Medicare Reference Documents

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

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

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 County Summary of Benefits
Allwell Medicare (HMO)

Duval, Lake, Pinellas, Polk, and Volusia counties

  • English- Summary of Benefits
  • Espanol- Summary of Benefits
Allwell Medicare Premier (HMO)

Duval, Hernando, Pasco, Pinellas, Polk, and Volusia counties

  • English- Summary of Benefits
  • Espanol- Summary of Benefits  
Allwell Medicare (HMO)

Manatee, Marion, Palm Beach, and Seminole counties

  • English- Summary of Benefits
  • Espanol- Summary of Benefits    
Allwell Medicare (HMO)

Miami-Dade county

  • English- Summary of Benefits
  • Espanol- Summary of Benefits
Allwell Medicare Premier (HMO) Miamie-Dade county
  • English- Summary of Benefits
  • Espanol- Summary of Benefits     
Allwell Medicare (HMO) Hillsborough county
  • English- Summary of Benefits
  • Espanol- Summary of Benefits    
Allwell Medicare Premier (HMO) Hillsborough county
  • English- Summary of Benefits
  • Espanol- Summary of Benefits    
Allwell Medicare (HMO) Osceola county
  • English- Summary of Benefits
  • Espanol- Summary of Benefits    
Allwell Medicare Premier (HMO) Osceola county
  • English- Summary of Benefits
  • Espanol- Summary of Benefits    
Allwell Medicare (HMO) Orange county
  • English- Summary of Benefits
  • Espanol- Summary of Benefits    
Allwell Medicare Premier (HMO) Orange county
  • English- Summary of Benefits
  • Espanol- Summary of Benefits    
Allwell Medicare (HMO) Broward county
  • English- Summary of Benefits
  • Espanol- Summary of Benefits    
Allwell Medicare Premier (HMO) Broward county
  • English- Summary of Benefits
  • Espanol- Summary of Benefits    

For HMO SNP Members:  

Plan Name County  Summary of Benefits
Allwell Dual Medicare (HMO SNP)

Baker, Duval, Hardee, Hernando, Manatee, Marion, Martin, Polk, and Volusia counties

  • English- Summary of Benefits
  • Espanol- Summary of Benefits
Allwell Dual Medicare (HMO SNP)

Hillsborough, Lake, Orange, Osceola, Pasco, Pinellas, Seminole, St. Lucie counties

  • English- Summary of Benefits
  • Espanol- Summary of Benefits  
Allwell Dual Medicare (HMO SNP)

Broward and Palm Beach counties

  • English- Summary of Benefits
  • Espanol- Summary of Benefits     
Allwell Dual Medicare (HMO SNP)

Miami - Dade county

  • English- Summary of Benefits
  • Espanol- Summary of Benefits  

Hillsborough county
Hillsborough county
Hillsborough county

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 County Evidence of Coverage 
Allwell Medicare (HMO)

Duval, Lake, Pinellas, Polk, and Volusia counties

  • English- Evidence of Coverage
  • Espanol- Evidence of Coverage
Allwell Medicare Premier (HMO)

Duval, Hernando, Pasco, Pinellas, Polk, and Volusia counties

  • English- Evidence of Coverage
  • Espanol- Evidence of Coverage
Allwell Medicare (HMO)

Manatee, Marion, Palm Beach, and Seminole counties

  • English- Evidence of Coverage
  • Espanol- Evidence of Coverage
Allwell Medicare (HMO)

Miami-Dade county

  • English- Evidence of Coverage
  • Espanol- Evidence of Coverage
Allwell Medicare Premier (HMO) Miamie-Dade county
  • English- Evidence of Coverage
  • Espanol- Evidence of Coverage
Allwell Medicare (HMO) Hillsborough county
  • English- Evidence of Coverage
  • Espanol- Evidence of Coverage
Allwell Medicare Premier (HMO) Hillsborough county
  • English- Evidence of Coverage
  • Espanol- Evidence of Coverage
Allwell Medicare (HMO) Osceola county
  • English- Evidence of Coverage
  • Espanol- Evidence of Coverage
Allwell Medicare Premier (HMO) Osceola county
  • English- Evidence of Coverage
  • Espanol- Evidence of Coverage
Allwell Medicare (HMO) Orange county
  • English- Evidence of Coverage
  • Espanol- Evidence of Coverage
Allwell Medicare Premier (HMO) Orange county
  • English- Evidence of Coverage
  • Espanol- Evidence of Coverage
Allwell Medicare (HMO) Broward county
  • English- Evidence of Coverage
  • Espanol- Evidence of Coverage
Allwell Medicare Premier (HMO) Broward county
  • English- Evidence of Coverage
  • Espanol- Evidence of Coverage

For HMO SNP Members:  

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

Baker, Duval, Hardee, Hernando, Manatee, Marion, Martin, Polk, and Volusia counties

  • English- Evidence of Coverage
  • Espanol- Evidence of Coverage
Allwell Dual Medicare (HMO SNP)

Hillsborough, Lake, Orange, Osceola, Pasco, Pinellas, Seminole, St. Lucie counties

  • English- Evidence of Coverage
  • Espanol- Evidence of Coverage
Allwell Dual Medicare (HMO SNP)

Broward and Palm Beach counties

  • English- Evidence of Coverage
  • Espanol- Evidence of Coverage
Allwell Dual Medicare (HMO SNP)

Miami - Dade county

  • English- Evidence of Coverage
  • Espanol- Evidence of Coverage

HMO Reconsideration Form 

HMO SNP Redetermination Form 

HMO SNP Redetermination Form 

HMO Reconsideration Form 

If you were enrolled in Sunshine Health Medicare Advantage 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  County ANOC
Allwell Medicare (HMO) Duval, Lake, Pinellas, Polk, and Volusia counties
  • English- ANOC
  • Espanol- ANOC
Allwell Medicare Premier (HMO) Duval, Hernando, Pasco, Pinellas, Polk, and Volusia counties
  • English- ANOC
  • Espanol- ANOC
Allwell Medicare (HMO) Manatee, Marion, Palm Beach, and Seminole counties
  • English- ANOC
  • Espanol- ANOC
Allwell Medicare (HMO) Miami-Dade county
  • English- ANOC
  • Espanol- ANOC
Allwell Medicare Premier (HMO) Miamie-Dade county
  • English- ANOC
  • Espanol- ANOC
Allwell Medicare (HMO) Hillsborough county
  • English- ANOC
  • Espanol- ANOC
Allwell Medicare Premier (HMO) Hillsborough county
  • English- ANOC
  • Espanol- ANOC
Allwell Medicare (HMO) Osceola county
  • English- ANOC
  • Espanol- ANOC
Allwell Medicare Premier (HMO) Osceola county
  • English- ANOC
  • Espanol- ANOC
Allwell Medicare (HMO) Orange county
  • English- ANOC
  • Espanol- ANOC
Allwell Medicare Premier (HMO) Orange county
  • English- ANOC
  • Espanol- ANOC
Allwell Medicare (HMO) Broward county
  • English- ANOC
  • Espanol- ANOC
Allwell Medicare Premier (HMO) Broward county
  • English- ANOC
  • Espanol- ANOC

For HMO SNP Members:  

Plan Name County  ANOC
Allwell Dual Medicare (HMO SNP)

Baker, Duval, Hardee, Hernando, Manatee, Marion, Martin, Polk, and Volusia counties

  • English- ANOC
  • Espanol- ANOC
Allwell Dual Medicare (HMO SNP)

Hillsborough, Lake, Orange, Osceola, Pasco, Pinellas, Seminole, St. Lucie counties

  • English- ANOC
  • Espanol- ANOC
Allwell Dual Medicare (HMO SNP)

Broward and Palm Beach counties

  • English- ANOC
  • Espanol- ANOC
Allwell Dual Medicare (HMO SNP)

Miami - Dade county

  • English- ANOC
  • Espanol- ANOC

This is the complete list of prescription drugs covered by Allwell.

Please select the document for your plan and county:

For HMO Members:

Plan Name  County Formulary
Allwell Medicare (HMO)

Duval, Lake, Pinellas, Polk, and Volusia counties

  • English- Formulary
  • Espanol- Formulary
Allwell Medicare Premier (HMO)

Duval, Hernando, Pasco, Pinellas, Polk, and Volusia counties

  • English- Formulary
  • Espanol- Formulary
Allwell Medicare (HMO)

Manatee, Marion, Palm Beach, and Seminole counties

  • English- Formulary
  • Espanol- Formulary
Allwell Medicare (HMO)

Miami-Dade county

  • English- Formulary
  • Espanol- Formulary
Allwell Medicare Premier (HMO) Miamie-Dade county
  • English- Formulary
  • Espanol- Formulary
Allwell Medicare (HMO) Hillsborough county
  • English- Formulary
  • Espanol- Formulary
Allwell Medicare Premier (HMO) Hillsborough county
  • English- Formulary
  • Espanol- Formulary
Allwell Medicare (HMO) Osceola county
  • English- Formulary
  • Espanol- Formulary
Allwell Medicare Premier (HMO) Osceola county
  • English- Formulary
  • Espanol- Formulary
Allwell Medicare (HMO) Orange county
  • English- Formulary
  • Espanol- Formulary
Allwell Medicare Premier (HMO) Orange county
  • English- Formulary
  • Espanol- Formulary
Allwell Medicare (HMO) Broward county
  • English- Formulary
  • Espanol- Formulary
Allwell Medicare Premier (HMO) Broward county
  • English- Formulary
  • Espanol- Formulary

For HMO SNP Members:  

Plan Name County  Formulary
Allwell Dual Medicare (HMO SNP) Duval, Lake, Pinellas, Polk, and Volusia counties
  • English- Formulary
  • Espanol- 7Formulary
Allwell Dual Medicare (HMO SNP) Duval, Hernando, Pasco, Pinellas, Polk, and Volusia counties
  • English- Formulary
  • Espanol- Formulary
Allwell Dual Medicare (HMO SNP) Manatee, Marion, Palm Beach, and Seminole counties
  • English- Formulary
  • Espanol- Formulary
Allwell Dual Medicare (HMO SNP) Miami-Dade county
  • English- Formulary
  • Espanol- Formulary

Baker, Duval, Hardee, Hernando, Manatee, Marion, Martin, Polk, and Volusia counties

Hillsborough county
Hillsborough county
Hillsborough county
Hillsborough county

This booklet 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 in your plan's brochure.

Please select the document for your plan and county:

For HMO Members:

Plan Name County OTC Benefits Brochure
Allwell Medicare (HMO)

Duval, Lake, Pinellas, Polk, and Volusia counties

  • Not Available
Allwell Medicare Premier (HMO)

Duval, Hernando, Pasco, Pinellas, Polk, and Volusia counties

  • Not Available
Allwell Medicare (HMO)

Manatee, Marion, Palm Beach, and Seminole counties

  • Not Available
Allwell Medicare (HMO)

 

Miami-Dade county

  • English- OTC Benefits Brochure
  • Espanol- OTC Benefits Brochure
Allwell Medicare Premier (HMO) Miamie-Dade county
  • English- OTC Benefits Brochure
  • Espanol- OTC Benefits Brochure  
Allwell Medicare (HMO) Hillsborough county
  • Not Available
Allwell Medicare Premier (HMO) Hillsborough county
  • Not Available
Allwell Medicare (HMO) Osceola county
  • Not Available
Allwell Medicare Premier (HMO) Osceola county
  • Not Available
Allwell Medicare (HMO) Orange county
  • Not Available
Allwell Medicare Premier (HMO) Orange county
  • Not Available
Allwell Medicare (HMO) Broward county
  • English- OTC Benefits Brochure
  • Espanol- OTC Benefits Brochure 
Allwell Medicare Premier (HMO) Broward county
  • English- OTC Benefits Brochure
  • Espanol- OTC Benefits Brochure 

For HMO SNP Members:  

Plan Name County  OTC Benefits Brochure
Allwell Dual Medicare (HMO SNP)

Baker, Duval, Hardee, Hernando, Manatee, Marion, Martin, Polk, and Volusia counties

  • English- OTC Benefits Brochure
  • Espanol- OTC Benefits Brochure
Allwell Dual Medicare (HMO SNP)

Hillsborough, Lake, Orange, Osceola, Pasco, Pinellas, Seminole, St. Lucie counties

  • English- OTC Benefits Brochure
  • Espanol- OTC Benefits Brochure
Allwell Dual Medicare (HMO SNP)

Broward and Palm Beach counties

  • English- OTC Benefits Brochure
  • Espanol- OTC Benefits Brochure     
Allwell Dual Medicare (HMO SNP)

Miami - Dade county

  • English- OTC Benefits Brochure
  • Espanol- OTC Benefits Brochure 

OTC Benefits Brochure
OTC Benefits Brochure

Need help at the doctor's office?

Visiting the doctor’s office can be difficult when you are trying to remember the details of your medical needs and health concerns over a period of time. With the amount of paperwork to fill out and questions to answer, it can be hard to make sure you are able to tell your doctor exactly what the problems are.   

Don’t wait until you get to the doctor’s office to start thinking of the reasons for your appointment. Try these helpful doctor visit guides to learn what to expect and prepare to ask your own questions about your medications, treatment options, warning signs, health tips and diet needs.

These helpful guides include details about common medical issues, so you’ll be ready to talk to your doctor about your issue, find out the information you need, and better understand what to expect from your visit.

  1. Click on any of the forms listed below
  2. Print out the form you need
  3. Fill in the answers before your appointment
  4. Take it with you to the doctor

These helpful doctor visit guides can be useful when you're being seen for any of the following conditions:

  • Asthma
  • Coronary Artery Disease
  • Diabetes
  • High Blood Pressure
  • High Cholesterol
  • Weight Management

Use this form to enroll and receive prescription drugs by mail.

Please select the form for your plan. 

  • English HMO Form Ɩ Espanol HMO Formulario
  • English HMO SNP Form Ɩ Espanol HMO SNP Formulario

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 page to learn more. 

  • 2018 - PHI Authorization Form
    • Use this form when you want to allow Allwell to share your health information with a person or group.
  • 2018- PHI Revocation Form
    • Use this form when you want Allwell to cancel or revoke your previous permission to share health information with a person or group.
  • 2018 - Appointing a Representative
    • Use this form to name a person to act as your representative. Must be completed by you and accepted by the person you appoint.
  • 2018 - Multi-language Interpreter Services
    • We have free interpreters to answer questions in multiple languages. Call Member Services.
  • 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.

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!

Beginner's Guide to Medicare Booklet...Coming Soon

 

 


Last Updated: 06/30/2017
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