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You will need Adobe Acrobat Reader to view and print PDF files of program materials, which provide details about Partnership benefits and other important member information. (Download a free copy of Adobe Acrobat Reader.)
If you need materials in other formats or languages, please contact us. 2012 Summary of Benefits H5209-002_H7475-001_PSB06-20-11A CMS Approved 09/06/2011 Information on applicable benefit conditions and limitations, premiums, cost sharing and conditions associated with the receipt and use of benefits.
2012 Formulary H5209-002_H7475-001_CWHPFC07-14-11A CMS Approved 09/06/2011 A current list of covered drugs representing the prescription therapies believed to be a necessary part of a quality program. The Formulary may change throughout the year as we add new less expensive generic drugs, remove drugs that are determined to be unsafe or ineffective, or add prior authorization, quantity limits and/or step therapy restrictions on a drug.
2012 Formulary Medicaid Supplement_H5209-002_H7475-001_CWHPFMS07-14-11A CMS Approved 08/02/2011
2012 Formulary PA Criteria
2012 Formulary ST Criteria
Part D Formulary Transition Policy and Procedure
Medicare Part D Low-Income Subsidy Premium Assistance Grievance, Appeal, Coverage Determination and Exception Processes Partnership Combined Provider and Pharmacy Directory H5209-002_H7475-001_PPD09_3-2-09A CMS Approved 06/23/2009 List of network providers, including physicians, hospitals, clinics, pharmacies and other care providers. For the most up-to-date information on providers, contact us at the number below.
Partnership Combined Provider and Pharmacy Directory - Network Updates H5209-002_H7475-001_PPDOA_1-30-12A_FINAL Populated Template 02/20/2012 These provider network updates include provider name and location changes, and provider additions and removals effective February 12, 2009-January 31, 2011. For the most up-to-date information on providers or printed copies of materials, contact us at the number below.
2012 Evidence of Coverage H5209-002_H7475-001_PEOC11-3-11A CMS Approved 12/08/2011 Information on all covered services, our obligations to you and your rights and responsibilities as a member.
2012 Annual Notice of Change Cover Letter H5209-002_H7475-001_ANOCLTR07-22-11A File & Use 09/06/2011
2012 Annual Notice of Change H5209-002_H7475-001_ANOC07-22-11A File & Use 09/06/2011
For More Information To learn more about Partnership benefits, contact us at (608) 245-3075 or 1-800-963-0035, Monday-Friday, 8 a.m. to 4:30 p.m., CT. TTY users call WI Relay 711. Call Medicare at 1-800-MEDICARE (1-800-633-4227) (TTY/TDD 1-877-486-2048), 24 hours a day, 7 days a week, or visit www.medicare.gov for more information about Medicare. Call Wisconsin Medicaid at 1-800-362-3002 (TTY/TDD 1-888-701-1251), 8 a.m. to 6 p.m., Monday-Friday, or visit www.dhs.wisconsin.gov/medicaid for more information about Medicaid. Partnership, offered by Care Wisconsin Health Plan, Inc., is a Wisconsin Family Care Partnership and Medicare Advantage Health Maintenance Organization (HMO) Special Needs Plan. Care Wisconsin Health Plan, Inc. has contracts with both Wisconsin Medicaid and Medicare. The plan's contracts with Medicaid and Medicare are renewed annually, and the availability of coverage beyond the end of the current contract year is not guaranteed. Joining | Request Information H5209-002_H7475-001_CWHPWEB_12-21-11A CMS Approved 12/29/2011 Last Updated 12/21/2011 DHS Approved 12/22/2011
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