Medicare Health Plan Details 2026
Date: 01/13/26
Wellcare (Medicare) – Important Updates for 2026
In 2026, we will continue offering our current Arizona HMO Medicare plans. The PPO plan will no longer be available.
The table below includes key details for each HMO plan.
We’re also updating the brand name effective January 1, 2026: Current: Wellcare by Allwell → New: Wellcare
Questions? Contact your Provider Engagement Account Manager or email us: AzCHProviderEngagement@azcompletehealth.com
| Key Information | H5590 Wellcare HMO DSNP (HIDE) | H0351 Wellcare HMO & CSNP |
|---|---|---|
| AZ Plan Name(s) | Wellcare Dual Liberty Sync | Wellcare Simple, Simple Value and Specialty Simple |
| Care Management (CM) | Members may access CM services through their Medicare benefit | |
| Customer Service | [NEW] 1-855-445-3580 (Duals Customer Service) | 1-800-977-7522 (Medicare only) |
| Key Information | H5590 Wellcare HMO DSNP (HIDE) | H0351 Wellcare HMO & CSNP |
|---|---|---|
Claims Address | EDI Payor ID: 68069 [NEW] Paper Claims: Wellcare P.O. Box 9700 Farmington, MO 63640-0700 Reminder: For aligned members (Medicare: Wellcare Medicaid: Arizona Complete Health-Complete Care Plan), most services require only one claim submitted to Wellcare. It will automatically “crossover” to Medicaid. Exceptions include: DME, FQHC, Medicare Certified Home Health, and Part B Only Institutional claims. | EDI
Paper Wellcare Attn: P.O. Farmington, OR P.O. Farmington, |
| Claim Edits | New HMO DSNP pre-payment edits will take effect in early 2026. Until then, some claims may undergo post-payment review instead of prepayment validation. Additional details are provided in separate a provider communication included with this one. | No change to current process |
Check Schedule |
Note: Bank code changes effective Jan 1, 2026, will temporarily result in receipt of two separate checks depending on the claim date of service |
|
| EFT/835s | To continue to receive EFT payments and 835s for DSNP claims, you must log onto the Zelis (Payspan) system and add available registration codes (Reg Codes) for this line of business. You don’t need to register unless the provider is new. | If you are currently receiving EFT payments and 835s you need to do nothing other than, periodically check Zelis (Payspan) for opportunities to address new registration codes (RINs) created when we correct/update/replace “pay to” information |
| A Zelis (Payspan) Tip Sheet outlining the steps to register available Reg Codes to your existing account is included with this communication | ||
| Member ID Cards |
| A sample 2026 AZ Medicare ID card is provided below |
| Prior Authorizations (PA) |
| Submit PA requests separately based on the line of business |
| PA requests may be submitted via fax or online (preferred) via our secure provider portal Login | Arizona Complete Health or Availity Essentials | ||
| Provider Manual |
For AzCH-CCP details, see | Refer to the Wellcare Provider Manual located in AZ Manuals and Forms for Medicare policies and |
| Provider News | You can explore provider news articles available at Medicare News | |
| Provider Quick Reference Guide (QRG) | Your go-to resource for:
Access the QRG here: Arizona Complete Health Medicaid manual | |
| Provider Secure Portal Login | Provider Secure Portal Login | |
| Provider Website | Provider Website | |
AZ 2026 Sample Medicare ID Cards HMO DSNP (HIDE)
AZ 2026 Sample Medicare ID Cards (Wellcare HMO & CSNP)
