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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 2021 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

2021 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)

2021 Prescription Drug Information (Part D)

These will take you to:

• Step Therapy Criteria

• Prior Authorization Criteria

• Link to the Pharmacy Directory

2021 Formularies

These will take you to:

• Abridged Formulary

• Comprehensive Formulary

As a member, you should have received a postcard in the mail about how you can find important member information on our website. PrimeTime Health Plan is proud to be accredited by the National Committee for Quality Assurance (NCQA) and dedicated to quality of care and service. We want our members to be well informed and have convenient access to information regarding their health plan. 

Using the drop down buttons below, you can learn about your rights as a member, wellness program and services offered by PrimeTime Health Plan, and other important information to which you have access. 

If you have questions regarding this information, please contact PrimeTime Health Plan at 330-363-7407 or 1-800-577-5084

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Last updated: 08/05/2020
Reviewed: 9/16/2021