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PrimeTime Health Plan has a number of plan designs for you to choose from. Our number one goal is to provide you with an affordable health plan designed to enhance your Medicare coverage. Have a doctor or a pharmacy that you prefer? We have more than 4,800 highly-skilled and dedicated physicians in our network and more than 30,000 pharmacies serving our PrimeTime Health Plan members!
Please click a button below for more information:

Common Member Forms & Documents

This will take you to:

• All plan Evidence of Coverage (EOC) forms

• All plan Annual Notices of Change

• How to appoint a Representative

• Prescription Drug Information & Order Form

• ESI Mail Order Brochure and Order Form

• Request for Medicare Prescription Drug Coverage Determination

• Multi-Language/Non-Discrimination Notices & Services

Member Health & Wellness Information

This will take you to:

• Online Health Library & Self-Management Tools

• Health Resources

• SilverandFit Information

Member Information

This will take you to:

• Advance Directives

• Federal Disasters

• National Coverage Determinations

2020 Plan Information2019 Plan Information

These will take you to:

• Information about our plans

• Links to Additional Information about our plans

• Links to our Medication Therapy Management (MTM)

2020 Prescription Drug Information (Part D)2019 Prescription Drug Information (Part D)

These will take you to:

• Step Therapy Criteria

• Prior Authorization Criteria

• Link to the Pharmacy Directory

2020 Formularies2019 Formularies

These will take you to:

• Abridged Formulary

• Comprehensive Formulary

Last updated: 09/16/2019