Health Plans Documents

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Member Forms
EasyCare EasyCare Plus Total
Health Information Exchange Fact Sheet and Form
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Your Rights and Responsibilities
Total EasyCare Plus EasyCare
Information About Our Grievances and Appeals Process
EasyCare Plus Total EasyCare
Making Decisions About Your Health Care
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EasyCare Plus
Member Rights and Responsibilities upon Disenrollment
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EasyCare EasyCare Plus Total
Patient Self-Determination Policies
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EasyCare EasyCare Plus Total
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
EasyCare EasyCare Plus Total
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