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Health Plans Documents

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

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Clinical Coverage Criteria References
Total EasyCare Plus EasyCare
Acupuncture Authorization Guideline
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Total EasyCare EasyCare Plus
EasyCare EasyCare Plus Total

Click on the link and please refer to the PDF under “Other Documents” titled: “Healthplex Dental Claim Review Guidelines (Comprehensive & Limited Plans)”

Total EasyCare Plus EasyCare
Medical Necessity and Other Clinical Coverage Criteria (Coming Soon)
Total EasyCare Plus EasyCare
Outpatient Physical, Occupational, and Speech Therapy Coverage Guideline
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Annual Notice of Change
EasyCare
Annual Notice of Change
EasyCare Plus
Annual Notice of Change
Total
Annual Notice of Change
Summary of Benefits
EasyCare
Summary of Benefits
EasyCare Plus
Summary of Benefits