Plan Benefit Materials | Allwell from Absolute Total Care

Plan Materials and Forms

 

Listed below are some documents that may be helpful at different times during your membership. 

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
Allwell Medicare (HMO) H1436-002 Abbeville, Allendale, Bamberg, Barnwell, Beaufort, Berkeley, Charleston, Cherokee, Chester, Chesterfield, Clarendon, Colleton, Dillon, Edgefield, Florence, Georgetown, Greenwood, Hampton, Jasper, Laurens, Lee, Marion, Marlboro, McCormick, Newberry, Orangeburg, Union and Williamsburg
Allwell Medicare (HMO) H1436-004 Anderson, Calhoun, Fairfield, Greenville, Kershaw, Lexington, Oconee, Pickens, Richland, Saluda and Spartanburg

For HMO D-SNP Members:  

Plan Name CMS# County  Summary of Benefits
Allwell Dual Medicare
(HMO D-SNP)
H1436-005 Abbeville, Allendale, Anderson, Bamberg, Barnwell, Beaufort, Berkeley, Calhoun, Charleston, Cherokee, Chester, Chesterfield, Clarendon, Colleton, Dillon, Edgefield, Fairfield, Florence, Georgetown, Greenville, Greenwood, Hampton, Jasper, Kershaw, Laurens, Lee, Lexington, Marion, Marlboro, McCormick, Newberry, Oconee, Orangeburg, Pickens, Richland, Saluda, Spartanburg, Union and Williamsburg

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 
Allwell Medicare (HMO) H1436-002 Abbeville, Allendale, Bamberg, Barnwell, Beaufort, Berkeley, Charleston, Cherokee, Chester, Chesterfield, Clarendon, Colleton, Dillon, Edgefield, Florence, Georgetown, Greenwood, Hampton, Jasper, Laurens, Lee, Marion, Marlboro, McCormick, Newberry, Orangeburg, Union and Williamsburg
Allwell Medicare (HMO) H1436-004 Anderson, Calhoun, Fairfield, Greenville, Kershaw, Lexington, Oconee, Pickens, Richland, Saluda and Spartanburg

For HMO D-SNP Members:

Plan Name CMS # County  Evidence of Coverage
Allwell Dual Medicare 
(HMO D-SNP)


H1436-005 Abbeville, Allendale, Anderson, Bamberg, Barnwell, Beaufort, Berkeley, Calhoun, Charleston, Cherokee, Chester, Chesterfield, Clarendon, Colleton, Dillon, Edgefield, Fairfield, Florence, Georgetown, Greenville, Greenwood, Hampton, Jasper, Kershaw, Laurens, Lee, Lexington, Marion, Marlboro, McCormick, Newberry, Oconee, Orangeburg, Pickens, Richland, Saluda, Spartanburg, Union and Williamsburg

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
Allwell Medicare (HMO)

H1436-002 Abbeville, Allendale, Bamberg, Barnwell, Beaufort, Berkeley, Charleston, Cherokee, Chester, Chesterfield, Clarendon, Colleton, Dillon, Edgefield, Florence, Georgetown, Greenwood, Hampton, Jasper, Laurens, Lee, Marion, Marlboro, McCormick, Newberry, Orangeburg, Union and Williamsburg
Allwell Medicare (HMO)

H1436-004 Anderson, Calhoun, Fairfield, Greenville, Kershaw, Lexington, Oconee, Pickens, Richland, Saluda and Spartanburg

For HMO D-SNP Members:  

Plan Name CMS # County  Annual Notice Of Changes
Allwell Dual Medicare 
(HMO D-SNP)
H1436-005 Abbeville, Allendale, Anderson, Bamberg, Barnwell, Beaufort, Berkeley, Calhoun, Charleston, Cherokee, Chester, Chesterfield, Clarendon, Colleton, Dillon, Edgefield, Fairfield, Florence, Georgetown, Greenville, Greenwood, Hampton, Jasper, Kershaw, Laurens, Lee, Lexington, Marion, Marlboro, McCormick, Newberry, Oconee, Orangeburg, Pickens, Richland, Saluda, Spartanburg, Union and Williamsburg

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

Ordering is easy. Just follow the steps in your plan's catalog.


 

Preventive Guidelines

Preventive guidelines are based on the health needs and opportunities for improvement identified as part of the Quality Assurance Program Improvement (QAPI) program. When possible, Absolute Total Care adopts preventive guidelines that are published by nationally recognized organizations or government institutions. These guidelines may also be a statewide collaborative and/or a consensus of healthcare professionals in the applicable field.

 

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