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.”

HMO   |   HMO C-SNP   |  HMO D-SNP

HMO Plans

Wellcare Low Premium (HMO) H0562-012

Counties: Imperial, San Diego

Annual Notice of Change

Summary of Benefits

Evidence of Coverage

  • Evidence of Coverage - English (PDF) - Coming Soon
  • Evidence of Coverage - Spanish (PDF) - Coming Soon

Dental Benefit Details

  • Dental Benefit Details - English (PDF) - Coming Soon
  • Dental Benefit Details - Spanish (PDF) - Coming Soon

Your OTC Highlight

Wellcare Low Premium (HMO) H0562-097

Counties: San Francisco

Annual Notice of Change

Summary of Benefits

Evidence of Coverage

  • Evidence of Coverage - English (PDF) - Coming Soon
  • Evidence of Coverage - Chinese (Traditional) (PDF) - Coming Soon

Dental Benefit Details

  • Dental Benefit Details - English (PDF) - Coming Soon
  • Dental Benefit Details - Chinese (Traditional) (PDF) - Coming Soon

Your OTC Highlight

Wellcare Low Premium (HMO) H0562-133

Counties: Amador, Yolo

Annual Notice of Change

Summary of Benefits

Evidence of Coverage

  • Evidence of Coverage - English (PDF) - Coming Soon
  • Evidence of Coverage - Spanish (PDF) - Coming Soon

Dental Benefit Details

  • Dental Benefit Details - English (PDF) - Coming Soon
  • Dental Benefit Details - Spanish (PDF) - Coming Soon

Wellcare Low Premium (HMO) H0562-136

Counties: Los Angeles, Orange

Annual Notice of Change

Summary of Benefits

Evidence of Coverage

  • Evidence of Coverage - English (PDF) - Coming Soon
  • Evidence of Coverage - Spanish (PDF) - Coming Soon

Dental Benefit Details

  • Dental Benefit Details - English (PDF) - Coming Soon
  • 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

  • Evidence of Coverage - English (PDF) - Coming Soon
  • Evidence of Coverage - Spanish (PDF) - Coming Soon

Dental Benefit Details

  • Dental Benefit Details - English (PDF) - Coming Soon
  • Dental Benefit Details - Spanish (PDF) - Coming Soon

Wellcare Simple Focus (HMO) H0562-125

Counties: Los Angeles, Orange

Annual Notice of Change

Summary of Benefits

Evidence of Coverage

  • Evidence of Coverage - English (PDF) - Coming Soon
  • Evidence of Coverage - Spanish (PDF) - Coming Soon

Dental Benefit Details

  • Dental Benefit Details - English (PDF) - Coming Soon
  • 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

  • Evidence of Coverage - English (PDF) - Coming Soon
  • Evidence of Coverage - Spanish (PDF) - Coming Soon

Dental Benefit Details

  • Dental Benefit Details - English (PDF) - Coming Soon
  • Dental Benefit Details - Spanish (PDF) - Coming Soon

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HMO C-SNP Plans

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

  • Evidence of Coverage - English (PDF) - Coming Soon
  • Evidence of Coverage - Spanish (PDF) - Coming Soon

Dental Benefit Details

  • Dental Benefit Details - English (PDF) - Coming Soon
  • Dental Benefit Details - Spanish (PDF) - Coming Soon

Your OTC Highlight

Wellcare Specialty Simple Focus (HMO C-SNP) H0562-138

Counties: San Francisco

Summary of Benefits

Evidence of Coverage

  • Evidence of Coverage - English (PDF) - Coming Soon

Dental Benefit Details

  • Dental Benefit Details - English (PDF) - Coming Soon

Your OTC Highlight

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HMO D-SNP Plans

Wellcare CalViva Health Dual Align (HMO D-SNP) H3561-007

Counties: Fresno, Kings, Madera

Annual Notice of Change

Summary of Benefits

  • Summary of Benefits - English (PDF) - Coming Soon
  • Summary of Benefits - Hmong (PDF) - Coming Soon
  • Summary of Benefits - Spanish (PDF) - Coming Soon

Evidence of Coverage

  • Evidence of Coverage - English (PDF) - Coming Soon
  • Evidence of Coverage - Hmong (PDF) - Coming Soon
  • Evidence of Coverage - Spanish (PDF) - Coming Soon

Dental Benefit Details

  • Dental Benefit Details - English (PDF) - Coming Soon
  • Dental Benefit Details - Hmong (PDF) - Coming Soon
  • Dental Benefit Details - Spanish (PDF) - Coming Soon

Wellcare Dual Liberty (HMO D-SNP) H3561-009

Counties: Imperial, Kern, Orange, Placer, Riverside, San Bernardino, San Diego, San Francisco

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) - Coming Soon
  • 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) - Coming Soon
  • 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) - Coming Soon
  • Annual Notice of Change: Wellcare Dual Align (HMO D-SNP) H3561-008 to Wellcare Health Net Dual Align (HMO D-SNP) H3561-008 - Chinese (PDF) - Coming Soon
  • 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) - Coming Soon
  • 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) - Coming Soon
  • 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) - Coming Soon
  • 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) - Coming Soon
  • 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) - Coming Soon
  • 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) - Coming Soon
  • 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) - Coming Soon
  • 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) - Coming Soon
  • 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) - Coming Soon
  • 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) - Coming Soon
  • Annual Notice of Change: Wellcare Dual Liberty (HMO D-SNP) H3561-001 to Wellcare Health Net Dual Align (HMO D-SNP) H3561-008 - Chinese (PDF) - Coming Soon
  • 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) - Coming Soon
  • 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) - Coming Soon
  • 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) - Coming Soon
  • 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) - Coming Soon
  • 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) - Coming Soon
  • 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) - Coming Soon
  • Annual Notice of Change: Wellcare Dual Liberty (HMO D-SNP) H3561-001 to Wellcare Health Net Dual Align (HMO D-SNP) H3561-008 - Vietnamese (PDF) - Coming Soon

Summary of Benefits

  • Summary of Benefits - English (PDF) - Coming Soon
  • Summary of Benefits - Arabic (PDF) - Coming Soon
  • Summary of Benefits - Armenian (PDF) - Coming Soon
  • Summary of Benefits - Cambodian/Khmer (PDF) - Coming Soon
  • Summary of Benefits - Chinese (PDF) - Coming Soon
  • Summary of Benefits - Farsi (PDF) - Coming Soon
  • Summary of Benefits - Hmong (PDF) - Coming Soon
  • Summary of Benefits - Korean (PDF) - Coming Soon
  • Summary of Benefits - Russian (PDF) - Coming Soon
  • Summary of Benefits - Spanish (PDF) - Coming Soon
  • Summary of Benefits - Tagalog (PDF) - Coming Soon
  • Summary of Benefits - Vietnamese (PDF) - Coming Soon

Evidence of Coverage

  • Evidence of Coverage - English (PDF) - Coming Soon
  • Evidence of Coverage - Arabic (PDF) - Coming Soon
  • Evidence of Coverage - Armenian (PDF) - Coming Soon
  • Evidence of Coverage - Cambodian/Khmer (PDF) - Coming Soon
  • Evidence of Coverage - Chinese (PDF) - Coming Soon
  • Evidence of Coverage - Farsi (PDF) - Coming Soon
  • Evidence of Coverage - Hmong (PDF) - Coming Soon
  • Evidence of Coverage - Korean (PDF) - Coming Soon
  • Evidence of Coverage - Russian (PDF) - Coming Soon
  • Evidence of Coverage - Spanish (PDF) - Coming Soon
  • Evidence of Coverage - Tagalog (PDF) - Coming Soon
  • Evidence of Coverage - Vietnamese (PDF) - Coming Soon

Dental Benefit Details

  • Dental Benefit Details - English (PDF) - Coming Soon
  • Dental Benefit Details - Arabic (PDF) - Coming Soon
  • Dental Benefit Details - Armenian (PDF) - Coming Soon
  • Dental Benefit Details - Cambodian/Khmer (PDF) - Coming Soon
  • Dental Benefit Details - Chinese (PDF) - Coming Soon
  • Dental Benefit Details - Farsi (PDF) - Coming Soon
  • Dental Benefit Details - Hmong (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

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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