OneCare (HMO D-SNP)

Member Documents

Things you may need

2025 Member Documents

2024 Member Documents

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Download the 2024 OneCare Provider and Pharmacy Directory (Updated 09/17/24) Download PDF Icon Use the provider directory to find a doctor, specialist, pharmacy or other provider near you.

Download the 2024 OneCare member handbook (Updated 3/4/2024) Download PDF Icon It lists what is covered, how to get services, your rights as a member, your responsibilities, and much more.

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Download the 2024 OneCare summary of benefits (Updated 8/15/2023) Download PDF Icon This is a summary, please see the OC evidence of coverage for the full benefits list.

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2024 OneCare list of covered drugs (formulary) This includes criteria for prior authorization. It also has criteria for step therapy.

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2024 Over-the-Counter (OTC) Catalog and Ordering Instructions  Download PDF Icon Download the catalog. Learn how to order OTC items online, by phone or by mail.

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2024 Annual Notice of Change (Updated 8/2/2023) Download PDF Icon Read the 2024 Annual Notice of Change.

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2024 OneCare plan rating (Updated 10/18/2023) Download PDF Icon The Medicare star rating program rates all health and prescription drug plans each year. It is based on a plan’s quality and performance.

Other Member Documents

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Latest member newsletter Download PDF Icon Read tips to keep you and your family healthy

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Common forms Find many of the forms you may need.

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Other important documents See the Notice of Privacy Practices, Notice of Nondiscrimination and other documents.

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To file a complaint with Medicare, click on the following link to complete a complaint form on the Medicare website: Medicare Complaint Form.

H5433_25WEB001_M_2025 (Accepted 9/17/2024)

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