Thank You for Being a Loyal Member of CarePlus Health Plans, Inc.
As a member of CarePlus, this page is just for you. Here you can find the information and forms you need to manage your health care decisions, and provide us with feedback.
We want to make it easy for you to stay in control of your health care. As one of our 67,000* members, you are the reason why we work hard to provide you with improved benefits, value and convenience each year. We have always believed that good health care starts with taking good care of your health. That's why we focus on prevention and giving you the benefits you need to stay healthy and happy.
*Medicare Advantage Current Membership Report-EDW (07/21/2011)
CarePlus Health Plans, Inc.'s Newsletter
Today newsletter is published twice a year for CarePlus Health Plans, Inc. members. The articles in this publication are primarily for educational purposes, and should not be considered specific medical advice. Should any beneficiary feel the need for medical advice, please consult your Primary Care Provider for specific health concerns.
Summary of the Florida Patient's Bill of Rights and Responsibilities
- CarePlus Health Plans, Inc. Summary of the Florida Patient's Bill of Rights and Responsibilities
- English
Letter Samples & Templates
Exceptions, Grievance, and Appeals, Coverage Determinations, Redeterminations and Reconsiderations Information
For important information and forms regarding Coverage Determinations, Grievances, Redeterminations and Reconsiderations please click here.
Additional Resources
- Prior Authorization/Medical Exception Form (Provider Use Only)
- English
- Instructions for completing and submitting the Prior Authorization/Medical Exception Form
- English
- Contact numbers for Enrollees and Physicians who have Questions and need to Inquire about the status of the Grievance, Coverage Determination and Appeal processes
- English
- How to Obtain an Aggregate Number of Grievances, Appeals and Exceptions Filed with the Plan
- English
Note: You can also access the following forms at the CMS Part D appeals webpage links below:
- Part D Request for Medicare Prescription Drug Determination Request Form (for use by enrollees)
- Part D Coverage Determination Request Form (for use by providers)
You can also find detailed information in Chapter 9 of the CarePlus Health Plans, Inc. Evidence of Coverage with regard to grievances, coverage determinations (including exceptions), and the appeals process. 2012 CarePlus Medicare Advantage Plan Information
Over-The- Counter (OTC) Forms
If you are enrolled in one of the CarePlus benefit plans that offers an over-the-counter benefit, you may receive a set monthly amount of over-the-counter products, such as cough medicine, pain relievers, and first aid at no cost to you. Your order will be conveniently shipped to your home. OTC benefits may not be available with some benefit plans. Please refer to your Evidence of Coverage (EOC) for detailed information.
National Coverage Determinations
From time-to-time CMS makes changes to the services that are covered by Medicare. These changes are updated via National Coverage Determinations. You can access the NCD information by using the link below.
Plan Information
For any questions on our plans, how to change plans, the information on this website, or if you simply would like speak to a representative, please do not hesitate to contact our Member Services department at 1-800-794-5907. If you use a TTY device, please call 711. We are open 7 days a week, from 8 a.m. to 8 p.m. From February 15 until the following Annual Election Period (AEP), you may leave us a voice mail message after-hours, Saturdays, Sundays and holidays and we will return your call the next business day.