These plans are available for business to offer their Medicare-eligible employees and retirees. The Summary of Benefits, Evidence of Coverage, and other information below explain the details about each plan.
Service area: You must live in Brevard County or Indian River County in Florida to enroll in these plans.
Benefits
Summary of Benefits — These booklets explain general information about the plans we have for employer groups and compares them to original Medicare. They also include information about premiums, cost sharing, out-of-network coverage, any limitations, and more.
 Group POS/Plus A Summary of Benefits (Español coming soon)
Group Plus B Summary of Benefits (Español coming soon)
Group Basic A Summary of Benefits (Español coming soon)
Delta Dental Summary of Benefits (Español)
Evidence of Coverage —These documents contain the most detailed information about the Group plans:
Group POS Evidence of Coverage (Español coming soon)
Group Plus A Evidence of Coverage (coming soon) (Español coming soon)
Group Plus B Evidence of Coverage (Español coming soon)
Group Basic A Evidence of Coverage (Español coming soon)
Delta Dental Evidence of Coverage for Group plans (Español)
Prescription drug information
Formulary and pharmacies
Comprehensive formulary — a complete list of covered drugs (Español coming soon)
Participating pharmacies — listed in the provider/pharmacy directory (Español coming soon)
Forms
Mail order prescriptions from Health First Family Pharmacy
Mail order prescriptions from MedVantx
Prescription reimbursement form
Requirements
Prior authorization requirements
Transition policy
Medication therapy management, and drug and/or utilization management
Extra help for prescription drug costs
People with limited incomes may qualify for Extra Help to pay for their prescription drug costs. If you qualify, Medicare could pay for up to seventy-five (75) percent or more of your drug costs including monthly prescription drug premiums, annual deductibles, and co-insurance. Additionally, those who qualify will not be subject to the coverage gap or a late enrollment penalty. Many people are eligible for these savings and don’t even know it. You may be able to get Extra Help to pay for your prescription drug premiums and costs. To see if you qualify for getting Extra Help, call:
- 1-800-MEDICARE (1-800-633-4227). TTY/TDD users should call 1-877-486-2048, 24 hours a day/7days a week;
- The Social Security Administration at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY/TDD users should call 1-800-325-0778; or
- Your State Medicaid Office.
Assistance with Best Available Evidence for Low Income Subsidy
Provider/pharmacy directories
Search for physicians
Printable provider (physician/pharmacy) directory — includes information about authorizations, our network of doctors, ancillary services like labs, fitness centers, etc., and also pharmacies (Español coming soon)
Delta Dental provider directory (Español coming soon)
Your privacy, rights, and procedures for grievances, appeals, exceptions
Part D prescription drug prior authorizations, exceptions, appeals and grievances
Medical prior authorizations, appeals, and grievances
Notice of privacy practices
Please refer to your Evidence of Coverage (EOC) for more details about these topics, as well as your rights and responsibilities upon disenrollment:
Group POS Evidence of Coverage (Español coming soon)
Group Plus A Evidence of Coverage (Español coming soon)
Group Plus B Evidence of Coverage (Español coming soon)
Group Basic A Evidence of Coverage (Español coming soon)
For more information about our quality assurance policies and procedures or to obtain an aggregate number of the our grievances, appeals, and exceptions, contact customer service.
How to enroll
If your employer (or former employer) offers Health First Health Plans as part of their employee or retiree benefits, check with them for details on how and when to enroll. They may prefer you send your completed enrollment form (and premium payment if necessary) to them. If they ask you to contact us directly to enroll, please follow these instructions.
Enrollment form
Y0089_MP3115 CMS Approved 10242012
Last updated: 12/6/2012
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