On this page, you’ll find important documents related to your MCC of VA (HMO SNP) plan. Click the links below to download each document.
A summary of what we cover and what you pay. It doesn’t list every service we cover or every limitation or exclusion. For a complete list of covered services and exclusions, refer to your Evidence of Coverage.
Your Medicare health benefits and services and prescription drug coverage as a member of MCC of VA (HMO SNP).
A list of MCC of VA (HMO SNP)’s current network of providers and pharmacies.
Information about the drugs covered in this plan. This formulary was updated on 10/01/2019.
Describes how medical information about you may be used and disclosed, and how you can get access to this information. Please read this notice carefully.
Describes the extra help you get paying for your prescription drugs.
Describes your monthly plan premium if you get extra help paying for your prescription drugs.