Employer Medicare Plan Materials and Forms
How to View and Download Files
To view or download a file, click the desired language link. The PDF file will open in a new window or tab of your browser. From there, you can also download or print the file.
- 2024 – Seniority Plus Overview Brochure (PDF)
- 2023 – Seniority Plus Overview Brochure (PDF)
- CA HMO Part C and Part D Star Ratings (PDF)
- Directory Flyer (PDF)
- Employer Group Medicare Drug and Pharmacy Information (including List of Drugs/Formulary)
- Employer Group Medicare - Covered Diabetes Testing Supplies (PDF)
- 2024 Medicare Step Therapy Part B (PDF)
- 2023 Medicare Step Therapy Part B (PDF)
- 2024 Healthy Discounts Brochure (PDF)
- Medicare Claim Form & Foreign Claim Questionnaire (PDF)
- Medicare Disenrollment Form – English (PDF)
- Medicare Disenrollment Form – En Español (Spanish) (PDF)
- Medicare Disenrollment Form – Chinese (PDF)
- 2024 Silver&Fit flyer (PDF)
Health Net Seniority Plus Employer (HMO) Provider and Pharmacy Directories
- Health Net Seniority Plus Employer (HMO) Provider and Pharmacy Directory – Los Angeles County (PDF)
- Health Net Seniority Plus Employer (HMO) Provider and Pharmacy Directory – Imperial and San Diego counties (PDF)
- Health Net Seniority Plus Employer (HMO) Provider and Pharmacy Directory – Orange County (PDF)
- Health Net Seniority Plus Employer (HMO) Provider and Pharmacy Directory – Riverside, San Bernadino and Santa Barbara counties (PDF)
- Health Net Seniority Plus Employer (HMO) Provider and Pharmacy Directory – Fresno, Kern, Santa Clara, and Tulare counties (PDF)
- Health Net Seniority Plus Employer (HMO) Provider and Pharmacy Directory – Alameda, Contra Costa, San Joaquin, and Stanislaus counties (PDF)
- Health Net Seniority Plus Employer (HMO) Provider and Pharmacy Directory – Placer, Sacramento, Solano, and Yolo counties (PDF)
- Health Net Seniority Plus Employer (HMO) Provider and Pharmacy Directory – San Francisco, San Mateo, Santa Cruz, and Sonoma counties (PDF)
Health Net Seniority Plus Employer (HMO) Provider Directories
- Health Net Seniority Plus Employer (HMO) Provider Directory – Los Angeles County (PDF)
- Health Net Seniority Plus Employer (HMO) Provider Directory – Imperial and San Diego counties (PDF)
- Health Net Seniority Plus Employer (HMO) Provider Directory – Orange County (PDF)
- Health Net Seniority Plus Employer (HMO) Provider Directory – Riverside, San Bernadino and Santa Barbara counties (PDF)
- Health Net Seniority Plus Employer (HMO) Provider Directory – Fresno, Kern, Santa Clara, and Tulare counties (PDF)
- Health Net Seniority Plus Employer (HMO) Provider Directory – Alameda, Contra Costa, San Joaquin, and Stanislaus counties (PDF)
- Health Net Seniority Plus Employer (HMO) Provider Directory – Placer, Sacramento, Solano, and Yolo counties (PDF)
- Health Net Seniority Plus Employer (HMO) Provider Directory – San Francisco, San Mateo, Santa Cruz, and Sonoma counties (PDF)
Medicare Advantage Provider Directories
- Medicare Advantage Dental HMO Provider Directory (PDF)
- Medicare Advantage Vision HMO Provider Directory (PDF)
- Medicare Advantage Chiropractic and Acupuncture Provider Directory (PDF)
- Medicare Advantage Mental Health and Substance Abuse Network Provider Directory (PDF)
- Medicare Advantage Silver&Fit® Provider Directory (PDF)
- Medicare Advantage (HMO) Plan Provider and Pharmacy Directory – Los Angeles County (PDF)
- Medicare Advantage (HMO) Plan Provider and Pharmacy Directory – Imperial & San Diego counties (PDF)
- Medicare Advantage (HMO) Plan Provider and Pharmacy Directory – Orange County (PDF)
- Medicare Advantage (HMO) Plan Provider and Pharmacy Directory – Riverside, San Bernadino & Santa Barbara counties (PDF)
- Medicare Advantage (HMO) Plan Provider and Pharmacy Directory – Alameda, Contra Costa, Fresno, Kern, Marin, Placer, Sacramento, San Francisco, San Joaquin, San Mateo, Santa Clara, Santa Cruz, Solano, Sonoma, Stanislaus, Tulare & Yolo counties (PDF)
- Medicare Advantage Dental HMO Provider Directory (PDF)
- Medicare Advantage HMO Vision Provider Directory (PDF)
- Medicare Advantage Chiropractic and Acupuncture HMO Provider Directory (PDF)
- Medicare Advantage HMO Mental Health and Substance Abuse Network Provider Directory (PDF)
- Medicare Advantage Silver&Fit® Provider Directory (PDF)