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Part D Coverage Resource

  • Plan Documents

2027 NV Enrollment Book – Champion Plus (HMO C-SNP) (English)

  • Document
  • Plan Documents

2027 CA Enrollment Book – Champion Plus (HMO C-SNP) (English)

  • Document
  • Plan Documents

2027 NV Enrollment Book – Champion Care & Champion Choice (HMO C-SNP) (English)

  • Document
  • Plan Documents

2027 CA Enrollment Book – Champion Care & Champion Choice (HMO C-SNP) (English)

  • Document
  • Plan Documents

2027 CA Enrollment Book – Champion AnWell (HMO) (English)

  • Document
  • Plan Documents

2027 NV Enrollment Book – Champion Ally (HMO) (English)

  • Document
  • Plan Documents

2027 CA Enrollment Book – Champion Ally (HMO) (English)

  • Document
  • Plan Documents

2027 NV Enrollment Book – Champion Advantage & Champion Connect (HMO-POS C-SNP) (English)

  • Document
  • Plan Documents

2027 CA Enrollment Book – Champion Advantage & Champion Connect (HMO-POS C-SNP) (English)

  • Document
  • Plan Documents

2027 CA Evidence of Coverage (EOC) for Champion Secure Plan (English)

  • Document
  • Plan Documents

2027 CA Evidence of Coverage (EOC) for Champion Home Plan (English)

  • Document
  • Plan Documents

2027 CA Evidence of Coverage (EOC) for Champion Compass Plan (English)

  • Document
  • Plan Documents

2027 CA Evidence of Coverage (EOC) for Champion AnWell Plan (English)

  • Document
  • Part D Coverage, Plan Documents

Covered Medication List (Formulary) – Nevada (Spanish)

*Note: Covered Medication List (Formulary) is updated on a monthly basis.
  • Document
  • Part D Coverage, Plan Documents

Covered Medication List (Formulary) – California (Spanish)

*Note: Covered Medication List (Formulary) is updated on a monthly basis.
  • Document
  • Part D Coverage, Plan Documents

Covered Medication List (Formulary) – California (English)

*Note: Covered Medication List (Formulary) is updated on a monthly basis.
  • Document
  • Part D Coverage, Plan Documents

Covered Medication List (Formulary) – Nevada (English)

*Note: Covered Medication List (Formulary) is updated on a monthly basis.
  • Document
  • Part D Coverage, Plan Documents

Prior Authorization Criteria

*Note: Prior Authorization Criteria Form is updated on a monthly basis.
  • Document
  • Part D Coverage, Plan Documents

Step Therapy Criteria Form

*Note: Step Therapy Criteria Form is updated on a monthly basis.
  • Document
  • Plan Documents

2027 NV Evidence of Coverage (EOC) for Champion Choice Plan (English)

  • Document