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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) H1436-001

Abbeville, Allendale, Bamberg, Barnwell, Chester, Chesterfield, Clarendon, Dillon, Edgefield, Florence, Georgetown, Greenwood, Laurens, Lee, Marion, Marlboro, McCormick, Newberry, Orangeburg, Union, and Williamsburg counties

Allwell Medicare (HMO) H1436-002

Beaufort, Berkeley, Charleston, Colleton, Hampton and Jasper counties

Allwell Medicare (HMO) H1436-003

Calhoun, Fairfield, Kershaw, Richland and Saluda counties

Allwell Medicare (HMO) H1436-004

Anderson, Greenville, Pickens, and Spartanburg counties

For HMO SNP Members:  

Plan Name CMS# County  Summary of Benefits
Allwell Dual Medicare
(HMO SNP)
H1436-005 Abbeville, Allendale, Anderson, Bamberg, Barnwell, Beaufort, Berkeley, Calhoun, Charleston, Chester, Chesterfield, Clarendon, Colleton, Dillon, Edgefield, Fairfield, Florence, Georgetown, Greenville, Greenwood, Hampton, Jasper, Kershaw, Laurens, Lee, Marion, Marlboro, McCormick, Newberry, Orangeburg, Pickens, Richland, Saluda, Spartanburg, Union and Williamsburg counties
Allwell Dual Medicare Essentials
(HMO SNP)
H1436-006 Abbeville, Allendale, Anderson, Bamberg, Barnwell, Beaufort, Berkeley, Calhoun, Charleston, Chester, Chesterfield, Clarendon, Colleton, Dillon, Edgefield, Fairfield, Florence, Georgetown, Greenville, Greenwood, Hampton, Jasper, Kershaw, Laurens, Lee, Marion, Marlboro, McCormick, Newberry, Orangeburg, Pickens, Richland, Saluda, Spartanburg, Union and Williamsburg counties

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) H1436-001

Abbeville, Allendale, Bamberg, Barnwell, Chester, Chesterfield, Clarendon, Dillon, Edgefield, Florence, Georgetown, Greenwood, Laurens, Lee, Marion, Marlboro, McCormick, Newberry, Orangeburg, Union, and Williamsburg counties

Allwell Medicare (HMO) H1436-002

Beaufort, Berkeley, Charleston, Colleton, Hampton and Jasper counties

Allwell Medicare (HMO) H1436-003

Calhoun, Fairfield, Kershaw, Richland and Saluda counties

Allwell Medicare (HMO) H1436-004

Anderson, Greenville, Pickens, and Spartanburg counties

For HMO SNP Members:

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


H1436-005 Abbeville, Allendale, Anderson, Bamberg, Barnwell, Beaufort, Berkeley, Calhoun, Charleston, Chester, Chesterfield, Clarendon, Colleton, Dillon, Edgefield, Fairfield, Florence, Georgetown, Greenville, Greenwood, Hampton, Jasper, Kershaw, Laurens, Lee, Marion, Marlboro, McCormick, Newberry, Orangeburg, Pickens, Richland, Saluda, Spartanburg, Union and Williamsburg counties
Allwell Dual Medicare Essentials
(HMO SNP)
H1436-006 Abbeville, Allendale, Anderson, Bamberg, Barnwell, Beaufort, Berkeley, Calhoun, Charleston, Chester, Chesterfield, Clarendon, Colleton, Dillon, Edgefield, Fairfield, Florence, Georgetown, Greenville, Greenwood, Hampton, Jasper, Kershaw, Laurens, Lee, Marion, Marlboro, McCormick, Newberry, Orangeburg, Pickens, Richland, Saluda, Spartanburg, Union and Williamsburg counties

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)

H1436-001 Abbeville, Allendale, Bamberg, Barnwell, Chester, Chesterfield, Clarendon, Dillon, Edgefield, Florence, Georgetown, Greenwood, Laurens, Lee, Marion, Marlboro, McCormick, Newberry, Orangeburg, Union, and Williamsburg counties
Allwell Medicare (HMO)

H1436-002 Beaufort, Berkeley, Charleston, Colleton, Hampton and Jasper counties
Allwell Medicare (HMO)

H1436-003 Calhoun, Fairfield, Kershaw, Richland and Saluda counties
Allwell Medicare (HMO)

H1436-004 Anderson, Greenville, Pickens, and Spartanburg counties

For HMO SNP Members:  

Plan Name CMS# County  Annual Notice Of Changes
Allwell Dual Medicare 
(HMO SNP)
H1436-005 Abbeville, Allendale, Anderson, Bamberg, Barnwell, Beaufort, Berkeley, Calhoun, Charleston, Chester, Chesterfield, Clarendon, Colleton, Dillon, Edgefield, Fairfield, Florence, Georgetown, Greenville, Greenwood, Hampton, Jasper, Kershaw, Laurens, Lee, Marion, Marlboro, McCormick, Newberry, Orangeburg, Pickens, Richland, Saluda, Spartanburg, Union and Williamsburg counties
Allwell Dual Medicare Essentials
(HMO SNP)
H1436-006 Abbeville, Allendale, Anderson, Bamberg, Barnwell, Beaufort, Berkeley, Calhoun, Charleston, Chester, Chesterfield, Clarendon, Colleton, Dillon, Edgefield, Fairfield, Florence, Georgetown, Greenville, Greenwood, Hampton, Jasper, Kershaw, Laurens, Lee, Marion, Marlboro, McCormick, Newberry, Orangeburg, Pickens, Richland, Saluda, Spartanburg, Union and Williamsburg counties

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 Low Income Subsidy
Allwell Medicare (HMO)

H1436-001 Abbeville, Allendale, Bamberg, Barnwell, Chester, Chesterfield, Clarendon, Dillon, Edgefield, Florence, Georgetown, Greenwood, Laurens, Lee, Marion, Marlboro, McCormick, Newberry, Orangeburg, Union, and Williamsburg counties
Allwell Medicare (HMO)

H1436-002 Beaufort, Berkeley, Charleston, Colleton, Hampton and Jasper counties
Allwell Medicare (HMO)

H1436-003 Calhoun, Fairfield, Kershaw, Richland and Saluda counties
Allwell Medicare (HMO) H1436-004 Anderson, Greenville, Pickens, and Spartanburg counties

For HMO SNP Members:  

Plan Name CMS# County  Low Income Subsidy
Allwell Dual Medicare
(HMO SNP)
H1436-005 Abbeville, Allendale, Anderson, Bamberg, Barnwell, Beaufort, Berkeley, Calhoun, Charleston, Chester, Chesterfield, Clarendon, Colleton, Dillon, Edgefield, Fairfield, Florence, Georgetown, Greenville, Greenwood, Hampton, Jasper, Kershaw, Laurens, Lee, Marion, Marlboro, McCormick, Newberry, Orangeburg, Pickens, Richland, Saluda, Spartanburg, Union and Williamsburg counties
Allwell Dual Medicare Essentials
(HMO SNP)
H1436-006 Abbeville, Allendale, Anderson, Bamberg, Barnwell, Beaufort, Berkeley, Calhoun, Charleston, Chester, Chesterfield, Clarendon, Colleton, Dillon, Edgefield, Fairfield, Florence, Georgetown, Greenville, Greenwood, Hampton, Jasper, Kershaw, Laurens, Lee, Marion, Marlboro, McCormick, Newberry, Orangeburg, Pickens, Richland, Saluda, Spartanburg, Union and Williamsburg counties

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.

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

  • Disenrollment Form (PDF)
    • We don't want you to see you go. Let us improve your experience with our plan. Please call Member Services. We are here to help. If you are still dissatisfied, please fill out and mail the disenrollment form.

Important choices can be simple choices. So let us help!

Take a look at the below Beginner's Guide to Medicare booklet.  Our Medicare guide will give you a solid foundation for understanding the basics of Medicare and available options you have as a new Medicare beneficiary.

If you have any questions or need assistance, call us.  We are here to help!

 

 

This is an introduction to the provider and pharmacy directory, including an explanation of the provider symbols found in the directory.

Visit our Find a Doctor or Pharmacy page to learn more. 

  • Best Available Evidence (BAE)
    • This is a CMS policy that allows for changes to cost-sharing for low-income beneficiaries when there is evidence that information from a beneficiary is not up-to-date or accurate.

medicare phone number

 

Can't find what you need? Contact Member Services. We are here to help!