Illinois Plan Benefit Materials


This booklet gives you a summary of costs and coverage in your plan. Please select the document for your plan and county:

Plan Name CMS# County Summary of Benefits
Wellcare Complete - Giveback (HMO) H7399-001 Cook, DuPage, Kane, Kankakee, Will

This booklet gives you a complete list of services, limitations and exclusions for your plan coverage. Please select the document for your plan and county:

Plan Name CMS # County Evidence of Coverage (EOC)
Wellcare Complete - Giveback (HMO) H7399 - 001 Cook, DuPage, Kane, Kankakee, Will
  • Evidence of Coverage, H7399-001 - Spanish (PDF) - coming soon
  • Dental Benefit Details - English (PDF) - coming soon

If you were enrolled in Ascension Complete last year, this booklet will tell you about changes to your plan’s costs and benefits for the coming year. Please select the document for your plan and county:

Plan Name CMS# County Annual Notice of Changes
Wellcare Complete - Giveback (HMO) H7399-001 Cook, DuPage, Kane, Kankakee, Will

If you have questions please, contact Member Services.