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show Pharmacy Benefits menu
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- Find a Doctor or Pharmacy
- List of Drugs (Formulary)
- Medication Therapy Management (MTMP)
- Mail Order Service
- Specialty Pharmacy
- Coverage Determinations and Redeterminations
- Prior Authorization, Step Therapy & Quantity Limitations
- Out-of-Network Pharmacies
- Medication (Drug) Management and Safety
- Drug Transition Policy
- Pharmacy Forms
- Medicare Prescription Payment Plan
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Plan Benefit Materials | Trillium Advantage

Plan Benefit Materials
Learn about your plan and all that it has to offer by reviewing helpful plan documents such as the Annual Notice of Change (ANOC), Summary of Benefits, and Evidence of Coverage.
To get started, locate your plan in the list of plans below and select “Plan Benefits.”
HMO
Additional Forms
If you have questions please, contact Member Services.
Plan Benefit Materials
Learn about your plan and all that it has to offer by reviewing helpful plan documents such as the Annual Notice of Change (ANOC), Summary of Benefits, and Evidence of Coverage.
To get started, locate your plan in the list of plans below and select “Plan Benefits.”
HMO D-SNP
Wellcare Dual Select (HMO-POS D_SNP) H2174-001
Counties: Lane
Annual Notice of Changes
Summary of Benefits
Evidence of Coverage
Wellcare Dual Reserve (HMO-POS D-SNP) H2174-012
Counties: Lane
Wellcare Dual Access (HMO-POS D-SNP) H2174-013
Counties: Lane
Additional Forms
If you have questions please, contact Member Services.
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