Medicare Advantage Dual Care Plan Documents
Find the documents you need to help you manage your prescription drug 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
2021 Annual Notice of Change Dual Care Plus (HMO SNP) English | español
2021 Evidence of Coverage Dual Care Plus (HMO SNP) English | español
2021 Summary of Benefits Dual Care Plus (DSNP) English | español
2021 Plan Star Rating (HMO-POS) English | español
2021 Enrollment Form Dual Care Plus (HMO SNP) English | español
2021 Drug Formulary (HMO SNP) English | español
2019 Program Summary Results English | español
2021 Pharmacy Directory English | español
2021 Find a Doctor or Hospital English | español
2021 Low Income Premium Subsidy (HMO SNP) English | español
2021 Prescription Drug Transition Policy (HMO SNP) English | español
2021 Personal Medication List (HMO SNP) English | español
2021 Prescription Drug Coverage Determination Request Form (HMO SNP) English | español
2021 Online Coverage Determination Request Form
2021 Prescription Drug Coverage Redetermination Request Form (HMO SNP) English | español
2021 Online Coverage Determination Request Form
2021 Automated Premium Payment (ACH) Form (DSNP)
Last Updated: 12312020
Y0096_WEBNMMM21
Last Updated: 12312020
Y0096_WEBNMMM21