Health Plans Documents

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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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EnglishSpanishChinese
EasyCare EasyCare Plus Total
Patient Self-Determination Policies
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EnglishSpanishChinese
EasyCare EasyCare Plus Total
Planning in Advance for Your Medical Treatment
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EnglishSpanishChinese
EasyCare
Member Rights and Responsibilities upon Disenrollment
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EnglishSpanishChinese
EasyCare Plus
Member Rights and Responsibilities upon Disenrollment
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EnglishSpanishChinese
Total
Member Rights and Responsibilities upon Disenrollment
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EnglishSpanishChinese
Prior Authorization Request Forms
EasyCare EasyCare Plus Total
Request for Medicare Prescription Drug Coverage Determination – Online Form
EasyCare EasyCare Plus Total
Request for Medicare Prescription Drug Coverage Determination – PDF Form
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Determination Form
EasyCare EasyCare Plus Total
Request for Medicare Prescription Drug Coverage Redetermination
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Redetermination Form