Health Plans Documents

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Prior Authorization Requirements
Total EasyCare Plus
Prior Authorization Requirements
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July 2026
EasyCare
Prior Authorization Requirements
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July 2026
Requirements and Policies
Total EasyCare Plus EasyCare
Medicare Part D Opioid Policies
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Opioid Pharmacist Tip Sheet
Total
Prescription Drug Transitional Care Policy
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EnglishSpanishChinese
EasyCare Plus
Prescription Drug Transitional Care Policy
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EnglishSpanishChinese
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
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Determination Form
Total EasyCare Plus EasyCare
Request for Medicare Prescription Drug Coverage Redetermination
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Redetermination Form