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The Grove
Plan Documents
2022 Plan documents
Medicare Advantage (HMO)
2022 Annual Notice of Change – Premera Blue Cross Medicare Advantage (HMO)
2022 Evidence of Coverage – Premera Blue Cross Medicare Advantage (HMO)
2022 Notificación anual de cambios – Premera Blue Cross Medicare Advantage (HMO)
2022 Evidencia de cobertura – Premera Blue Cross Medicare Advantage (HMO)
Diabetic glucose monitors and supplies preferred brands and manufacturers
Suministros y medidores de glucosa para clientes con diabetes
Medicare Advantage Alpine (HMO)
2022 Annual Notice of Change – Premera Blue Cross Medicare Advantage Alpine (HMO)
2022 Evidence of Coverage – Premera Blue Cross Medicare Advantage Alpine (HMO)
Diabetic glucose monitors and supplies preferred brands and manufacturers
Medicare Advantage Charter + Rx (HMO)
2022 Annual Notice of Change – Premera Blue Cross Medicare Advantage Charter + Rx (HMO)
2022 Evidence of Coverage – Premera Blue Cross Medicare Advantage Charter + Rx (HMO)
Diabetic glucose monitors and supplies preferred brands and manufacturers
Medicare Advantage Classic (HMO)
2022 Annual Notice of Change – Premera Blue Cross Medicare Advantage Classic (HMO)
2022 Evidence of Coverage – Premera Blue Cross Medicare Advantage Classic (HMO)
2022 Notificación anual de cambios
– Premera Blue Cross Medicare Advantage Classic (HMO)
2022 Evidencia de cobertura
– Premera Blue Cross Medicare Advantage Classic (HMO)
Diabetic glucose monitors and supplies preferred brands and manufacturers
Suministros y medidores de glucosa para clientes con diabetes
Medicare Advantage Classic Plus (HMO)
2022 Annual Notice of Change – Premera Blue Cross Medicare Advantage Classic Plus (HMO)
2022 Evidence of Coverage – Premera Blue Cross Medicare Advantage Classic Plus (HMO)
Diabetic glucose monitors and supplies preferred brands and manufacturers
Medicare Advantage Peak + Rx (HMO)
2022 Annual Notice of Change – Premera Blue Cross Medicare Advantage Peak + Rx (HMO)
2022 Evidence of Coverage – Premera Blue Cross Medicare Advantage Peak + Rx (HMO)
Diabetic glucose monitors and supplies preferred brands and manufacturers
Medicare Advantage Sound + Rx (HMO)
2022 Annual Notice of Change – Premera Blue Cross Medicare Advantage Sound + Rx (HMO)
2022 Evidence of Coverage – Premera Blue Cross Medicare Advantage Sound + Rx (HMO)
Diabetic glucose monitors and supplies preferred brands and manufacturers
Medicare Advantage Total Health (HMO)
2022 Annual Notice of Change – Premera Blue Cross Medicare Advantage Total Health (HMO)
2022 Evidence of Coverage – Premera Blue Cross Medicare Advantage Total Health (HMO)
2022 Notificación anual de cambios
– Premera Blue Cross Medicare Advantage Total Health (HMO)
2022 Evidencia de cobertura
– Premera Blue Cross Medicare Advantage Total Health (HMO)
Diabetic glucose monitors and supplies preferred brands and manufacturers
Suministros y medidores de glucosa para clientes con diabetes
2022 Medicare Advantage summary of benefits
All plans
Resumen de beneficios
Pre enrollment checklist
Lista de verificación de preinscripción
2021 Plan documents
Medicare Advantage (HMO)
2021 Annual Notice of Change – Premera Blue Cross Medicare Advantage (HMO)
2021 Evidence of Coverage – Premera Blue Cross Medicare Advantage (HMO)
Diabetic glucose monitors and supplies preferred brands and manufacturers
Medicare Advantage Alpine (HMO)
2021 Annual Notice of Change – Premera Blue Cross Medicare Advantage Alpine (HMO)
2021 Evidence of Coverage – Premera Blue Cross Medicare Advantage Alpine (HMO)
Diabetic glucose monitors and supplies preferred brands and manufacturers
Medicare Advantage Charter + Rx (HMO)
2021 Annual Notice of Change – Premera Blue Cross Medicare Advantage Charter + Rx (HMO)
2021 Evidence of Coverage – Premera Blue Cross Medicare Advantage Charter + Rx (HMO)
Diabetic glucose monitors and supplies preferred brands and manufacturers
Medicare Advantage Classic (HMO)
2021 Annual Notice of Change – Premera Blue Cross Medicare Advantage Classic (HMO)
2021 Evidence of Coverage – Premera Blue Cross Medicare Advantage Classic (HMO)
Diabetic glucose monitors and supplies preferred brands and manufacturers
Medicare Advantage Classic Plus (HMO)
2021 Annual Notice of Change – Premera Blue Cross Medicare Advantage Classic Plus (HMO)
2021 Evidence of Coverage – Premera Blue Cross Medicare Advantage Classic Plus (HMO)
Diabetic glucose monitors and supplies preferred brands and manufacturers
Medicare Advantage Core (HMO)
2021 Annual Notice of Change – Premera Blue Cross Medicare Advantage Core (HMO)
2021 Evidence of Coverage – Premera Blue Cross Medicare Advantage Core (HMO)
2021
Notificación anual de cambios
– Premera Blue Cross Medicare Advantage Core (HMO)
2021
Evidencia de cobertura
– Premera Blue Cross Medicare Advantage Core (HMO)
Diabetic glucose monitors and supplies preferred brands and manufacturers
Suministros y medidores de glucosa para clientes con diabetes
Medicare Advantage Core Plus (HMO)
2021 Annual Notice of Change – Premera Blue Cross Medicare Advantage Core Plus (HMO)
2021 Evidence of Coverage – Premera Blue Cross Medicare Advantage Core Plus (HMO)
2021
Notificación anual de cambios
– Premera Blue Cross Medicare Advantage Core Plus (HMO)
2021
Evidencia de cobertura
– Premera Blue Cross Medicare Advantage Core Plus (HMO)
Diabetic glucose monitors and supplies preferred brands and manufacturers
Suministros y medidores de glucosa para clientes con diabetes
Medicare Advantage Peak + Rx (HMO)
2021 Annual Notice of Change – Premera Blue Cross Medicare Advantage Peak + Rx (HMO)
2021 Evidence of Coverage – Premera Blue Cross Medicare Advantage Peak + Rx (HMO)
Diabetic glucose monitors and supplies preferred brands and manufacturers
Medicare Advantage Sound + Rx (HMO)
2021 Annual Notice of Change – Premera Blue Cross Medicare Advantage Sound + Rx (HMO)
2021 Evidence of Coverage – Premera Blue Cross Medicare Advantage Sound + Rx (HMO)
Diabetic glucose monitors and supplies preferred brands and manufacturers
Medicare Advantage Total Health (HMO)
2021 Annual Notice of Change – Premera Blue Cross Medicare Advantage Total Health (HMO)
2021 Evidence of Coverage – Premera Blue Cross Medicare Advantage Total Health (HMO)
Diabetic glucose monitors and supplies preferred brands and manufacturers
2021 Medicare Advantage summary of benefits
All plans
Resumen de beneficios
Pre enrollment checklist
Lista de verificación de preinscripción
Other Plan documents
Medicare star ratings
2022
2022 Star ratings – Total Health (HMO), Classic (HMO), Classic Plus (HMO), Medicare Advantage (HMO)
2022
Calificaciones por estrellas Medicare
– Total Health (HMO), Classic (HMO), Classic Plus (HMO), Medicare Advantage (HMO)
2022 Star ratings – Sound + Rx (HMO), Peak + Rx (HMO), Charter + Rx (HMO), Alpine (HMO)
2022
Calificaciones por estrellas Medicare
– Sound + Rx (HMO), Peak + Rx (HMO), Charter + Rx (HMO), Alpine (HMO)
2021
2021 Star ratings – Total Health (HMO), Core Plus (HMO), Core (HMO), Classic (HMO), Classic Plus (HMO), Medicare Advantage (HMO)
2021
Calificaciones por estrellas Medicare
– Total Health (HMO), Core Plus (HMO), Core (HMO), Classic (HMO), Classic Plus (HMO), Medicare Advantage (HMO)
2021 Star ratings – Sound + Rx (HMO), Peak + Rx (HMO), Charter + Rx (HMO), Alpine (HMO)
2021
Calificaciones por estrellas Medicare
– Sound + Rx (HMO), Peak + Rx (HMO), Charter + Rx (HMO), Alpine (HMO)