Medicare Brokers - Forms and Resources
Request materials: Medicare Advantage Materials Request Form
2025 Forms and Resources
- Individual Election Formupdated 06/12/2025
- Scope of Appointment (online)
- Scope of Appointment (pdf)
- Summary of Benefits
- Evidence of Coverageupdated 05/15/2025
- Senior Health Plan Star Rating
- Protected Health Information (PHI) Authorization Form
- Welcome Checklist for Onboarding Members
2025 Silver Plus Links
- Service Area
- Senior Health Plan Provider Directory
- Find a Dentist
- Search the Prescription Drug Formulary
- Find a Pharmacy
- Wallet Benefit
- Mail Order Benefits
- Over-the-Counter (OTC) Benefit
- Dental Benefits
- Hearing Aid Benefit
- Routine Vision & Eyewear
- Non-emergency transportation
- CancerCare
- Senior Center
- Health Risk Assessment
