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
Ascension Complete Illinois Reward (HMO)	H7399-001	Cook, DuPage, Kane and Will counties	Summary of Benefits, H7399-001 - English (PDF) Summary of Benefits, H7399-001 - Spanish (PDF)
Ascension Complete Illinois Secure (HMO)	H7399-002	Cook, DuPage, Kane and Will counties	Summary of Benefits, H7399-002 - English (PDF) Summary of Benefits, H7399-002 - Spanish (PDF)

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)
Ascension Complete Illinois Reward (HMO)	H7399 - 001	Cook, DuPage, Kane and Will counties	Evidence of Coverage, H7399-001 - English (PDF)
Ascension Complete Illinois Secure (HMO)	H7399 - 002	Cook, DuPage, Kane and Will counties	Evidence of Coverage, H7399-002 - English (PDF)

Your current plan may have an over-the-counter benefit that allows you to purchase over-the-counter (OTC) health and wellness products. This catalog includes a list of over-the-counter items that you can order to be directly mailed to your home. Check the catalog for item limits.

Ordering is easy! Just follow the steps listed on your plan's catalog.

Over-the-Counter Catalog - English / Spanish (PDF)

Member Newsletter, Summer 2020

Plan Name	CMS#	County	Summary of Benefits
Ascension Complete AMITA Health Reward	H7399-001	Cook, DuPage, Kane and Will counties	Summary of Benefits, H7399-001 - English (PDF) Summary of Benefits, H7399-001 - Spanish (PDF)
Ascension Complete AMITA Health Secure	H7399-002	Cook, DuPage, Kane and Will counties	Summary of Benefits, H7399-002 - English (PDF) Summary of Benefits, H7399-002 - Spanish (PDF)

Plan Name	CMS #	County	Evidence of Coverage (EOC)
Ascension Complete AMITA Health Reward	H7399 - 001	Cook, DuPage, Kane and Will counties	Evidence of Coverage, H7399-001 - English (PDF) Evidence of Coverage, H7399-001 - Spanish (PDF)
Ascension Complete AMITA Health Secure	H7399 - 002	Cook, DuPage, Kane and Will counties	Evidence of Coverage, H7399-002 - English (PDF) Evidence of Coverage, H7399-002 - Spanish (PDF)

Plan Name	CMS#	County	Annual Notice of Changes (ANOC)
Ascension Complete AMITA Health Reward	H7399-001	Cook, DuPage, Kane and Will counties	Annual Notice of Changes, H7399-001 - English (PDF) Annual Notice of Changes, H7399-001 - Spanish (PDF)
Ascension Complete AMITA Health Secure	H7399-002	Cook, DuPage, Kane and Will counties	Annual Notice of Changes, H7399-002 - English (PDF) Annual Notice of Changes, H7399-002 - Spanish (PDF)

If you have questions please, contact Member Services.

Illinois Plan Benefit Materials

Summary of Benefits

Evidence of Coverage (EOC)

Optional Benefit Individual Enrollment Form

Optional Supplemental Benefits Flyer

Over-the-Counter Benefits

Member Newsletter

Illinois Plan Benefit Materials

Summary of Benefits

Evidence of Coverage (EOC)

Annual Notice of Changes (ANOC)

Over-the-Counter Benefits

Optional Supplemental Benefits Flyer

Brochures, Flyers and Inserts