2023 Plan Information

The information provided here is intended to be a summary of our plan, effective January 1, 2023.

Forms

  • Appointment of Representative Form (English)

  • Appointment of Representative Form (Spanish)

  • CMS Part D Coverage Determination Request Form (English)

  • CMS Part D Coverage Redetermination Request Form (English)

  • MedImpact Part D Coverage Determination Form

Additional Member Resources

Please click on the following link to access Centers for Medicare & Medicaid Services website:

www.cms.gov

Please click on the following link to access the Medicare and You Handbook:

Medicare and You Handbook

Please click on the following link to obtain information on help with prescription drug costs:

https://www.ssa.gov/benefits/medicare/prescriptionhelp/

Disclaimers

CommuniCare Advantage is a health plan with a Medicare contract.  Enrollment in CommuniCare Advantage depends on contract renewal.   

 

ATTENTION: If you speak another language, language assistance services, free of charge, are available to you. Call1-888-244-4430, TTY users should call 1-855-266-4584, 24 hours a day, 7 days a week. The call is free.

 

ATENCIÓN: Si habla español, hay servicios de asistencia de idiomas disponibles sin cargo. Llame al 1-888-244-4430 (TTY: 1-855-266-4584). Las llamadas a estos números son gratuitas.

 

请注意:如果您说简体中文,可免费获得语言援助服务。请致电 1-888-244-4430(听障专线:1-855-266-4584)。通话免费。

 

PANSININ: Kung nagsasalita kayo ng ibang wika, may mga paglingkod na pagtulong sa wika na maabot ninyo, na libre. Tawagan ang 1-888-244-4430 (TTY: 1-855-266-4584). Liber ang tawag na ito.

 

請注意:如果您說繁體中文,可免費獲得語言援助服務。請致電 1-888-244-4430(聽障專線:1-855-266-4584)。通話免費。

 

CHÚ Ý: Nếu bạn nói tiếng Việt, các dịch vụ hỗ trợ ngôn ngữ, miễn phí, sẽ có sẵn cho bạn. Gọi số 1-888-244-4430 (TTY: 1-855-266-4584). Cuộc gọi được miễn phí.

 

ة تنبيه: إذا كنت تتحدث اللغة العربية، فإن خدمات المساعدة اللغوية متاحة لك بدون أي مقابل. اتصل بالرقم

1-888-244-4430 (الهاتف النصي: 1-855-266-4584)) . الاتصال مجاني.

 

 

توجه: اگر به زبان فارسی صحبت می‌کنید، خدمات کمک زبانی، به صورت رایگان، در اختیار شماست. با 4430-244-888-1 (پیام‌نگار: 1-855-266-4584) تماس بگیرید. تماس با این شماره‌ها رایگان است.

 

 

 

 

Last Website Update 11/21/2022
H4733_Website2023