Health Plans Documents

Access forms, documents, and resources for all Medicare Advantage plans.

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Prescription Drug Copay Table
EasyCare
Prescription Drug Copay Table
2026 Plan
EnglishSpanishChinese
Drug List (Formulary)
EasyCare
2026 Online Drug List (Formulary)
EasyCare
Drug List (Formulary)
Download PDF:
2026 Plan Formulary - August 2026 (English/Spanish/Chinese)
EasyCare
Future Formulary Changes

Please check these formulary updates for upcoming changes in the drug coverage list.

Download PDF:
August 2026
Step Therapy Requirements
EasyCare
Step Therapy Requirements
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August 2026
Prior Authorization Requirements
EasyCare
Prior Authorization Requirements
Download PDF:
August 2026
Requirements and Policies
EasyCare EasyCare Plus Total
Medicare Part D Opioid Policies
Download PDF:
Opioid Pharmacist Tip Sheet
EasyCare
Prescription Drug Transitional Care Policy
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EnglishSpanishChinese
Prior Authorization Request Forms
EasyCare Plus EasyCare Total
Request for Medicare Prescription Drug Coverage Determination – Online Form
Total EasyCare Plus EasyCare
Request for Medicare Prescription Drug Coverage Determination – PDF Form
Download PDF:
Determination Form