Agent Information | Medicare Health Plan Solutions

Aviso de no discriminación en actividades y programas de salud
Resumen de beneficios (Not Avl in Spanish)
Start Rating (Not Avl in Spanish)
Prueba de cobertura
Aviso anual de cambios
Cobertura de suministros para la diabetes para 2019
Solicitud de inscripción
Formulario integral 2019
Autorización previa
Terapia escalonada
Condiciones y limitaciones de la Parte D
Cobertura para medicamentos recetados fuera de la red
Control de calidad
Tabla de resumen de las primas con subsidio por bajos ingresos (LIS, por sus siglas en inglés)
Formulario de reclamación de medicamentos recetados
Formulario de pedido de medicamentos recetados con entrega a domicilio
Formulario de solicitud de determinación de cobertura para medicamentos recetados de Medicare
Formulario de desafiliación

Amerivantage Dual Coordination (HMO SNP)

____________________English____________________________

Summary of Benefits
Evidence of Coverage
Annual Notice of Changes
2019 diabetes supply OLS_006 AGP
Enrollment Application
2019 Comprehensive Formulary
Prior Authorization
Step Therapy
Part D Conditions and Limitations
Out of Network Prescription Drug Coverage
2019 Quality Assurance_006 AGP
Low Income Subsidy (LIS) Premium Summary Table
Prescription Drug Claim Form
Prescription Drug Home Delivery Order Form
Medicare Prescription Drug Coverage Determination Request Form
Disenrollment Form
Star Rating
Non Discrimination Notice

_________________________Spanish_______________________

Resumen de beneficios
Prueba de cobertura
Aviso anual de cambios
Cobertura de suministros para la diabetes para 2019
Solicitud de inscripción
Formulario integral 2019
Autorización previa
Terapia escalonada
Condiciones y limitaciones de la Parte D
Cobertura para medicamentos recetados fuera de la red
Control de calidad
Tabla de resumen de las primas con subsidio por bajos ingresos (LIS, por sus siglas en inglés)
Formulario de reclamación de medicamentos recetados
Formulario de pedido de medicamentos recetados con entrega a domicilio
Formulario de solicitud de determinación de cobertura para medicamentos recetados de Medicare
Formulario de desafiliación
Resumen de beneficios
Solicitud de inscripción
Calificaciones por estrellas

Amerivantage Select (HMO)

______________________English______________________________

Notice of Non-Discrimination in Health Programs and Activities
Star Rating
Summary of Benefits
Evidence of Coverage
Annual Notice of Changes
2019 Coverage of Diabetic Supplies
Enrollment Application
2019 Comprehensive Formulary
Prior Authorization
Step Therapy
Part D Conditions and Limitations
Out of Network Prescription Drug Coverage
Quality Assurance
Low Income Subsidy (LIS) Premium Summary Table
Prescription Drug Claim Form
Prescription Drug Home Delivery Order Form
Medicare Prescription Drug Coverage Determination Request Form
Disenrollment Form
2019 Select HMO Directory

_________________________Spanish_______________________

Resumen de beneficios (Not avl in spanish)
Star Rating (Not Avl in Spanish)
Prueba de cobertura
Aviso anual de cambios
Cobertura de suministros para la diabetes para 2019
Solicitud de inscripción
Formulario integral 2019
Autorización previa
Terapia escalonada
Condiciones y limitaciones de la Parte D
Cobertura para medicamentos recetados fuera de la red
Control de calidad
target=”_blank”Tabla de resumen de las primas con subsidio por bajos ingresos (LIS, por sus siglas en inglés)
Formulario de reclamación de medicamentos recetados
Formulario de pedido de medicamentos recetados con entrega a domicilio
Formulario de solicitud de determinación de cobertura para medicamentos recetados de Medicare
Formulario de desafiliación

Amerivantage Dual Secure (HMO SNP)

______________________English______________________________

Notice of Non-Discrimination in Health Programs and Activities
Summary of Benefits
Evidence of Coverage_Y0114_19_35821_U_C_246
2019 diabetes supply OLS_006 AGP_rev
Enrollment Instructions
Enrollment Application
2019 Comprehensive Formulary
Prior Authorization
Step Therapy
Part D Conditions and Limitations
2019 Out of Network Prescription Drug Coverage 006 AGP_wcag
Quality Assurance
Prescription Drug Transition Policy
Medication Therapy Management Information
Low Income Subsidy (LIS) Premium Summary Table
Drug_Claim_Form
Prescription Drug Home Delivery Order Form
Medicare Prescription Drug Coverage Determination Request Form
Redetermination (Appeal) of Medicare Prescription Drug Denial Request Form
Disenrollment Form
Information about the Medicare Contract
Start Rating

_________________________Spanish_______________________

Resumen de beneficios
Prueba de cobertura
Cobertura de suministros para la diabetes para 2019
Solicitud de inscripción
Formulario integral 2019
Autorización previa
Terapia escalonada
Condiciones y limitaciones de la Parte D
Cobertura para medicamentos recetados fuera de la red
Control de calidad
Tabla de resumen de las primas con subsidio por bajos ingresos (LIS, por sus siglas en inglés)
Formulario de reclamación de medicamentos recetados
Formulario de pedido de medicamentos recetados con entrega a domicilio
Formulario de solicitud de determinación de cobertura para medicamentos recetados de Medicare
Formulario de desafiliación
Star Rating (Not Avail in Spanish)

Amerivantage ESRD (HMO-POS SNP)

______________________English______________________________

Notice of Non-Discrimination in Health Programs and Activities
Summary of Benefits
Evidence of Coverage
2019 Coverage of Diabetic Supplies
Enrollment Application
2019 Comprehensive Formulary
Prior Authorization
Step Therapy
Part D Conditions and Limitations
Out of Network Prescription Drug Coverage
Quality Assurance
Low Income Subsidy (LIS) Premium Summary Table
Prescription Drug Claim Form
Medicare Prescription Drug Coverage Determination Request Form
Disenrollment Form
Star Rating

_________________________Spanish_______________________

Aviso de no discriminación en actividades y programas de salud
Resumen de beneficios
Prueba de cobertura
Cobertura de suministros para la diabetes para 2019
Solicitud de inscripción
Formulario integral 2019
Autorización previa
Terapia escalonada
Condiciones y limitaciones de la Parte D
Cobertura para medicamentos recetados fuera de la red
Control de calidad
Tabla de resumen de las primas con subsidio por bajos ingresos (LIS, por sus siglas en inglés)
Formulario de reclamación de medicamentos recetados
Formulario de pedido de medicamentos recetados con entrega a domicilio
Formulario de solicitud de determinación de cobertura para medicamentos recetados de Medicare
Formulario de desafiliación
Star Rating (Not avail in Spanish)

Cigna Healthspring Plans

2018 Scope of Appointment Form

2018Rules of Engagement

eAgent User Guide – Agent

eEnrollment User Guide

HAAL Guide OrderSalesKitTool

Sales Presentation Checklist

Scope of Appointment Resource

Cigna-HealthSpring Preferred (HMO)

formulary-ea-mapd
SUMMARY OF BENEFITS h4513-025-000-cigna-healthspring-preferred-hmo-sb
EVIDENCE OF COVERAGE h4513-025-cigna-healthspring-preferred-hmo-eoc
multi-language-insert-ma
Overview
pre-enrollment-checklist-hmo-chs
starrating-h4513

Cigna-HealthSpring TotalCare (HMO-SNP)

formulary-ds
SUMMARY OF BENEFITS h4513-010-000-cigna-healthspring-totalcare-hmo-snp-sb
EVIDENCE OF COVERAGE h4513-010-cigna-healthspring-totalcare-hmo-eoc
multi-language-insert-ma
Overview
pre-enrollment-checklist-dsnp-chs
starrating-h4513

Cigna-HealthSpring Rx Plans

Cigna-HealthSpring Rx Secure (PDP)

Overview

Cigna-HealthSpring Rx Secure-Essential (PDP)

Overview

Cigna-HealthSpring Rx Secure-Extra (PDP)

Overview

Clover Plans

Clover_2019_provider_directory_tx_c

Clover Health Choice Value (PPO) 2019

Clover Health Choice Value (PPO) 2019

Clover Health Classic (HMO) 2019

Clover Health Classic (HMO) 2019

Humana Plans

HumanaChoice PPO R4182-004

Overview HumanaChoice PPO R4182-004
MyOption Dental High PPO
MyOption_FitnessWB_2019
SOB R4182004000SB19
SOB Spanish R4182004000SBSP19
EOC R4182004000EOC19
EOC Spanish R4182004000EOCSP19
Star Rating R4182GHA09ECHH19
Star Rating Spanish R4182GHA09ECHH19RS
Formulary
Formulary Spanish
Provider Directory

Humana Gold Plus HMO H0028-035

Overview HMO H0028-035
MyOption Enhanced Dental_Plus_HMO2019
SOB HMO H0028-035
SOB Spanish HMO H0028-035
EOC HMO H0028-035
EOC Spanish HMO H0028-035
Star Rating H0028-035
Star Rating(Spanish) H0028-035
Formulary H0028-035
Formulary Spanish H0028-035
PROVIDER DIRECTORY

Humana Gold Plus SNP-DE HMO H0028-034

Overview HMO H0028-034
SOB HMO H0028-034
SOB Spanish HMO H0028-034
EOC HMO H0028-034
EOC Spanish HMO H0028-034
Star Rating H0028GHA09ECHH19
Star Rating(Spanish)H0028GHA09ECHH19RS
Formulary HMO H0028-034
Formulary Spanish HMO H0028-034
Provider Directory

Humana Gold Plus SNP-DE HMO H0028-031

Overview HMO H0028-031
SOB H0028031000SB19
SOB Spanish H0028031000SBSP19
EOC H0028031000EOC19
EOC Spanish H0028031000EOCSP19
Star Rating Humana Choice PPO R4182-001
Star Rating(Spanish) Humana Choice PPO R4182-001
Formulary HMO H0028-031
Spanish Formulary HMO H0028-031
Provider Directory

HumanaChoice PPO PPO R4182-001

Overview HumanaChoice PPO R4182-001
MyOption_FitnessWB_2019
SOB HumanaChoice PPO R4182-001
SOB Spanish HumanaChoice PPO R4182-001
EOC HumanaChoice PPO R4182-001
EOC Spanish HumanaChoice PPO R4182-001
Star Rating Humana Choice PPO R4182-001
Star Rating (Spanish) Humana Choice PPO R4182-001
Formulary HumanaChoice PPO
Formulary Spanish HumanaChoice PPO
Provider Directory

HumanaChoice PPO PPO H5216-128

Overview HumanaChoice PPO H5216-128
MyOption Dental High PPO
SOB H5216128000SB19
SOB Spanish H5216128000SBSP19
EOC H5216128000EOC19
EOC Spanish H5216128000EOCSP19
Star Rating H5216GHA09ECHH19
Star Rating Spanish H5216GHA09ECHH19RS
Provider Directory No Rx Coverage

HumanaChoice PPO PPO H5216-043-001

Overview HumanaChoice PPO H5216-043-001
SOB H5216043001SB19
SOB Spanish H5216043001SBSP19
EOC H5216043001EOC19
EOC Spanish H5216043001EOCSP19
Star Rating H5216GHA09ECHH19
Star Rating Spanish H5216GHA09ECHH19RS
Formulary
Formulary (Spanish)
Provider Directory

HumanaChoice PPO PPO R4182-003

Overview HumanaChoice PPO R4182-003
MyOption_FitnessWB_2019
SOB R4182003000SB19
SOB Spanish R4182003000SBSP19
EOC R4182003000EOC19
EOC Spanish R4182003000EOCSP19
Star Rating R4182GHA09ECHH19
Star Rating(Spanish) R4182GHA09ECHH19
Provider Directory

Humana Rx Plans

Humana Preferred Rx Plan PDP S5884-143

Plan Overview
SOB S5884143000SB19
Resumen de beneficios S5884143000SBSP19
Evidence of Coverage S5884143000EOC19
Evidencia de cobertura S5884143000EOCSP19
Medicare Star Rating
Calificaciones por estrellas Medicare

Humana Enhanced PDP S5884-020

Plan Overview Humana Enhanced PDP
Summary of Benefits S5884020000SB19
Resumen de beneficios S5884020000SBSP19
Evidence of Coverage S5884020000EOC19
Calificaciones por estrellas Medicare
Evidencia de cobertura S5884020000EOCSP19
Medicare Star Ratings
Calificaciones por estrellas Medicare S5884GHA09ECHH19RS

Humana Walmart Rx Plan PDP S5884-168

Plan Overview Humana Walmart Rx Plan PDP
Summary of Benefits S5884168000SB19
Resumen de beneficios S5884168000SBSP19
Evidence of Coverage S5884168000EOC19
Evidencia de cobertura S5884168000EOCSP19
Medicare Star Ratings
Calificaciones por estrellas Medicare

Imperial Plans

Imperial Enrollment Application

BLANK IMPERIAL DIRECT FAX

2019 Over-the-Counter Benefit and Order Form

Benefit-Highlights-2019

Dual (HMO SNP) PBP 004

Summary of Benefits (HMO) PBP 004-TX-SB-2019_M-ENG-Accepted-09.11.18
Resumen de beneficios (HMO) PBP 004-Spanish-TX-SB-2019_M-SP-Alternate-Format-09.13.18
Evidence of Coverage-Dual-HMO-SNP-2019_M-ENG_NM-09.26.18-1
Evidencia de cobertura-Dual-HMO-SNP-2019_M-SP-Alternate-Format-10.03.18-2
Dental-Benefit-(HMO) PBP 004-TX-Dental-Benefit-Dir-2019_M-ENG-Approved-09.12.18

Traditional (HMO) PBP 003

Summary of Benefits (HMO) PBP 003-TX-SB-2019_M-ENG-Accepted-09.11.18
Spanish Summary of Benefits (HMO) PBP 003-Spanish -TX-SB-2019_M-SP-Alternate-Format-09.13.18
Evidence of Coverage (HMO) PBP 003-TX-EOC-Traditional-HMO-2019_M-ENG_NM-09.13.18
Evidencia de cobertura-Traditional-HMO-2019_M-SP-Alternate-Format-10.03.18
Dental-Benefit (HMO) PBP 003-TX-Dental-Benefit-Dir-2019_M-ENG-Approved-09.12.18
Beneficios Dentales-2019_M-SP-Alternate-Format-09.27.18

Value (HMO SNP) PBP 005

Summary of Benefits (HMO) PBP 005-TX-SB-2019_M-ENG-Accepted-09.11.18
Resumen de beneficios(HMO) PBP 005-Spanish-TX-SB-2019_M-SP-Alternate-Format-09.13.18
Evidence of Coverage (HMO) PBP 005-TX-EOC-Value-HMO-SNP-2019_M-ENG_NM-09.13.18
Imperial Insurance Company of Texas (HMO SNP) Pre-Enrollment
Herramienta de evaluación para la calificación IR_033-TX-CSNP-Assessment_C-SP-10.03.18
(HMO) PBP 005-TX-Dental-Benefit-Dir-2019_M-ENG-Approved-09.12.18

United Healthcare Plans

UnitedHealthcare Dual Complete® Choice (Regional PPO SNP) R6801-011

Annual Notice of Changes -R6801-011-EN
Annual Notice of Changes -R6801-011-SPANISH
Enrollment Application -R6801-011-EN
Enrollment Application-R6801-011-SPANISH
Enrollment Kit -R6801-011-EN
Enrollment Kit -R6801-011-SPANISH
Evidence of Coverage -R6801-011-EN
Evidence of Coverage -R6801-011-SPANISH
Formulary-R6801-011-EN
Formulary-R6801-011-SPANISH
Provider Directory -seleccionados-R6801-011-PD-ES
Provider Directory -SelectCounties-R6801-011-PD-EN
STAR Rating-R6801-011-EN
STAR Rating-R6801-011-SPANISH
Summary of Benefits -R6801-011-EN
Summary of Benefits -R6801-011-SPANISH
Vendor Information -R6801-011-EN
Vendor Information -R6801-011-SPANISH

UnitedHealthcare Dual Complete® Focus (HMO SNP) H4527-006

Annual Notice of Changes -H4527-006-EN
Annual Notice of Changes -H4527-006-SPANISH
Enrollment Application -H4527-006-EN
Enrollment Application -H4527-006-ES
Enrollment Kit -H4527-006-EN
Enrollment Kit -H4527-006-ES
Evidence of Coverage -H4527-006-EN
Evidence of Coverage -H4527-006-ES
Formulary-H4527-006-EN
Formulary-H4527-006-ES
Medicare Plan Star Ratings -H4527-006-EN
Medicare Plan Star Ratings -H4527-006-SPANISH
Provider Directory -CondadodeElPaso-H4527-006-PD-ES
Provider Directory -ElPaso-H4527-006-PD-EN
Summary of Benefits -H4527-006-EN
Summary of Benefits -H4527-006-SPANISH
Vendor Information -H4527-006-EN
Vendor Information-H4527-006-SPANISH

UnitedHealthcare Dual Complete® (PPO SNP) H2228-041

ANOC-H2228-041-EN
ANOC-H2228-041-Spanish
ENROLLMENT APP-H2228-041-EN
ENROLLMENT APP-H2228-041-Spanish
Enrollment Kit-H2228-041-EN
Enrollment Kit-H2228-041-Spanish
EOC-H2228-041-EN
EOC-H2228-041-Spanish
Formulary-H2228-041-EN
Formulary-H2228-041-Spanish
Provider Directory-ElPaso-H2228-041
Provider Directory-ElPaso-H2228-041-Spanish
SOB-H2228-041-EN
SOB-H2228-041-Spanish
STAR Rating-H2228-041-EN
STAR Rating-H2228-041-Spanish
VendorInfo-H2228-041-EN
VendorInfo-H2228-041-Spanish

WellCare Plans

WellCare TexanPlus Classic (HMO)

Plan Details for Wellcare TaxanPlus Classic (HMO)
SoB TX_CARE_TexanPlus_Classic_003_16320_Summary_of_Benefits_ENG_2019_R
SoB Spanish TX_CARE_TexanPlus_Classic_003_17566_Summary_of_Benefits_SPA_2019_R
EoC TX_CARE_TexanPlus_Classic_003_17755_EOC_ENG_2019
2019 WellCare TexanPlus Classic (HMO) Star Rating
Formulary NA9WCMFOR16617E_CV05
Enrollment_Application_ENG_2019
Spanish NA_CARE_Enrollment_Application_SPA_2019_R
tx_ccp_EFT_Form_2010
Medical_Reimbursement_Claim_Form_ENG_8_2018_R
Spanish NA_CARE_Medical_Reimbursement_Claim_Form_SPA_9__2018
OTC_reimbursementform_eng_2016_R
TX_CARE_TexanPlus_LPO_Provider_Directory_18235_ENG_10_2018
Member attestation_form_04_2013
Appointment_rep_eng_2012
Hipaa_release_information_eng_2015
Hipaa_release_information_spa_2015
Hipaa_release_revocation_form_eng_2015
Hipaa_release_revocation_form_spa_2015

WellCare Value (HMO-POS)

Plan Details for WellCare Value (HMO-POS)
Summary_of_Benefits_ENG_2019_R
Summary_of_Benefits_SPANISH_2019_R
EOC_ENG_2019 5 Star_Ratings_H0174_ENG_2019_R
EFT_Form_2010
Enrollment_Application_ENG_2019
Enrollment_Application_SPANISH_2019_R
Direct_Member_Reimbursement_Form_ENG
Medical_Reimbursement_Claim_Form_SPAN
OTC_reimbursementform_eng
EOB_sample_english
EOB_sample_spanish
Member_Appointment_of_Representative_ENG
Member attestation_form
HIPPA_release_information_eng
HIPPA_release_information_span
HIPPA_release_revocation_form_eng
HIPPA_release_revocation_form_span
2019 Comprehensive Formulary

WellCare Dividend Prime (HMO)

Plan Details for WellCare Dividend Prime (HMO)
Dividend_Prime_Summary_of_Benefits_ENG_2019_R
Dividend_Prime_Summary_of_Benefits_SPANISH_2019_R
Dividend_Prime_007_17756_EOC_ENG_2019
2019 Comprehensive Formulary
Dividend Prime Star_Ratings_H0174_ENG_2019_R
Enrollment_Application_ENG_2019
Enrollment_Application_SPANISH_2019_R
TX_ccp_EFT_Form
Direct_Member_Reimbursement_Form_ENG
Medical_Reimbursement_Claim_Form_SPANISH
OTC_reimbursementform_eng
EOB_sample_eng
EOB_sample_spanish
Member_Appointment_of_Representative_ENG
Member attestation_form_04_2013
HIPPA_release_information_eng
HIPPA_release_revocation_form_eng
Star Rating

Las Vegas Agents Click Here

New Mexico Agents Click Here

*UPDATE* 07/27/2020

Telesale/Online Tools for all carriers

2020 El Paso, TX Plans

AARP Plans

United Healthcare Plans

Aetna Plans

Allwell Plans

Amerigroup Plans

Blue Cross Blue Shield Plan

Cigna Healthspring Plans

Clover Plans

Humana Plans

Imperial Health Plan

MUTUAL OF OMAHA

Silver Scripts Plans

Wellcare Plans

2019 El Paso, TX Plans

AARP PLANS

AETNA PLANS

Amerigroup Plans

Cigna Healthspring Plans

Clover Plans

Humana Plans

Humana Rx Plans

Imperial Plans

United Healthcare Plans

WellCare Plans

UPDATE 07/27/2020