CenterLight Healthcare - Member Information

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Ready to talk? Call us at 1-877-226-8500 from 8:00 am to 8:00 pm EST, 7 days a week. TTY users should call 711.

CenterLight Healthcare Direct

Member Information – 2012 Plans

As a member of CenterLight Healthcare Direct, a health plan with a Medicare contract, our team of doctors, nurses, social workers, rehabilitation therapists and others will work with you to meet your medical and prescription drug needs whether you live in your own home, in a nursing home or assisted living facility. If you are enrolled in our Complete plan, our goal is to help you enjoy the highest possible quality of life.

In this section, you will find the tools you need to understand and manage your healthcare benefits. Click on the links below to access information available to you as a member of our plan.

Member Rights and Responsibilities

Summary of Benefits

Evidence of Coverage

Formulary and Formulary Information

Provider Network

Pharmacy Network

Medicare Part C Information

Medicare Part D Information

Prior Authorization Criteria for Medications (PDF, 83.9KB)

List of Drugs that Have Quantity Limits (PDF, 80.9KB)

List of Drugs that Require Step Therapy (PDF, 10.2KB)

Medical Information Privacy Notice

Low Income Subsidy Premium Table (PDF, 7.5KB)

Over-the-Counter Drug Chart (PDF, 40.7KB)

Medicare Plan Ratings (PDF, 363KB)

You may also download member forms by clicking on the following links:

Coverage Determination Form (PDF, 27KB)

Member IRE Reconsideration Form (PDF, 22.6KB)

Appointment of Representative Form (PDF, 37.4KB)

Appointment of Representative Form (Spanish) (PDF, 39.1KB)

2012 Enrollment Form (Complete) (PDF, 294KB)

If you have questions about your coverage, your care provider or any other aspects of the network, please contact us. You can give us a call at 1-877-226-8500 (TTY: 711) from 8:00 a.m. to 8:00 p.m. EST, 7 days a week or send us an email at MemberServices@centerlight.org.