Health Plans Documents

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

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Drug Benefits for EasyCare Plus

Choose your plan to view or download information about your drug benefits, including formularies. You can also select specific document types to view or download the ones you need.

Prior Authorization Request Forms
EasyCare EasyCare Plus Total
Request for Medicare Prescription Drug Coverage Determination – PDF Form
Download PDF:
Determination Form
EasyCare EasyCare Plus Total
Request for Medicare Prescription Drug Coverage Redetermination
Download PDF:
Redetermination Form