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2022 Plan Materials
Please see the links below for information about 2022 plans. Members can also find plan-specific 2022 coverage documents through the online member portal.
2022 Summary of Benefits
NetworkCares (PPO D-SNP)
Network Health Medicare Go (PPO)
2022 Evidence of Coverage
Network PlatinumPlus (PPO)
Network PlatinumPlus Pharmacy (PPO)
Network PlatinumPremier (PPO)
Network PlatinumPremier Pharmacy (PPO)
NetworkCares (PPO D-SNP)
Network Health Medicare Go (PPO)
2022 Annual Notice of Change
Network PlatinumSelect (PPO)
Network PlatinumChoice (PPO)
Network PlatinumPlus (PPO)
Network PlatinumPlus Pharmacy (PPO)
Network PlatinumPremier (PPO)
Network PlatinumPremier Pharmacy (PPO)
NetworkCares (PPO D-SNP)
Network Health Medicare Go (PPO)
2022 Delta Dental Plan Certificate of Coverage
Delta Dental Coverage Included with Most* Plans in Northeast Wisconsin
*Dental coverage is not included with Network PlatinumSelect (PPO)
Delta Dental Coverage for NetworkCares (PPO D-SNP)
Specific dental coverage for our members that are dual-eligible.
Delta Dental Coverage Included with Most* Plans in Southeast Wisconsin
*Dental coverage is not included with Network Health Medicare Go (PPO).
Delta Dental Coverage Included with Network Health Medicare Explore (HMO)
Delta Dental Rider Coverage
Optional supplemental dental program available to add on to all plans
2021 Plan Materials
For 2021 plan information and documents see 2021 Plan Materials.
