These plans are available to Brevard and Indian River County businesses for their employees. Health benefit plans offered by Health First Health Plans, Inc. (HFHP) may be subject to limitations and exclusions. For costs and complete details, contact your employer, insurance agent, or HFHP.

Benefits

Prescription drug information

• Participating pharmacies
• 5-tier preferred drug list (formulary)
• 3-tier preferred drug list (formulary)
• Prescription reimbursement form
• Order mail order prescriptions online
• Prescription mail order form
• Pharmacy authorization/exception request form - must be completed and submitted by your physician

Provider information

• Provider directory (search for physicians)
• Provider directory (printable format)
• Ancillary services (labs, hospitals, etc.)
• Participating pharmacies

Authorizations

• Medical services that require authorization
• Medical authorization request form - must be completed and submitted by your physician
• Radiology services that require authorization
• Pharmacy authorization/exception request form - must be completed and submitted by your physician

General information

• Member handbook
• Group exclusions and limitations
•  Pro-Health benefit
• Member rights and responsibilities
• Notice of privacy practices
• Member newsletter
• Health education programs
• Agency for Health Care Adminstration

Forms

• Prescription mail order form
• Prescription reimbursement form
• General reimbursement form
• Appoint a representative - authorize someone to act on your behalf
• Pharmacy authorization/exception request form - must be completed and submitted by your physician
• Medical authorization request form - must be completed and submitted by your physician

6/27/2012

This information provides a general overview of our commercial HMO plans with answers to important questions. For detailed information, please refer to your Member Handbook or Certificate of Coverage, or contact Customer Service.