Plan Documents and Forms (2011)

Looking for 2012 Plan Documents? Click here.

» Peoples Health Choices 65 (HMO)
» Peoples Health Choices Plus (HMO-POS)
» Peoples Health Choices Select (HMO-POS)
» Peoples Health Secure Health (HMO SNP)
» Peoples Health Group Medicare for OGB (HMO-POS)
» Peoples Health Group Medicare Gold (HMO-POS)
» Other Documents and Forms

Peoples Health Choices 65 (HMO)

Quick Guide
Download PDF (512 KB)

Summary of Benefits
Download PDF (464 KB)

Evidence of Coverage
Download PDF (1.2 MB)

Abridged Formulary
Download PDF (1.5 MB)

Provider Directory
Download PDF (3.9 MB)

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Peoples Health Choices Plus (HMO-POS)

Quick Guide
Download PDF (576 KB)

Summary of Benefits
Download PDF (464 KB)

Evidence of Coverage
Download PDF (1.5 KB)

Abridged Formulary
Download PDF (1.6 KB)

Provider Directory
Download PDF (4.4 MB)

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Peoples Health Choices Select (HMO-POS)

Quick Guide
Download PDF (556 KB)

Summary of Benefits
Download PDF (464 KB)

Evidence of Coverage
Download PDF (1.5 MB)

Abridged Formulary
Download PDF (1.6 KB)

Provider Directory
Download PDF (4.4 MB)

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Peoples Health Secure Health (HMO SNP)

Quick Guide
Download PDF (512 KB)

Summary of Benefits
Download PDF (308 KB)

Evidence of Coverage
Download PDF (1.5 KB)

Abridged Formulary
Download PDF (1.6 KB)

Provider Directory
Download PDF (4.4 MB)

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Peoples Health Group Medicare for OGB (HMO-POS)

Quick Guide
Download PDF (512 KB)

Evidence of Coverage
Download PDF (512 KB)

Abridged Formulary
Download PDF (1.9 MB)

Provider Directory
Download PDF (4.4 MB)

Top Of Page

Peoples Health Group Medicare (HMO-POS)

Quick Guide
Download PDF (512 KB)

Evidence of Coverage
Download PDF (512 KB)

Abridged Formulary
Download PDF (512 KB)

Provider Directory
Download PDF (4.4 MB)

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Other Documents and Forms

Notice of Privacy Practices - describes how your medical information may be used and disclosed and how you can get access to this information.
Download PDF (588 KB)

Pharmacy Request Form - a form for you and your doctor to complete if your doctor would like to request an exception to the Peoples Health formulary
Download PDF (28 KB)

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