Plan Documents
Welcome to the SECUR HMO I-SNP Medicare Advantage Plan Documents section. Here, you'll find all the essential documents you need to understand your SECUR Health Plan, manage your benefits, and make the most of your healthcare coverage.
Key Plan Documents
1. Summary of Benefits (SOB)
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- Overview: Get a clear and concise summary of what’s covered under your SECUR HMO I-SNP plan, including information on costs, covered services, and more.
- Why It's Important: This document is crucial for quickly understanding the key aspects of your plan and making informed healthcare decisions.
4. Formulary (Drug List)
- Overview: Review the list of prescription drugs covered under your SECUR HMO I-SNP plan, including both generic and brand-name medications.
- Why It's Important: Knowing which medications are covered helps you manage your prescriptions and avoid unexpected costs.
2. Evidence of Coverage (EOC)
- Overview: The EOC provides a detailed explanation of your benefits, how to use them, and your rights as a member of either SECUR HMO I-SNP plan (SECUR Advantage or SECUR Enhanced).
- Why It's Important: It’s your go-to resource for understanding all the details about your coverage, including what’s included, excluded, and any limitations.
5. Out-of-Network Liability and Emergency Care
- Overview: Understand your coverage options and potential costs if you receive care outside of the SECUR network or in emergency situations.
- Why It's Important: Protect yourself from unexpected expenses by understanding when and how out-of-network care is covered.
- Out-of-network/non-contracted providers are under no obligation to treat plan members, except in emergency situations. Please call our Member Services number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services.
3. Provider & Pharmacy Directory
- Overview: Access a comprehensive list of healthcare providers and pharmacies within the SECUR network.
- Why It's Important: Ensure you’re receiving care from in-network providers to maximize your benefits and minimize out-of-pocket expenses.
Provider Directory (H3048_2025ProvDirectory_C) last updated 3-15-25
Pharmacy Directory (H3048_PharmDirectory_CY25_C)Â last updated 04-21-25
6. Additional Documents
Advance Directive Information and Forms
Appointment of Representative Form
Direct Member Reimbursement Form
Over-the-Counter (OTC) Product Catalog 2025
Part D Prescription Drug Plan Transition Policy Description
Permission to Share Information Form
Request for Prior Approval for Out-of-Network Provider Form
Stay Informed and Updated
It’s important to regularly review your plan documents to stay informed about your benefits. By understanding your SECUR HMO I-SNP Medicare Advantage plan, you can make the best choices for your healthcare needs.
For any questions or further assistance, don’t hesitate to contact our Member Services team. We’re here to help you navigate your plan and ensure you have all the information you need.
NOTE: Prefer a hard copy of any plan documents? Contact Member Services at 1.833.76SECUR (1.833.767.3287) or TTY 711 to request any plan document by mail.
Find a Provider, Pharmacy or Drug
Search from our database of doctors, hospitals, and other healthcare facilities. You can also find pharmacies or drugs covered by our health plan.