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
Formularies
Is a list of prescription drugs covered by your health plan.
Use Tier 1 formulary if you are enrolled in:
- Elderplan for Medicaid Beneficiaries (HMO-POS D-SNP)
- Elderplan Advantage for Nursing Home Residents (HMO-POS I-SNP)
- Elderplan Plus Long-Term Care (HMO-POS D-SNP)
Use Tier 5 formulary if you are enrolled in:
- Elderplan Flex (HMO-POS)
- Elderplan Extra Help (HMO-POS)
- Elderplan Assist (HMO-POS IE-SNP)
- Elderplan Select (HMO-POS I-SNP/IE-SNP)
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
Member Handbooks
Services Offered at Home
Transportation Brochure
All plan materials, such as your Summary of Benefits and Formulary, are on this website. However, if you prefer to have them emailed to you or mailed to your home, fill out the Secure Member Request Form.
Annual Notice of Change
Summary of Benefits
Evidence of Coverage
Formularies
Elderplan for Medicaid Beneficiaries (HMO D-SNP)
Elderplan Advantage for Nursing Home Residents (HMO I-SNP)
Elderplan Plus Long-Term Care (HMO D-SNP)
Elderplan Flex (HMO)
Elderplan Extra Help (HMO)
Elderplan Assist (HMO IE-SNP)
Star Ratings
For Elderplan Plus Long-Term Care
For other Elderplan Plans
Find a Form
Member Brochures
Member Handbooks
Services Offered at Home
Transportation Brochure
HomeFirst Plan Materials
Additional plan materials can be found on the HomeFirst Plan Materials page.