Health Plans Documents
Access forms, documents, and resources for all Medicare Advantage plans.
Choose your plan to view or download your plan materials. You can also select specific documents to view or download the ones you need.
When Medicare does not fully define coverage for a service through statute, regulation, National Coverage Determinations, or Local Coverage Determinations, we use clinical coverage criteria based on current evidence, treatment guidelines, and clinical literature. These criteria comply with CMS requirements and are publicly available.
Click on the link and please refer to the PDF under “Other Documents” titled: “Healthplex Dental Claim Review Guidelines (Comprehensive & Limited Plans)”
Information on how to get interpreter services at no cost