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
2020
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)
2019
FirstCare Advantage Dual SNP Summary of Benefits (SOB)
(last updated 05/16/2019)
FirstCare Advantage Dual SNP Summary of Benefits (SOB) - Version en Español
(last updated 05/21/2019)
Annual Notice of Changes
2020
FirstCare Advantage Dual SNP Annual Notice of Changes (ANOC)
(last updated 09/12/2019)
FirstCare Advantage Dual SNP Annual Notice of Changse (ANOC) - Version en Español
(last updated 09/12/2019)
Evidence of Coverage
2020
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)
2019
FirstCare Advantage Dual SNP Evidence of Coverage (EOC)
(last updated 06/07/2019)
FirstCare Advantage Dual SNP Evidence of Coverage (EOC) - Version en Español
(last updated 06/07/2019)
Formularies
2020
FirstCare Advantage Dual SNP Formulary
(last updated 10/09/2019)
FirstCare Advantage Dual SNP Formulary - Version en Español
(last updated 10/09/2019)
2019
FirstCare Advantage Dual SNP Abridged Formulary
(last updated 12/01/2019)
FirstCare Advantage Dual SNP Abridged Formulary - Version en Español
(last updated 12/01/2019)
FirstCare Advantage Dual SNP Comprehensive Formulary
(last updated 12/01/2019)
FirstCare Advantage Dual SNP Comprehensive Formulary - Version en Español
(last updated 12/01/2019)
Provider Directory
2020
FirstCare Advantage Dual SNP Provider Directory - Bilingual
(last updated 09/25/2019)
2019
FirstCare Advantage Dual SNP Provider/Pharmacy Directory
(last updated 11/27/2019)
FirstCare Advantage Dual SNP Provider/Pharmacy Directory - Version en Español
(last updated 11/27/2019)
Pharmacy Directory
2020
2019 FirstCare Advantage Dual SNP Pharmacy Directory
(last updated 09/01/2019)
2019 FirstCare Advantage Dual SNP Pharmacy Directory - Version en Español
(last updated 09/01/2019)
2019
2019 FirstCare Advantage Dual SNP Provider/Pharmacy Directory
(last updated 111/27/2019)
2019 FirstCare Advantage Dual SNP Provider/Pharmacy Directory - Version en Español
(last updated 11/27/2019)
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 myFirstCare Self-Service and click on Notification Preferences. Non-members may contact Customer Service at 1-866-229-4969.
H5742_WEBSITE_2020_A | Last updated: 12/10/19.