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2025 Centers Plan for Nursing Home Care (HMO I-SNP) Materials

 

Comprehensive Formulary (Drug List)

Language Link Last Updated
English download 02/03/25
Español download 02/04/25
 

Other Formulary-Related Documents

Language Link Last Updated
Prior Authorization Requirement download 02/04/25
Step Therapy Requirement download 02/04/25
Future Formulary Changes  download 08/05/24
 

Interpreter Services & Non-Discrimination Notice

Language Link Last Updated
English download 12/18/24
Spanish download 12/18/24
 

Evidence of Coverage

Language Link Last Updated
English download 11/19/24
Español download 11/19/24

Annual Notice of Changes

Language Link Last Updated
English download 11/19/24
Español download 11/19/24

Summary of Benefits

Language Link Last Updated
English download 11/19/24
Español download 11/19/24

Click here for the most up-to-date list of Providers

Medicare Provider Directory (pdf)

Languages Link Last Updated
English 

download

09/30/24
Español  download 10/15/24

Pharmacy Directory (pdf)

Languages Link Last Updated
English download 10/17/24
Español download 10/15/24

If you would like a copy of our Provider/Pharmacy Directory mailed to you, please call Member Services at 1-877-940-9330

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Medicare Disclaimer

 

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Last modified: Feb 4, 2025