Your plan documents
Every year, Medicare reviews plans based on a 5-star rating system. You can check your plan's Star Ratings (PDF).
Materials
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- Formulary (drug list) – English (PDF)
- Formulary (drug list) – Spanish (PDF)
- Formulary updates (PDF)
- Machine readable formulary file -CSV
- Mail order pharmacy
- Medication Therapy Management
- Prior authorization criteria (PDF)
- Part D Step therapy criteria (PDF)
- Medicare Part B step therapy preferred drug list
- Prescription Drug search tool
- Pharmacy Reimbursement Form (PDF)
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Coming soon.
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Forms
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- Authorized representative request form
- Prior authorization form (PDF)
- Pharmacy Prior Authorization (Coverage Determination) form (PDF)
- Pharmacy Appeal form (PDF)
- Medicare Prescription Payment Plan Participation Request Form - English (PDF)
- Medicare Prescription Payment Plan Participation Request Form - Spanish (PDF)
- Wig Member Reimbursement Form - English (PDF)
- Wig Member Reimbursement Form - Spanish (PDF)
Resources
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Behavioral health crisis line
1-866-600-2139 (TTY: 711)
General behavioral health line
1-866-600-2139 (TTY: 711)
24-Hour Nurse Line
1-866-600-2139 (TTY: 711)
Nonemergency medical rides
1-888-513-1612 (TTY: 711)
March Vision Care
Find a provider or pharmacy
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Coming soon.
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We want to make sure you’re happy with the care you receive. If you have any issues with your health plan or a provider, you can file a grievance. If you’re not okay with a decision we made, you can file an appeal. Your feedback helps us improve our services. To file a grievance or appeal, call us at 1-866-600-2139 (TTY: 711).
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Population Health Programs to keep you healthy
For more information on how to use any of the programs listed below just call our Care Management team at 1-866-600-2139 (TTY: 711). You can choose to join or leave the program at anytime.
National Coverage Determination (NCD) notices
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Starting October 28, 2025, Medicare covers Renal Denervation (RDN) for uncontrolled high blood pressure.
You may qualify if you meet all these requirements:
Your blood pressure stays at or above 140/90 mm Hg, even with treatment.
Your provider confirms your diagnosis with home or ambulatory blood pressure monitoring.
You try recommended medicines and lifestyle changes for at least six weeks.
Your provider checks and treats other causes, such as sleep apnea or hormone problems.
You do not have a condition that makes RDN unsafe.
Your primary doctor manages your blood pressure for six months and sees you at least three times.
You have no more than two virtual visits during those three visits.
You have never had an RDN procedure.
A specially trained doctor must perform RDN. You must get the procedure at a center with a hypertension program and imaging.
Medicare covers RDN only in a CMS-approved clinical study listed on NCBI. Medicare doesn’t cover RDN outside a CMS-approved study.
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Starting October 28, 2025, Medicare covers Cardiac Contractility Modulation (CCM) for some people with heart failure.
CCM uses a small device to send signals that help your heart pump better.
Medicare covers CCM only in a CMS-approved research study under Coverage with Evidence Development (CED). These studies help Medicare learn how well CCM works.
You may qualify if you meet these requirements:
You meet the FDA-approved criteria for CCM.
You still have symptoms after at least three months of recommended medicines and treatments.
You do not have any FDA-listed conditions that make CCM unsafe.
You have not had a heart transplant.
You are age 18 or older.
You must get CCM and related services through a CMS-approved study listed on NCBI.
These studies follow strict rules and include follow-up care.
They compare CCM to other treatments.
They track survival and heart failure hospital stays for at least two years.
They review results by age and other health conditions, such as diabetes and blood pressure.
They also review results by heart condition type, CRT use and LVEF.
Medicare does not cover CCM for heart failure outside a CMS-approved study.