Health Plans Documents

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Forms
Total EasyCare Plus EasyCare
Health Information Exchange Fact Sheet and Form
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Your Rights and Responsibilities
EasyCare EasyCare Plus Total
Information About Our Grievances and Appeals Process
EasyCare EasyCare Plus Total
Making Decisions About Your Health Care
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EasyCare Plus
Member Rights and Responsibilities upon Disenrollment
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Total EasyCare Plus EasyCare
Patient Self-Determination Policies
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EasyCare Plus Total EasyCare
Planning in Advance for Your Medical Treatment
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Prior Authorization Request Forms
EasyCare EasyCare Plus Total
Medicare Prior Authorization Requirements
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Medicare Prior Authorization Requirements
Total EasyCare Plus EasyCare
New York State Medicaid Prior Authorization Request Form for Prescriptions
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NYS Medicaid Prior Authorization Request Form
Total EasyCare Plus EasyCare
Opioid Prior Authorization Request Form
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Opioid Prior Authorization Request Form
Total EasyCare Plus EasyCare
Request for Medicare Prescription Drug Coverage Determination – Online Form