Medicare resources and forms

Medicare is complex, but we want to make it easy for you get everything you need. Browse plan documents, plan information and more.

Evidence of Coverage

Your Evidence of Coverage (EOC) explains what the plan covers, how much you pay and more. Your EOC also includes:

  • Information about in- and out-of-network coverage rules
  • Your rights and responsibilities as a member
  • Your rights and responsibilities if you disenroll
  • Our rights and responsibilities if you disenroll
Annual Notice of Changes

Your Annual Notice of Changes (ANOC) describes changes to your plan's coverage, costs and administration. These changes are effective starting in January.

The Summary of Benefits outlines what each plan covers and what you’ll pay for those services. The booklet doesn’t list everything that is covered by your plan, or every limitation or exclusion. For a full list of covered services, see the Evidence of Coverage above.

HealthPartners UnityPoint Health has strong networks of doctors, clinics and pharmacies in your area that you can see for a lower cost.

Using your plan’s out-of-network benefit, you can also see any doctor that accepts Medicare and is willing to see you.

Your HealthPartners UnityPoint Health Medicare plan includes prescription drug coverage (Medicare Part D). Part D plans include a formulary, which is a list of drugs covered by the plan.

Our pharmacists and doctors update the drug list each year based on the latest medication and treatment information, which helps us include the safest and most effective prescription drugs available.

Additional Part D resources include:

Get one-on-one help from a pharmacist to be sure you’re getting the most out of your medications. MTM is available at no cost with any HealthPartners UnityPoint Health Medicare plan.

If you have concerns about the care you received, you can find information on filing an appeal or grievance or requesting a coverage decision.

You can also learn about appointing a representative (PDF) and completing the form (PDF). In addition, you can take a look at the Medicare complaint form and see information from the Medicare Ombudsman Center.

The Centers for Medicare and Medicaid Services (CMS) may release National Coverage Determinations (NCDs) throughout the year. NCDs inform Medicare beneficiaries of new services or therapies that are covered (or changed) under Original Medicare.

If a new NCD impacts services covered by your HealthPartners UnityPoint Health Medicare plan, we post them below. Previous NCDs include:

It might also be helpful to visit the CMS Medicare Coverage Database.

Use these Medicare resources to find more information about:

Have questions?

If you need assistance finding care in your network, a Medicare form or details about your plan, our Member Services staff is ready to help.

From Oct. 1 through March 31, we’re available 8 a.m. to 8 p.m. CT, seven days a week. From April 1 through Sept. 30, we're available 8 a.m. to 8 p.m. CT, Monday - Friday.

Looking for something else?

Our member resources page has additional information and tools for getting the most out of your coverage, living healthier and more.

Legal information

Out-of-network/non-contracted providers are under no obligation to treat HealthPartners UnityPoint Health members, except in emergency situations. Please call our customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services.

Last updated August 2022
H3416_001602 Accepted