Michigan 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:

For HMO Members:

Plan Name CMS # County Summary of Benefits
Wellcare Complete No Premium (HMO) H0482- 002 Arenac, Bay, Genesee, Iosco, Kalamazoo, Lapeer, Livingston, Macomb, Oakland, Saginaw, St. Clair, Tuscola, Wayne
Wellcare Complete - Giveback (HMO) H0482- 003 Arenac, Bay, Genesee, Iosco, Kalamazoo, Lapeer, Livingston, Macomb, Oakland, Saginaw, St. Clair, Tuscola, Wayne

For HMO D SNP Members:

Plan Name CMS # County Summary of Benefits
Wellcare Complete Dual Access (HMO D-SNP) H0482- 005 Arenac, Bay, Genesee, Iosco, Kalamazoo, Lapeer, Livingston, Macomb, Oakland, Saginaw, St. Clair, Tuscola, Wayne

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:

For HMO Members:

Plan Name CMS # County Evidence of Coverage (EOC)
Wellcare Complete No Premium (HMO) H0482- 002 Arenac, Bay, Genesee, Iosco, Kalamazoo, Lapeer, Livingston, Macomb, Oakland, Saginaw, St. Clair, Tuscola, Wayne
  • Dental Benefit Details - English (PDF) - coming soon
Wellcare Complete - Giveback (HMO) H0482- 003 Arenac, Bay, Genesee, Iosco, Kalamazoo, Lapeer, Livingston, Macomb, Oakland, Saginaw, St. Clair, Tuscola, Wayne
  • Dental Benefit Details - English (PDF) - coming soon

For HMO D SNP Members:

Plan Name CMS # County Evidence of Coverage (EOC)
Wellcare Complete Dual Access (HMO D-SNP) H0482- 005 Arenac, Bay, Genesee, Iosco, Kalamazoo, Lapeer, Livingston, Macomb, Oakland, Saginaw, St. Clair, Tuscola, Wayne
  • 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:

For HMO Members:

Plan Name CMS # County Annual Notice of Changes (ANOC)
Ascension Complete Michigan Secure (HMO) to Wellcare Complete No Premium (HMO) H0482- 004 to H0482 -002 Arenac, Bay, Genesee, Iosco, Kalamazoo, Saginaw, Tuscola
Wellcare Complete No Premium (HMO) H0482- 002 Arenac, Bay, Genesee, Iosco, Kalamazoo, Saginaw, Tuscola
Wellcare Complete - Giveback (HMO) H0482- 003 Arenac, Bay, Genesee, Iosco, Kalamazoo, Lapeer, Livingston, Macomb, Oakland, Saginaw, St. Clair, Tuscola, Wayne
Ascension Complete Michigan Reward (HMO) to Wellcare Complete - Giveback (HMO) H0482- 001 to H0482 - 003 Lapeer, Livingston, Macomb, Oakland, St. Clair, Wayne

For HMO DSNP Members:

Plan Name CMS # County Annual Notice of Changes (ANOC)
Wellcare Complete Dual Access (HMO D-SNP) H0482- 005 Arenac, Bay, Genesee, Iosco, Kalamazoo, Lapeer, Livingston, Macomb, Oakland, Saginaw, St. Clair, Tuscola, Wayne
Ascension Complete Michigan DSNP (HMO D-SNP) to Wellcare Complete Dual Access (HMO D-SNP) H0482-006 to H0482-005 Arenac, Bay, Genesee, Iosco, Kalamazoo, Lapeer, Livingston, Macomb, Oakland, Saginaw, St. Clair, Tuscola, Wayne

 

If you have any questions please, contact Member Services.

If you have any questions please, contact Member Services.