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Elderplan Plan Materials

Annual Notice of Change (ANOC)

This tells you about Medicare changes that will impact your current plan benefits or costs.

Summary of Benefits (SOB)

Provides a snapshot of your plan’s costs, benefits and covered health services.

Evidence of Coverage (EOC)

Is a detailed guide of what is covered and what is not


Is a list of prescription drugs covered by your health plan.

Use Tier 1 formulary if you are enrolled in:

  • Elderplan for Medicaid Beneficiaries
  • Elderplan Advantage for Nursing Home Residents
  • Elderplan Plus Long-Term Care

Use Tier 5 formulary if you are enrolled in: 

  • Elderplan Flex
  • Elderplan Extra Help
  • Elderplan Assist
  • Elderplan Select

Star Ratings

Helps Medicare beneficiaries compare the quality of health and drug plans.

For Elderplan Plus Long-Term Care

For other Elderplan Plans

LIS Premium Summary

Member Brochures

OTC and Flex Brochures

Member Handbooks

Services Offered at Home

Transportation Brochure