Plan Documents

Understanding your plan and our commitment to quality health care is very important. See which medications are covered, our prescription drug policy and programs, any National Coverage Determinations, and more.

Here you'll find a collection of our Massachusetts Medicare plan forms and plan information. Just click on the links below to download the forms you need.


Employer Group retiree coverage varies. Contact your employer's benefits administrator for specific information or, call Member Service at 1-800-200-4255 (TTY: 711), as follows: from February 15 through September 30, 8:00 a.m. to 8:00 p.m. ET, Monday through Friday, and from October 1 through February 14, 8:00 a.m. to 8:00 p.m. ET, seven days a week.

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