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PDF's

2017 English

• 2017 Benefits Brochure
• 2017 Benefits Brochure
• Add to your healthcare coverage with an Enhanced Health Benefits package.
• Annual Notice of Changes for 2017
• Annual Notice of Changes for 2017: Aspire Health Advantage Plus
• Annual Notice of Changes for 2017: Aspire Health Advantage Value
• Enhanced Health Optional Supplemental Benefits Disenrollment Form
• Enhanced Health Optional Supplemental Benefits Enrollment Form
• Evidence of Coverage: Aspire Health Advantage
• Evidence of Coverage: Aspire Health Advantage Plus
• Evidence of Coverage:Aspire Health Advantage Value
• INSTRUCTIONS FOR JOINING ASPIRE HEALTH ADVANTAGE VALUE (HMO), ASPIRE HEALTH ADVANTAGE (HMO), or ASPIRE HEALTH ADVANTAGE PLUS (HMO-POS)
• Medicare & You 2017
• Medication Therapy Management Program (MTMP) 2017 Reference Sheet
• Monthly Plan Premium for People who get Extra Help from Medicare to Help Pay for their Prescription Drug Costs
• Multi Language Insert
• Questions about Medicare and Aspire Health Plan? We’re glad you asked.
• Scope of Sales Appointment Confirmation Form
• Summary of Benefits
• Your health will benefit from Medicare plans created by Monterey County’s hospitals and doctors.

2017 Español

• Aspire Health Plan Prima mensual del plan para las personas que reciben “Ayuda adicional” de Medicare para pagar los costos de los medicamentos con receta
• Aviso Anual de Cambios para 2017: Aspire Health Advantage
• Aviso Anual de Cambios para 2017: Aspire Health Advantage Plus
• Aviso Anual de Cambios para 2017: Aspire Health Advantage Value
• Evidencia de cobertura: Aspire Health Advantage
• Evidencia de cobertura: Aspire Health Advantage Plus
• Evidencia de cobertura: Aspire Health Advantage Value
• Formulario de cancelación de la inscripción a los Beneficios Suplementarios Opcionales de Salud Mejorados
• Formulario de inscripción a los Beneficios Suplementarios Opcionales de Salud Mejorados
• INSTRUCCIONES PARA CONTRATAR ASPIRE HEALTH ADVANTAGE VALUE (HMO), ASPIRE HEALTH ADVANTAGE (HMO) O ASPIRE HEALTH ADVANTAGE PLUS (HMO-POS)
• Medicare Y Usted 2017

2016 English

• 2016 Medicare Star Ratings*
• Annual Notice of Changes for 2016
• Annual Notice of Changes for 2016
• Annual Notice of Changes for 2016
• Appeal & Grievance Form
• ASPIRE HEALTH PLAN PRIVACY POLICY
• AUTHORIZATION TO DISCLOSE PERSONAL HEALTH INFORMATION
• CLAIM REIMBURSEMENT REQUEST FORM
• CLAIM REIMBURSEMENT REQUEST FORM
• Disenrollment Form
• Evidence of Coverage: Aspire Health Advantage
• Evidence of Coverage: Aspire Health Advantage Plus
• Evidence of Coverage: Aspire Health Advantage Value
• Frequently Asked Questions
• Important Plan Information
• INSTRUCTIONS FOR JOINING ASPIRE HEALTH
• Medication Therapy Management Program (MTMP) 2016 Reference Sheet
• Monthly Plan Premium for People who get Extra Help from Medicare to Help Pay for their Prescription Drug Costs
• Multi-Language Insert
• Optional Supplemental Benefit Enrollment Form
• Optional Supplemental Dental Benefit
• Optional Supplemental Dental Benefit Disenrollment Form
• Part D Transition
• PERSONAL MEDICATION LIST
• Provider and Pharmacy Directory
• REQUEST FOR MEDICARE PRESCRIPTION DRUG COVERAGE DETERMINATION
• Request for Redetermination of Medicare Prescription Drug Denial
• Scope of Sales Appointment Confirmation Form
• Summary of Benefits

2016 Español

• 2016 Beneficios Información general
• Aspire Health Plan Prima mensual del plan para las personas que reciben Ayuda adicional de Medicare para pagar los costos de sus medicamentos con receta
• Aviso anual de cambios para 2016
• Aviso anual de cambios para 2016
• Aviso anual de cambios para 2016
• Calificaciones por estrellas Medicare 2016*
• Directorio de proveedores y farmacias
• Evidencia de cobertura: Aspire Health Advantage
• Evidencia de cobertura: Aspire Health Advantage Plus
• Evidencia de cobertura: Aspire Health Advantage Value
• Forma de Desafiliación para Beneficios Dentales Opcionales Suplementarios
• Formulario de apelaciones y reclamos
• Formulario de cancelación de la inscripción
• Formulario de confirmación de concertación de la cita de ventas
• Formulario de inscripción en los beneficios complementarios opcionales
• Información importante del plan
• INSTRUCCIONES PARA INSCRIBIRSE
• LISTA PERSONAL DE MEDICAMENTOS
• Preguntas frecuentes
• POLÍTICA DE PRIVACIDAD DE ASPIRE HEALTH PLAN
• Resumen de beneficios
• SOLICITUD DE RECLAMO PARA REEMBOLSO
• Solicitud de redeterminación de denegación de cobertura de medicamentos con receta de Medicare
• SOLICITUD PARA LA DETERMINACIÓN DE COBERTURA DE MEDICAMENTOS RECETADOS DE MEDICARE
• Transition NTC