Important Plan Documents
FirstCare Advantage Dual SNP (HMO SNP) has conveniently posted important plan documents that were included in the Annual Notice of Change/Evidence of Coverage mailing.
These include the Annual Notice of Change (ANOC) and Evidence of Coverage (EOC), a Comprehensive Formulary, and Provider/Pharmacy Directory. Please see FirstCare Advantage home page for a link to the Multi-Language Insert.
Summary of Benefits
FirstCare Advantage Dual SNP Summary of Benefits (SOB)
(last updated 09/24/2019)
FirstCare Advantage Dual SNP Summary of Benefits (SOB) - Version en Español
(last updated 09/24/2019)
Annual Notice of Changes
FirstCare Advantage Dual SNP Annual Notice of Changes (ANOC)
(last updated 09/12/2019)
FirstCare Advantage Dual SNP Annual Notice of Changes (ANOC) - Version en Español
(last updated 09/12/2019)
Evidence of Coverage
FirstCare Advantage Dual SNP Evidence of Coverage (EOC)
(last updated 12/10/2019)
FirstCare Advantage Dual SNP Evidence of Coverage (EOC) - Version en Español
(last updated 12/10/2019)
Formularies
FirstCare Advantage Dual SNP Formulary
(last updated 09/01/2020)
FirstCare Advantage Dual SNP Formulary - Version en Español
(last updated 09/01/20)
Provider Directory
FirstCare Advantage Dual SNP Provider Directory - Bilingual
(last updated 09/01/2020)
Pharmacy Directory
FirstCare Advantage Dual SNP Pharmacy Directory - Bilingual
(last updated 09/01/2020)
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_WEBSITE_2020_A | Last updated: 09/16/20.