• Benefits 
• Prescription drug information 
• Provider/pharmacy directory 
• Are you eligible?
• Enrollment
• Member forms
• Your privacy, rights, and procedures for grievances, appeals, and exceptions

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.

•  Summary of Benefits — Group POS 
•  Summary of Benefits — Group Plus A 
•  Summary of Benefits — Group Plus B 
•  Summary of Benefits — Group Basic A 
•  Summary of Benefits — Group Basic B 

These books contain detailed information about the Group plans:

•  Evidence of Coverage — Group POS 
•  Evidence of Coverage — Group Plus A
•  Evidence of Coverage — Group Plus B 
•  Evidence of Coverage — Group Basic A 
•  Evidence of Coverage — Group Basic B  

Prescription drug information

Health First Health Plans has contracts with pharmacies that equal or exceed CMS requirements for pharmacy access in your area. We have more than 100 network pharmacy locations in our local area, and more than 61,000 nation-wide.

•  Formulary - a complete list of covered drugs
• Participating pharmacies - listed in the provider/pharmacy directory
• Mail order prescriptions from Health First Family Pharmacy
• Mail order prescriptions from Ameripharm
• Prescription reimbursement form
• Prior authorizations, exceptions, appeals and grievances
• Transition policy
• Medication therapy management, and drug and/or utilization management

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 directory

• Search for physicians
•  Printable directory - includes information about authorizations, our network, ancillary services (labs, fitness centers, etc.), and pharmacies

Your privacy, rights, and procedures for grievances, appeals, exceptions

For these topics, refer to your Evidence of Coverage (EOC):

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.

Last updated: 8/20/2010

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Current issue

We can help! Health First Health Plans is here to help you get the prescription drugs you need. If you have a complaint regarding your Part D benefit, please give us the opportunity to resolve your issue by contacting our Customer Service Department:

Contact customer service