Disclaimer of Warranties and Liabilities, Notice of Nondiscrimination, and Notice of Availability

HI residents (H9916): ‘Ohana Health Plan, a plan offered by WellCare Health Insurance of Arizona, Inc.

Wellcare is the Medicare brand for Centene Corporation, an HMO, PPO, PFFS, PDP plan with a Medicare contract and is an approved Part D Sponsor. Our D-SNP plans have a contract with the state Medicaid program. Enrollment in our plans depends on contract renewal.

For Wellcare CalViva Health Dual Align members: CalViva Health is a Medi-Cal Managed Care Plan (MCP) and is the Local Initiative Health Plan for Medi-Cal managed care in Fresno, Kings, and Madera Counties. CalViva Health is a full-service health plan contracting with the Department of Health Care Services (DHCS) to provide Medi-Cal Covered Services to Medi-Cal managed care enrollees under the Two-Plan model in all ZIP codes in Fresno, Kings, and Madera Counties. CalViva Health contracts with Health Net Community Solutions, Inc. on a capitated basis to provide and arrange for Medi-Cal Covered Services in all ZIP codes in Fresno, Kings, and Madera Counties. Health Net Community Solutions, Inc. is a subsidiary of Health Net, LLC and Centene Corporation, and is the CalViva Health MCP’s Contracted Administrator in all ZIP codes in Fresno, Kings, and Madera Counties.

Michigan D-SNP residents: Wellcare Meridian Dual Align (HMO D-SNP) is a health plan that contracts with both Medicare and Michigan Medicaid to provide benefits of both programs to members. Enrollment in our plan depends on contract renewal.

Washington residents: “Wellcare” is issued by Coordinated Care of Washington, Inc.

Washington residents: “Wellcare” is issued by Coordinated Care of Washington, Inc., a subsidiary of Centene Corporation.

Washington residents: Health Net Life Insurance Company is contracted with Medicare for PPO plans. “Wellcare” is issued by Health Net Life Insurance Company.

Washington residents: “Wellcare” is issued by WellCare Health Insurance Company of Washington, Inc.

Washington residents: “Wellcare” is issued by WellCare Health Insurance Company of Washington, Inc., a subsidiary of Centene Corporation.

Washington S4802 residents: “Wellcare” is issued by WellCare Prescription Insurance, Inc.

CA EGWP members ONLY: Health Net is contracted with Medicare for HMO plans. Enrollment in Health Net depends on contract renewal.

Every year, Medicare evaluates plans based on a 5-star rating system.

Out-of-network/non-contracted providers are under no obligation to treat Plan members, except in emergency situations. Please call our customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services.

Benefits mentioned are a part of Special Supplemental Benefits for the Chronically Ill. Not all members will qualify. In addition to being high-risk, you must have one or more of the following chronic conditions: cancer, cardiovascular disorders, chronic and disabling mental health conditions, chronic lung disorders, diabetes. There are other eligible conditions not listed. Eligibility for this benefit cannot be guaranteed based solely on your condition. All applicable eligibility requirements must be met before the benefit is provided. For details, please contact us or see the plan’s Evidence of Coverage or Member Handbook.

AZ residents: For Wellcare Giveback (HMO), Wellcare Simple (HMO), and Wellcare Specialty Simple (HMO C-SNP): Wellcare’s pharmacy network includes limited lower-cost, preferred pharmacies in rural areas of Arizona. The lower costs advertised in our plan materials for these pharmacies may not be available at the pharmacy you use. For up-to-date information about our network pharmacies, including whether there are any lower-cost preferred pharmacies in your area, please call 1-800-977-7522 (TTY: 711) or consult the online pharmacy directory at go.wellcare.com/AZ.

NE residents: Wellcare’s pharmacy network includes limited lower-cost, preferred pharmacies in rural areas of Nebraska. The lower costs advertised in our plan materials for these pharmacies may not be available at the pharmacy you use. For up-to-date information about our network pharmacies, including whether there are any lower-cost preferred pharmacies in your area, please call 1-844-796-6811 (TTY: 711) for Wellcare Dual Liberty Sync (HMO-POS D-SNP) and Wellcare Dual Access Sync Open (PPO D-SNP); or call 1-800-977-7522 (TTY: 711) for Wellcare Giveback (HMO-POS), Wellcare Simple (HMO-POS), Wellcare Assist Open (PPO), and Wellcare Simple Open (PPO); or consult the online pharmacy directory at go.wellcare.com/NE.

OH residents: For Wellcare Dual Liberty (HMO-POS D-SNP): Wellcare’s pharmacy network includes limited lower-cost, preferred pharmacies in rural areas of Ohio. The lower costs advertised in our plan materials for these pharmacies may not be available at the pharmacy you use. For up-to-date information about our network pharmacies, including whether there are any lower-cost preferred pharmacies in your area, please call 1-833-998-4953 (TTY: 711) or consult the online pharmacy directory at go.wellcare.com/OH.

TX Wellcare H0174: For Wellcare: For Wellcare Dual Liberty Sync (HMO D-SNP): Wellcare’s pharmacy network includes limited lower-cost, preferred pharmacies in rural areas of Texas. The lower costs advertised in our plan materials for these pharmacies may not be available at the pharmacy you use. For up-to-date information about our network pharmacies, including whether there are any lower-cost preferred pharmacies in your area, please call 1-833-444-9089 (TTY: 711) or consult the online pharmacy directory at go.wellcare.com/Medicare.

TX Wellcare H4506: For Wellcare: For Wellcare Simple Value (HMO-POS): Wellcare’s pharmacy network includes limited lower-cost, preferred pharmacies in rural areas of Texas. The lower costs advertised in our plan materials for these pharmacies may not be available at the pharmacy you use. For up-to-date information about our network pharmacies, including whether there are any lower-cost preferred pharmacies in your area, please call 1-833-444-9088 (TTY: 711) or consult the online pharmacy directory at go.wellcare.com/Medicare.

TX Wellcare By Allwell H5294: For Wellcare By Allwell: Wellcare’s pharmacy network includes limited lower-cost, preferred pharmacies in rural areas of Texas. The lower costs advertised in our plan materials for these pharmacies may not be available at the pharmacy you use. For up-to-date information about our network pharmacies, including whether there are any lower-cost preferred pharmacies in your area, please call 1-800-977-7522 (TTY: 711) for Wellcare Simple (HMO) or call 1-855-445-3556 (TTY: 711) for Wellcare Dual Liberty Sync (HMO D-SNP), or consult the online pharmacy directory at go.wellcare.com/AllwellTX.

Arizona D-SNP plans: Contract services are funded in part under contract with the State of Arizona.

Arizona D-SNP plans H5590: Contract services are funded in part under contract with the State of Arizona.

For CA D-SNP members regarding Provider terminations: If you have been receiving care from a health care provider, you may have a right to keep your provider for a designated time period. Please contact Wellcare or Wellcare By Health Net Member Services, and if you have further questions, you are encouraged to contact the Department of Managed Health Care, which protects consumers, by telephone at its toll-free number, 1-888-466-2219, or at a TDD number for the hearing and speech impaired at 1-877-688-9891, or online at www.dmhc.ca.gov. If you have questions or a complaint regarding your health care services, you may contact the Department of Health Care Services (DHCS), Office of the Ombudsman at toll-free telephone number 1-888-452-8609 (TTY 711). Hours are Monday through Friday 8 a.m. to 5 p.m., except holidays.

For IL D-SNP members (H6971) regarding Medicaid Redetermination: Beware of scams. Illinois will never ask you for money to renew or apply for Medicaid. Report scams to the fraud report website or the Medicaid fraud hotline at 1-844-453-7283/1-844-ILFRAUD.

IL D-SNP members (H6971): If you use this program for rent or utilities, Housing and Urban Development (HUD) requires it to be reported as income if you seek assistance. Contact your local HUD office if you have questions.

Louisiana D-SNP members (H2491): Louisiana D-SNP members: As a Wellcare HMO D-SNP member, you have coverage from both Medicare and Medicaid. You receive your Medicare health care and prescription drug coverage through Wellcare and are also eligible to receive additional health care services and coverage through Louisiana Medicaid. Learn more about providers who participate in Louisiana Medicaid by visiting www.myplan.healthy.la.gov/en/find-provider or https://www.louisianahealthconnect.com. For detailed information about Louisiana Medicaid benefits, please visit the Medicaid website at https://ldh.la.gov/medicaid and select the “Learn about Medicaid Services” link. To request a written copy of our Medicaid Provider Directory, please contact us.

Louisiana D-SNP (H2491) prospective enrollees: Louisiana D-SNP prospective enrollees: For detailed information about Louisiana Medicaid benefits, please visit the Medicaid website at https://ldh.la.gov/medicaid or https://www.louisianahealthconnect.com. To request a written copy of our Medicaid Provider Directory, please contact us.

OR D-SNP (H2174) Wellcare members: You can get this communication in other languages, large print, Braille or a format you prefer. You can also ask for an interpreter. This help is free. Call 1-844-867-1156 or TTY 711. We accept relay calls. You can get help from a certified and qualified health care interpreter.

Puede obtener esta información en otros idiomas, en letra de imprenta grande, en braille o en un formato de su preferencia. También puede solicitor un intérprete. Esta ayuda es gratuita. Llame al 1-844-867-1156; los usuarios de TTY deben llamar al 711. Aceptamos llamadas del servicio de retransmisión. Puede obtener la asistencia de un intérprete certificado y calificado en atención médica.

TN D-SNP (H1416) members: Notice: TennCare is not responsible for payment for these benefits, except for appropriate cost sharing amounts. TennCare is not responsible for guaranteeing the availability or quality of these benefits. Any benefits above and beyond traditional Medicare benefits are applicable to Wellcare Medicare Advantage only and do not indicate increased Medicaid benefits.

Texas D-SNP (H0062) members: As a Wellcare By Superior HealthPlan member, you have coverage for both Medicare and Medicaid. You will receive your Medicare benefits and your STAR+PLUS Medicaid benefits through Wellcare Superior HealthPlan Dual Align (HMO D-SNP). You can learn more about providers who participate in Wellcare By Superior HealthPlan for Medicare and Medicaid by visiting https://www.wellcarefindaprovider.com/navigate-a-network.html. To request written copies of our Medicare and Medicaid Provider Directories, please contact us at 1-855-445-3556 (TTY: 711).

Texas D-SNP (H0174 & H5294) members: As a Wellcare HMO D-SNP member, you have coverage from both Medicare and Medicaid. You receive your Medicare health care and prescription drug coverage through Wellcare and are also eligible to receive additional health care services and coverage through Texas Medicaid. Learn more about providers who participate in Texas Medicaid by visiting https://www.wellcarefindaprovider.com/navigate-a-network.html. For detailed information about Texas Medicaid benefits, please visit the Texas Medicaid website at https://www.hhs.texas.gov/services/health/medicaid-chip/medicaid-chip-members/starplus. To request a written copy of our Medicaid Provider Directory, please contact us.

Texas D-SNP prospective enrollees: For detailed information about Texas Medicaid benefits, please visit the Texas Medicaid website at https://www.hhs.texas.gov/services/health/medicaid-chip/medicaid-chip-members/starplus. To request a written copy of our Medicaid Provider Directory, please contact us.

TX members: Wellcare By Allwell (HMO and HMO SNP) includes products that are underwritten by Superior HealthPlan, Inc.

TX members: Wellcare (HMO, HMO SNP, and PPO) includes products that are underwritten by WellCare of Texas, Inc., WellCare National Health Insurance Company, Superior HealthPlan, Inc., and SelectCare of Texas, Inc.

Wellcare Fidelis Dual Align (HMO D-SNP) is a Fully Integrated Dual Eligible Special Needs Plan with a Medicare contract and a contract with the New Jersey Medicaid program. Enrollment in Wellcare Fidelis Dual Align depends on contract renewal. This information is not a complete description of benefits. Contact the plan for more information. Limitations and restrictions may apply. Benefits may change on January 1 of each year. Your Part B premium is covered by Medicaid. This plan is available to those who have both Medicare and full Medicaid benefits. Wellcare uses a formulary. There is no obligation to enroll. Please contact Wellcare for details.

© Copyright 2026 Centene Corporation, © Copyright 2026 WellCare Health Plans, Inc.

†Other Pharmacies/Physicians/Providers are available in our network.