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2025 Centers Plan for Dual Coverage Care (HMO D-SNP) Materials

Comprehensive Formulary (Drug List)

Language Link Last Updated
English
09/04/25
中文
09/04/25
Español
09/04/25

Other Formulary-Related Documents

Language Link Last Updated
Prior Authorization Requirement
09/01/25
Step Therapy Requirement
09/01/25
Future Formulary Changes
09/22/25

Interpreter Services & Non-Discrimination Notice

Language Link Last Updated
English
05/01/25
Spanish
05/01/25

Evidence of Coverage

Language Link Last Updated
English
05/01/25
中文
05/01/25
Español
05/01/25

Annual Notice of Changes

Language Link Last Updated
English
05/01/25
中文
05/01/25
Español
05/01/25

Summary of Benefits

Language Link Last Updated
English
05/01/25
中文
05/01/25
Español
05/01/25

Medicare New York City Provider Directory (pdf)

Language Link Last Updated
English
07/03/25
中文
07/10/25
Español
07/10/25

Pharmacy Directory (pdf)

Language Link Last Updated
English
07/03/25
中文
07/10/25
Español
07/10/25

If you would like a copy of our Provider/Pharmacy Directory mailed to you, please call Member Services at 1-877-940-9330

Last modified: Oct 25, 2020