H3561-010-002
Counties: Amador, Calaveras, Inyo, Mono, Sacramento, San Joaquin, Stanislaus, Tulare, Tuolumne
Annual Notice of Change
- Annual Notice of Change: Wellcare Health Net Dual Align (HMO D-SNP) H3561-008-000 to Wellcare Health Net Dual Align (HMO D-SNP) H3561-010-002 - English (PDF)
- Annual Notice of Change: Wellcare Health Net Dual Align (HMO D-SNP) H3561-008-000 to Wellcare Health Net Dual Align (HMO D-SNP) H3561-010-002 - Arabic (PDF)
- Annual Notice of Change: Wellcare Health Net Dual Align (HMO D-SNP) H3561-008-000 to Wellcare Health Net Dual Align (HMO D-SNP) H3561-010-002 - Cambodian (PDF)
- Annual Notice of Change: Wellcare Health Net Dual Align (HMO D-SNP) H3561-008-000 to Wellcare Health Net Dual Align (HMO D-SNP) H3561-010-002 - Simplified Chinese (PDF)
- Annual Notice of Change: Wellcare Health Net Dual Align (HMO D-SNP) H3561-008-000 to Wellcare Health Net Dual Align (HMO D-SNP) H3561-010-002 - Farsi (PDF)
- Annual Notice of Change: Wellcare Health Net Dual Align (HMO D-SNP) H3561-008-000 to Wellcare Health Net Dual Align (HMO D-SNP) H3561-010-002 - Hmong (PDF)
- Annual Notice of Change: Wellcare Health Net Dual Align (HMO D-SNP) H3561-008-000 to Wellcare Health Net Dual Align (HMO D-SNP) H3561-010-002 - Russian (PDF)
- Annual Notice of Change: Wellcare Health Net Dual Align (HMO D-SNP) H3561-008-000 to Wellcare Health Net Dual Align (HMO D-SNP) H3561-010-002 - Spanish (PDF)
- Annual Notice of Change: Wellcare Health Net Dual Align (HMO D-SNP) H3561-008-000 to Wellcare Health Net Dual Align (HMO D-SNP) H3561-010-002 - Vietnamese (PDF)
Summary of Benefits
- Summary of Benefits - English (PDF)
- Summary of Benefits - Arabic (PDF)
- Summary of Benefits - Cambodian (PDF)
- Summary of Benefits - Simplified Chinese (PDF)
- Summary of Benefits - Farsi (PDF)
- Summary of Benefits - Hmong (PDF)
- Summary of Benefits - Russian (PDF)
- Summary of Benefits - Spanish (PDF)
- Summary of Benefits - Vietnamese (PDF)
Evidence of Coverage
- Evidence of Coverage - English (PDF)
- Evidence of Coverage - Arabic (PDF) - Coming Soon
- Evidence of Coverage - Cambodian (PDF) - Coming Soon
- Evidence of Coverage - Simplified Chinese (PDF) - Coming Soon
- Evidence of Coverage - Farsi (PDF) - Coming Soon
- Evidence of Coverage - Hmong (PDF) - Coming Soon
- Evidence of Coverage - Russian (PDF) - Coming Soon
- Evidence of Coverage - Spanish (PDF)
- Evidence of Coverage - Vietnamese (PDF) - Coming Soon
Dental Benefit Details
- Dental Benefit Details - English (PDF)
- Dental Benefit Details - Arabic (PDF) - Coming Soon
- Dental Benefit Details - Cambodian (PDF) - Coming Soon
- Dental Benefit Details - Simplified Chinese (PDF) - Coming Soon
- Dental Benefit Details - Farsi (PDF) - Coming Soon
- Dental Benefit Details - Hmong (PDF) - Coming Soon
- Dental Benefit Details - Russian (PDF) - Coming Soon
- Dental Benefit Details - Spanish (PDF) - Coming Soon
- Dental Benefit Details - Vietnamese (PDF) - Coming Soon
Your OTC Highlight
Wellcare Health Net 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) H3561-009 to Wellcare Health Net Dual Liberty (HMO D-SNP) H3561-009 - English (PDF)
- Annual Notice of Change: Wellcare Dual Liberty (HMO D-SNP) H3561-009 to Wellcare Health Net Dual Liberty (HMO D-SNP) H3561-009 - Arabic (PDF)
- Annual Notice of Change: Wellcare Dual Liberty (HMO D-SNP) H3561-009 to Wellcare Health Net Dual Liberty (HMO D-SNP) H3561-009 - Simplified Chinese (PDF)
- Annual Notice of Change: Wellcare Dual Liberty (HMO D-SNP) H3561-009 to Wellcare Health Net Dual Liberty (HMO D-SNP) H3561-009 - Farsi (PDF)
- Annual Notice of Change: Wellcare Dual Liberty (HMO D-SNP) H3561-009 to Wellcare Health Net Dual Liberty (HMO D-SNP) H3561-009 - Korean (PDF)
- Annual Notice of Change: Wellcare Dual Liberty (HMO D-SNP) H3561-009 to Wellcare Health Net Dual Liberty (HMO D-SNP) H3561-009 - Russian (PDF)
- Annual Notice of Change: Wellcare Dual Liberty (HMO D-SNP) H3561-009 to Wellcare Health Net Dual Liberty (HMO D-SNP) H3561-009 - Spanish (PDF)
- Annual Notice of Change: Wellcare Dual Liberty (HMO D-SNP) H3561-009 to Wellcare Health Net Dual Liberty (HMO D-SNP) H3561-009 - Tagalog (PDF)
- Annual Notice of Change: Wellcare Dual Liberty (HMO D-SNP) H3561-009 to Wellcare Health Net Dual Liberty (HMO D-SNP) H3561-009 - Vietnamese (PDF)
Summary of Benefits
- Summary of Benefits - English (PDF)
- Summary of Benefits - Arabic (PDF)
- Summary of Benefits - Simplified Chinese (PDF)
- Summary of Benefits - Farsi (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) - Coming Soon
- Evidence of Coverage - Simplified Chinese (PDF) - Coming Soon
- Evidence of Coverage - Farsi (PDF) - Coming Soon
- Evidence of Coverage - Korean (PDF) - Coming Soon
- Evidence of Coverage - Russian (PDF) - Coming Soon
- Evidence of Coverage - Spanish (PDF)
- Evidence of Coverage - Tagalog (PDF) - Coming Soon
- Evidence of Coverage - Vietnamese (PDF)
Dental Benefit Details
- Dental Benefit Details - English (PDF)
- Dental Benefit Details - Arabic (PDF) - Coming Soon
- Dental Benefit Details - Simplified Chinese (PDF) - Coming Soon
- Dental Benefit Details - Farsi (PDF) - Coming Soon
- Dental Benefit Details - Korean (PDF) - Coming Soon
- Dental Benefit Details - Spanish (PDF) - Coming Soon
- Dental Benefit Details - Tagalog (PDF) - Coming Soon
- Dental Benefit Details - Vietnamese (PDF) - Coming Soon
Your OTC Highlight
Additional Forms
- Medicare Step Therapy Part B (PDF) - Coming Soon
- 2027 Medicare Parts A & B Premiums and Deductibles (PDF) - Coming Soon
- Member Secure Portal Guide (PDF) - Coming Soon
If you have questions please, contact Member Services.