Important Plan Documents
Summary of Benefits
2021 FirstCare Advantage Dual SNP Summary of Benefits (SOB)
(last updated 10/01/20)
2021 FirstCare Advantage Dual SNP Summary of Benefits (SOB) - Version en Español
(last updated 10/01/20)
Annual Notice of Changes
2021 FirstCare Advantage Dual SNP Premier Annual Notice of Changes (ANOC)
(last updated 10/01/20)
2021 FirstCare Advantage Dual SNP Premier Annual Notice of Changes (ANOC) - Version en Español
(last updated 10/01/20)
Evidence of Coverage
2021 FirstCare Advantage Dual SNP Premier Evidence of Coverage (EOC)
(last updated 12/02/20)
2021 FirstCare Advantage Dual SNP Select Evidence of Coverage (EOC)
(last updated 12/02/20)
2021 FirstCare Advantage Dual SNP Premier Evidence of Coverage (EOC) - Version en Español
(last updated 12/02/20)
2021 FirstCare Advantage Dual SNP Select Evidence of Coverage (EOC) - Version en Español
(last updated 12/02/20)
Formularies
2021 FirstCare Advantage Dual SNP Formulary
(last updated 10/01/2021)
2021 FirstCare Advantage Dual SNP Formulary - Version en Español
(last updated 10/01/2021)
Provider Directory
2021 FirstCare Advantage Dual SNP Provider Directory - Bilingual
(last updated 10/01/2021)
Pharmacy Directory
2021 FirstCare Advantage Dual SNP Pharmacy Directory - Bilingual
(last updated 10/01/2021)
Fraud, Waste, and Abuse Education Insert
Fraud, Waste, and Abuse Educational Insert - Bilingual
Notice of Privacy Practices
Notice of Privacy Practices
Notice of Privacy Practices - Version en Español
Do you want a paper version? You can have one or more printed plan booklets mailed to your residential address. To request, current members should visit MyBSWHealth Member Portal and click on Settings / Notifications. Non-members may contact Customer Service at 1-866-229-4969.
H5742_WEBSITE2021_A | Last updated: 10/01/20.