Medicare Advantage Dual Care Plan Documents
Find the documents you need to help you manage your Medicare Advantage Dual Care plan offered by Blue Cross and Blue Shield of New Mexico.
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Blue Cross Medicare Advantage Dual Care Plus (HMO SNP)SM
2022 Annual Notice of Change Dual Care Plus (HMO SNP) English | español
2022 Evidence of Coverage Dual Care Plus (HMO SNP) English | español
2022 Summary of Benefits Dual Care Plus (DSNP) English | español
2022 Enrollment Form Dual Care Plus (HMO SNP) English | español
2022 Plan Star Rating (HMO SNP) English | español
2022 Drug Formulary (HMO SNP) English | español
2020 Program Summary Results English | español
2022 Pharmacy Directory English | español
2022 Find a Doctor or Hospital English | español
2022 Low Income Premium Subsidy (HMO SNP) English | español
2022 Prescription Drug Transition Policy (HMO SNP) English | español
2022 Personal Medication List (HMO SNP) English | español
2022 Prescription Drug Coverage Determination Request Form (HMO SNP) English | español
2022 Online Coverage Determination Request Form
2022 Prescription Drug Coverage Redetermination Request Form (HMO SNP) English | español
2022 Online Coverage Determination Request Form
2022 Automated Premium Payment (ACH) Form (DSNP)
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Blue Cross Medicare Advantage Dual Care Plus Preferred (PPO SNP)SM
2022 Evidence of Coverage Dual Care Preferred (PPO SNP) English | español
2022 Summary of Benefits Dual Care Preferred (PPO SNP) English | español
2022 Plan Star Rating (PPO-POS) — Plan too new to be measured
2022 Enrollment Form Dual Care Preferred (PPO SNP) English | español
2022 Drug Formulary (PPO SNP) English | español
2022 Pharmacy Directory English | español
2022 Find a Doctor or Hospital English | español
2022 Low Income Premium Subsidy (PPO SNP) English | español
2022 Prescription Drug Transition Policy (PPO SNP) English | español
2022 Personal Medication List (PPO SNP) English | español
2022 Prescription Drug Coverage Determination Request Form (PPO SNP) English | español
2022 Online Coverage Determination Request Form
2022 Prescription Drug Coverage Redetermination Request Form (PPO SNP) English | español
2022 Online Coverage Determination Request Form
2022 Automated Premium Payment (ACH) Form (DSNP)
Last Updated: 09302021
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