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Plans
All Plans
– Northern Nevada
– Southern Nevada
– Service Area
– Enroll
Enrollment Information
Request Information
Forms and Documents
Low Income Subsidy Extra Help
CMS Star Ratings
Directories
Prescriptions
Prescriptions
– Benefit Resources
– Formulary
Formulary Search
– Pharmacy Search
– Mail Order Information
– Over-the-Counter Benefit
– Medication Therapy Management (MTM)
Resources
Resources
– COVID-19 Member Information
– MyBenefits Login
– Accessing Care
– Teladoc
– Telehealth
– Dispatch Health
– Customer Service
New Members
Precertifications
Your Membership Card
– Member Grievance Procedure
– Member Rights & Responsibilities
– Member Perks
Gym Benefit
Healthy Tracks
Sterling Silver Club
– Personal Assistants
– Precertifications
Brokers
Contact
Prescription Drug
Benefit Resources
The following are resources and forms to help you better understand and manage your Part D prescription drug coverage.
Best Available Evidence
Request for Coverage Determinations Part D Appeal Rights
Form to Request for Part D Prescription Drug Coverage Determination (PDF)
Form to Request for Part D Prescription Drug Coverage Redetermination (PDF)
Transition Fills
Prescription Drug Coverage Stages
Free Glucose Meter (ContourNext Brand) Flyer
Free Glucose Meter (FreeStyle Brand) Flyer
Personal Medication List (PDF)
Prescription Reimbursement Claim Form (PDF)
Senior Care Plus
A Medicare Advantage organization from Hometown Health
