The links below provide important information and documents for Nascentia Health Plus members
If you have any questions, please call our Member Services Department at 1-888-477-0090 (TTY: 711).
Plan Information
2025 Nascentia Dual Advantage (D-SNP)
2024 Nascentia Dual Advantage (D-SNP)
2025 Nascentia Skilled Nursing Facility (I-SNP)
2024 Nascentia Skilled Nursing Facility (I-SNP)
Find a Doctor
Find a Pharmacy
Prescription Drug Information
Drug Formulary
Member Documents
Our Plans and Enrollment Process
About Medicare an1.d Medicare Advantage
- Annual Notice of Change
- Appointment of Representative Form (pdf)
- Appointment of Representative Instructions (pdf)
- Coverage Criteria and Utilization Management
- Coverage Determination Request Form (pdf)
- Drug Formulary
- Electronic Material Notice (pdf)
- Enrollment Application (pdf)
- Enrollment Instructions (pdf)
- Evidence of Coverage (EOC)
- Nascentia Health Plus Frequently Asked Questions (pdf)
- Grievances & Appeals
- HIPAA Release of Information
- 2025 LIS Premium Summary Chart (pdf), updated 10/01/2024
- 2024 LIS Premium Summary Chart (pdf), updated 10/01/2023
- Medication Therapy Management (MTM) Letter and Personal Medication List (pdf)
- Medication Therapy Management (MTM) Program Requirements
- Medicare Complaint Form
- Medicare Enrollment Help
- Medicare Plan Finder
- Medicare Star Rating (pdf)
- Member Rights & Responsibilities
- Nondiscrimination Notice (pdf)
- Pharmacy Directory
- Pharmacy Transition Process (pdf)
- 2025 Prior Authorization Requirements (pdf), updated 10/1/2024
- 2024 Prior Authorization Requirements (pdf), updated 1/1/2024
- Prior Authorization Request Form (pdf)
- Privacy Policy
- Provider Directory
- Redetermination Request Form (pdf)
- 2025 Summary of Benefits - Nascentia Dual Advantage (D-SNP) (pdf), updated 10/01/2024
- 2025 Summary of Benefits - Nascentia Skilled Nursing Facility (I-SNP) (pdf), updated 10/01/2024
- 2024 Summary of Benefits - Nascentia Dual Advantage (D-SNP) (pdf), updated 10/01/2023
- 2024 Summary of Benefits - Nascentia Skilled Nursing Facility (I-SNP) (pdf), updated 10/01/2023
Last Updated on October 1, 2024