SilverScript Plans

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SilverScript Choice (PDP) S5601-058

____________________English____________________

Evidence of Coverage

Formulay

Low income Subsidy Information

Prior authorization information

Step Therapy Information

Summary of Benefits

____________________Spanish____________________

Evidencia de Cobertura

Formulario

Resumen de Beneficios

Subsidio de Bajos Ingresos

SilverScript Plus (PDP) S5601-059

____________________English____________________

Evidence of Coverage

Formulary

Low income Subsidy Information

Prior Authorization Information

Step Therapy Information

Summary of Benefits

____________________Spanish____________________

Evidencia de Cobertura

Formulario

Resumen de Beneficios

Subsidio de Bajos Ingresos

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Allwell

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Allwell Low Income Subsidy

Low Income Subsidy LIS Premium Summary Table for people receiving extra help

Optional Supplemental Benefits

Allwell Medicare (HMO) H6446 – 001

____________________English____________________

Allwell Medicare (HMO) – English (PDF)

Allwell Evidence of Coverage

Extra Benefits Brochure H6446 – 001 – English (PDF)

Individual Enrollment Form – English (PDF)

Low Income Subsidy – H6446-001- English – (PDF)

Over-the-Counter Catalog –

Allwelll Summary of Benefits

Star Rating

____________________Spanish____________________

Allwell Medicare (HMO) – Spanish (PDF)

Individual Enrollment Form – Spanish (PDF)

Over-the-Counter Catalog – Spanish (PDF)

Summary of Benefits – H6446 – 001 – Spanish (PDF)

ALLWELL SALES PRESENTATIONS

____________________English____________________

SLIDESHOW
2020-ALL-AWSALESPRESENTATION-MA

____________________Spanish____________________

SLIDESHOW
2020-ALL-AWSALESPRESENTATION-MA_sp

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Anthem Plans

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Anthem MediBlue Breathe (HMO C-SNP)

____________________English____________________

2020 Comprehensive Formulary

annual notice of changes

Disenrollment form

Enrollmet application

Evidence of coverage

Part D step therapy

Prior authorization

Summary of benefits

____________________Spanish____________________

2020 Comprehensive Formulary

annual notice of changes

Summary of benefits

Anthem MediBlue Care On Site (HMO I-SNP)

____________________English____________________

2020 Comprehensive Formulary

annual notice of changes

Disenrollment form

Enrollmet application

Evidence of coverage

Part D step therapy

Summary of benefits

____________________Spanish____________________

2020 Comprehensive Formulary

annual notice of changes

Summary of benefits

Anthem MediBlue Connect Plus (HMO)

____________________English____________________

2020 Comprehensive Formulary

annual notice of changes

Disenrollment form

Enrollmet application

Part D step therapy

Prior authorization

Summary of benefits

____________________Spanish____________________

2020 Comprehensive Formulary

annual notice of changes

Summary of benefits

Anthem MediBlue Coordination Plus (HMO)

____________________English____________________

2020 Comprehensive Formulary

annual notice of changes

Evidence of coverage

Part D step therapy

Prior authorization

Summary of benefits

____________________Spanish____________________

2020 Comprehensive Formulary

annual notice of changes

Summary of benefits

Anthem MediBlue Diabetes (HMO C-SNP)

____________________English____________________

2020 Comprehensive Formulary

annual notice of changes

Disenrollment form

Enrollmet application

Evidence of coverage

Part D step therapy

Prior authorization

Summary of benefits

____________________Spanish____________________

2020 Comprehensive Formulary

annual notice of changes

Summary of benefits

Anthem MediBlue Heart (HMO C-SNP)

____________________English____________________

2020 Comprehensive Formulary

annual notice of changes

Disenrollment form

Enrollmet application

Evidence of coverage

Part D step therapy

Prior authorization

Summary of benefits

____________________Spanish____________________

2020 Comprehensive Formulary

annual notice of changes

Summary of benefits

Anthem MediBlue Plus (HMO)

____________________English____________________

2020 Comprehensive Formulary

annual notice of changes

Enrollmet application

Evidence of coverage

Part D step therapy

Prior authorization

Summary of benefits

____________________Spanish____________________

2020 Comprehensive Formulary

annual notice of changes

Evidence of coverage

Summary of benefits

Anthem MediBlue StartSmart Plus (HMO)

____________________English____________________

2020 Comprehensive Formulary

annual notice of changes

Disenrollment form

Enrollmet application

Evidence of coverage

Part D step therapy

Prior authorization

Summary of benefits

____________________Spanish____________________

2020 Comprehensive Formulary

annual notice of changes

Summary of benefits

Anthem MediBlue Value Plus (HMO)

____________________English____________________

2020 Comprehensive Formulary

annual notice of changes

Disenrollment form

Enrollmet application

Evidence of coverage

Part D step therapy

Prior authorization

Summary of benefits

____________________Spanish____________________

2020 Comprehensive Formulary

annual notice of changes

Summary of benefits

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Humana Plans

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Humana 2020 Customer Number Grid

How to complete SNP verification form

Humana Gold Plus HMO H6622-028

____________________English____________________

Evidence of Coverage

Summary of Benefits

Comprehensive Formulary

____________________Spanish____________________
Evidece of coverage

Summary of Benefits

Humana Gold Plus HMO H6622-056

____________________English____________________

Evidence of Coverage

Summary of Benefits

Comprehensive FormularyComprehensive Formulary

____________________Spanish____________________

Summary of Benefits

Humana Gold Plus Lung HMO H6622-030

____________________English____________________

Evidence of Coverage

Summary of Benefits

comprehensive.asp(13)

____________________Spanish____________________

Summary of Benefits

Humana Gold Plus SNP-Diabetes and Heart HMO H6622-029

____________________English____________________

Evidence of Coverage

Summary of Benefits

Comprehensive Formulary

____________________Spanish____________________

Coming soon…

Humana Kidney Care HMO

____________________English____________________

Evidence of Coverage

Summary of Benefits

Comprehensive Formulary

____________________Spanish____________________

Summary of Benefits

Humana Value Plus HMO H6622-064

____________________English____________________

Evidence of Coverage

Summary of Benefits

Comprehensive Formulary

____________________Spanish____________________

Summary of Benefits

Humana Choice PPO H5216-141

____________________English____________________

Evidence of Coverage

Summary of Benefits

Comprehensive Formulary

____________________Spanish____________________

Summary of Benefits

Humana Choice PPO H5216-036

____________________English____________________

Evidence of Coverage

Summary of Benefits

Comprehensive Formulary

____________________Spanish____________________

Summary of Benefits

Humana Choice PPO H5216-037

____________________English____________________

Evidence of Coverage

Summary of Benefits

____________________Spanish____________________

Coming Soon

Humana Honor PPO

____________________English____________________

Summary of Benefits(3)

Evidence of Coverage(1)
____________________Spanish____________________

Summary of Benefits(4)

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AARP PLANS

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AARP® Medicare Advantage Walgreens Plan 1 (HMO) H0609-038-000

____________________English____________________

Alternative Drugs List (PDF)

Benefit Highlights (Updated 08302019)

Comprehensive Formulary (PDF)

Evidence of Coverage (PDF)

Formulary Additions (PDF)

Formulary Deletions (PDF)

Pharmacy Directory Information (PDF)

Prior Authorization Criteria (PDF)

Provider Directory (PDF) (Updated 10012019)

Star Ratings (PDF) (Updated 04112019)

Step Therapy Criteria (PDF)

Summary of Benefits (PDF)

Vendor Information Sheet (PDF)

____________________Spanish____________________

Beneficios Importantes

Clasificación de la Calidad del Plan (PDF) (Actualizado 04112019)

Comprobante de Cobertura (PDF)

Directorio de Proveedores (PDF) (Actualizado 10012019)

Formulario Completo (PDF)

Información del Directorio de Farmacias (PDF)

Información sobre proveedores – Spanish (PDF)

Lista de Medicamentos Alternativos – Spanish (PDF) (Actualizado 09052019)

Resumen de Beneficios (PDF)

AARP® Medicare Advantage Walgreens Plan 2 (HMO) H0609-039-000

____________________English____________________

Alternative Drugs List (PDF)

Benefit Highlights (Updated 08302019)

Comprehensive Formulary (PDF)

Evidence of Coverage (PDF)

Formulary Additions (PDF)

Formulary Deletions (PDF)

Pharmacy Directory Information (PDF)

Prior Authorization Criteria (PDF)

Provider Directory (PDF) (Updated 10012019)

Star Ratings (PDF) (Updated 04112019)

Step Therapy Criteria (PDF)

Summary of Benefits (PDF)

Vendor Information Sheet (PDF)

____________________Spanish____________________
Beneficios Importantes

Clasificación de la Calidad del Plan (PDF) (Actualizado 04112019)

Comprobante de Cobertura (PDF)

Directorio de Proveedores (PDF) (Actualizado 10012019)

Formulario Completo (PDF)

Información del Directorio de Farmacias (PDF)

Información sobre proveedores – Spanish (PDF)

Lista de Medicamentos Alternativos – Spanish (PDF) (Actualizado 09052019)

Resumen de Beneficios (PDF)

AARP® Medicare Advantage Premier (HMO) H0609-031-000

____________________English____________________

Benefit Highlights

Comprehensive Formulary (PDF)

Evidence of Coverage (PDF)

Formulary Additions (PDF)

Formulary Deletions (PDF)

Pharmacy Directory Information (PDF)

Prior Authorization Criteria (PDF)

Provider Directory (PDF) (Updated 10012019)

Star Ratings (PDF) (Updated 04112019)

Step Therapy Criteria (PDF)

Summary of Benefits (PDF)

Vendor Information Sheet (PDF)

____________________Spanish____________________

Aviso Annual de Cambios (PDF)footnote5

Beneficios Importantes

Clasificación de la Calidad del Plan (PDF) (Actualizado 04112019)

Comprobante de Cobertura (PDF)

Directorio de Proveedores (PDF) (Actualizado 10012019)

Formulario Completo (PDF)

Información del Directorio de Farmacias (PDF)

Información sobre proveedores – Spanish (PDF)

Lista de Medicamentos Alternativos – Spanish (PDF) (Actualizado 09052019)

Resumen de Beneficios (PDF)

UnitedHealthcare® Medicare Advantage Focus (HMO) H0609-032-000

____________________English____________________

Alternative Drugs List (PDF)

Annual Notice of Changes (ANOC) (PDF)footnote5

Benefit Highlights

Comprehensive Formulary (PDF)

Evidence of Coverage (PDF)

Formulary Additions (PDF)

Formulary Deletions (PDF)

Pharmacy Directory Information (PDF)

Prior Authorization Criteria (PDF)

Provider Directory (PDF) (Updated 10012019)

Star Ratings (PDF) (Updated 04112019)

Step Therapy Criteria (PDF)

Summary of Benefits (PDF)

Vendor Information Sheet (PDF)

____________________Spanish____________________

Aviso Annual de Cambios (PDF)footnote5

Beneficios Importantes

Clasificación de la Calidad del Plan (PDF) (Actualizado 04112019)

Comprobante de Cobertura (PDF)

Directorio de Proveedores (PDF) (Actualizado 10012019)

Formulario Completo (PDF)

Información del Directorio de Farmacias (PDF)

Información sobre proveedores – Spanish (PDF)

Lista de Medicamentos Alternativos – Spanish (PDF) (Actualizado 09052019)

Resumen de Beneficios (PDF)

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