Resources / Materials

Website Resources and Materials

  • 2018 Summary of Benefits…Coming Soon
  • 2018 List of Drugs (Formulary)…Coming Soon
  • Certain prescription drugs that require prior authorization may be covered under Medicare Part B or D. Information may need to be submitted telling us the use and setting of the drug to make the decision.
  • 2018 Member Handbook…Coming Soon
  • Over-the-Counter brochure…Coming Soon
  • Multi-Language Interpreter Services…Coming Soon
  • 2018 Request for Medicare Prescription Drug Coverage Determination…Coming Soon (You cannot use this form for Medicare non-covered drugs: fertility drugs, drugs prescribed for weight loss, weight gain or hair growth, over the counter drugs, or prescription vitamins (except prenatal vitamins and fluoride preparations).
  • Hospice Prior Authorization Form
  • Prescription Drug Mail Order

Healthy Moves Member Newsletters

Healthy Moves is written with you in mind, to share important health information. You can find tips and timely topics to help you start or maintain your health. See below to get the newsletter in PDF for download.

Fall 2017...Coming Soon

Other Materials


Last Updated: 06/09/17