健保計劃文件
存取所有 Medicare Advantage 計劃的表格、文件和資源。
Drug Benefits
Choose your plan to view or download information about your drug benefits, including formularies. You can also select specific document types to view or download the ones you need.
階段治療要求
事先授權要求
事先授權申請表
EasyCare Plus
Total
EasyCare
EasyCare Plus
EasyCare
Total
Request for Medicare Prescription Drug Coverage Determination – PDF Form
下載 PDF：