Individual plan documents for 2020

Plan documents for 2019

Plan and coverage documents


Mail order, automatic payment and claims documents

Coverage decision, redetermination and exception documents

Drug policies and programs

  • Plan transition drug supply policy
    If you are transitioning to a MedicareBlue Rx plan, or if you take a drug that has been discontinued or is no longer on our drug list, you may be able to get a transition supply of your drug. Contact customer service with questions.
  • Medication therapy management (MTM) program
    MTM is a program to help you get the best results from your medication at the lowest cost. Members who meet certain requirements are eligible for this program. If you qualify, we will contact you directly.
  • High-risk medication alternatives
    See alternatives for some commonly prescribed high-risk medications. Talk with your doctor or pharmacist if you’re interested in learning more about alternatives for high-risk medications.

Appointing a representative and confidential information documents

  • Appoint a representative
    You can choose someone to file grievances, request coverage decisions and redeterminations on your behalf.
  • Our privacy practices
    Learn how information about you may be used and disclosed and how you can get access to this information.

Medicare resources

  • Medicare 101
    Learn about Medicare with this set of PowerPoint slides.