Questions? Contact Customer Service at (855) 645-8448
To view your pharmacy benefit information, see network pharmacies, check the drug lists and learn more about your prescription drug coverage visit the pharmacy benefits page.
Below you'll find our enrollment form that you can print out, complete and mail to Memorial Hermann Advantage. Mail your completed form to:
Memorial Hermann Medicare Advantage Enrollment
929 Gessner Road
Houston, Texas 77024
This document includes a detailed legal description of your benefits and costs as a member. All Evidence of Coverage (EOC) documents are organized by plan name.
Evidence of Coverage 2022 — HMO (English) / (Spanish)
Evidence of Coverage 2022 — Plus HMO (English) / (Spanish)
Evidence of Coverage 2022 — Jefferson HMO (English) / (Spanish)
Evidence of Coverage 2022 — Dual Advantage HMO (D-SNP) (English) / (Spanish)
The Summary of Benefits provides some of the features of our plans. These documents are organized by plan name. For a complete list of benefits, see your Evidence of Coverage (EOC).
Summary of Benefits 2022 — HMO (English) / (Spanish)
Summary of Benefits 2022 — Plus HMO (English) / (Spanish)
Summary of Benefits 2022 — Jefferson HMO (English) / (Spanish)
Summary of Benefits 2022 — Dual Advantage HMO (D-SNP) (English) / (Spanish)
Here at Memorial Hermann Advantage, we strive to provide our members with the most accurate Provider Directories. If you need help finding a network provider, please call Customer Service: (855) 645-8448 (TTY 711) or click here to access our online searchable directory. If you would like a Provider Directory mailed to you, you may call the number above, or request one here.
Aquí en Memorial Hermann Advantage nos esforzamos por ofrecer a nuestros miembros los Directorios de Proveedores más precisos. Si necesitas ayuda para encontrar un proveedor dentro de la red, llama al: (855) 645-8448 (TTY 711) O visita aquí para acceder a nuestro directorio de búsqueda online. Si deseas recibir por correo un Directorio de Proveedores, puedes llamar al número indicado más arriba o solicitar uno en el sitio web aquí.
Dental benefits under the Memorial Hermann Medicare Advantage plans are provided by Liberty Dental. Please review your plan’s Evidence of Coverage (EOC) to ensure you fully understand the dental benefits offered with your specific plan. Contact Liberty Dental directly at (888) 700-1246 for questions regarding your benefits or help finding an in-network provider. You may also register for online services or review your dental benefits at Liberty Dental.
(Please note that by clicking on this link, you will be leaving Memorial Hermann Advantage website.)
Available for Jefferson HMO and Dual Advantage HMO D-SNP, Modivcare manages routine non-emergency medical transportation (NEMT) for Memorial Hermann Health Plan members. Access to Modivcare is a benefit of your health plan and is designed to help you get to your:
Please be sure to have the following information available when booking your ride:
Please call at least 3 business days in advance, but not more than 2 weeks before your scheduled appointment.
Ride Assist Help Line: (855) 330-9138
Call the Ride Assist Help Line if your transportation is late or if you need to schedule a pick up from a facility.
Our plan allows for reimbursements of certain claims. Please download the form below, complete it and follow the submission directions.
The Medicare Program rates all health and prescription drug plans each year, based on a plan's quality and performance. Medicare Star Ratings help you know how good a job our plan is doing. You can use these Star Ratings to compare our plan's performance to other plans.
Appointment of Representative (AOR) Form (English) / (Spanish)
This form confirms your request for a particular person to act as your representative in connection with a claim.
For information on how to Authorization to Disclose Protected Health Information, visit our Privacy Page.