Documents and Forms

Here you can find important information regarding the 2022 WellSense Medicare Advantage (HMO) plan.

Important documents

Member forms and information

Pharmacy Information

Here you can find important information regarding the 2023 WellSense Added Value (HMO) plan.

Important documents

Member forms and information

  • Auto Pay Form
  • Care Management PHI Authorization Form
  • Fitness Reimbursement Form
  • Member Rights and Responsibilities
  • Prescription Reimbursement Form

Pharmacy Information

Here you can find important information regarding the 2023 WellSense Signature (HMO) plan.

Important documents

Member forms and information

  • Auto Pay Form
  • Care Management PHI Authorization Form
  • Fitness Reimbursement Form
  • Member Rights and Responsibilities
  • Prescription Reimbursement Form

Pharmacy Information

Here you can find important information regarding the 2023 WellSense Choice (HMO) plan.

Important documents

Member forms and information

  • Auto Pay Form
  • Care Management PHI Authorization Form
  • Fitness Reimbursement Form
  • Member Rights and Responsibilities
  • Prescription Reimbursement Form

Pharmacy Information

Here you can find important information regarding the 2022 WellSense Medicare Advantage (HMO) plan.

Important documents

Member forms and information

Pharmacy Information

Here you can find important information regarding the 2023 WellSense Added Value (HMO) plan.

Important documents

Member forms and information

Pharmacy Information

Here you can find important information regarding the 2023 WellSense Signature (HMO) plan.

Important documents

Member forms and information

Pharmacy Information

Here you can find important information regarding the 2023 WellSense Choice (HMO) plan.

Important documents

Member forms and information

Pharmacy Information