2020 Plan Materials

(Coverage Year: January 01, 2020 to December 31, 2020) 

As a member of Banner – University Care Advantage (HMO SNP), you will find documents and links below to provide you with information related to your benefits and the health plan. Contact the plan if you need further assistance.


2020 Annual Notice of Changes

The Annual Notices of Changes (ANOC) booklet tells about the changes between plan benefit years 2019 and 2020. Please select your county below to review changes to plan benefits.

Annual Notice of Changes (ANOC) Booklets

Review this section if you have both Medicare and Medicaid (AHCCCS Complete Care)

COUNTY/SERVICE AREA
Cochise / Gila / Graham / Greenlee / La Paz English Español
Pima English Español
Maricopa / Pinal English Español
Santa Cruz / Yuma English Español

Review this section if you have both Medicare and Medicaid (Arizona Long Term Care System)

COUNTY/SERVICE AREA
Cochise / Gila / Graham / Greenlee / La Paz English Español
Pima English Español
Maricopa / Pinal English Español
Santa Cruz / Yuma English Español


2020 Evidence of Coverage

This booklet gives you the details about your Medicare and Arizona Health Care Cost Containment System or AHCCCS (Medicaid) health care and prescription drug coverage from January 1, 2020 – December 31, 2020. It explains how to get coverage for the health care services and prescription drugs you need. This is an important legal document.

Evidence of Coverage Booklets

Review this section if you have both Medicare and Medicaid (AHCCCS Complete Care)

COUNTY / SERVICE AREA
Cochise / Gila / Graham / Greenlee / La Paz English Español
Pima English Español
Maricopa / Pinal English Español
Santa Cruz / Yuma English Español

Review this section if you have both Medicare and Medicaid (Arizona Long Term Care System)

COUNTY / SERVICE AREA
Cochise / Gila / Graham / Greenlee / La Paz English Español
Pima English Español
Maricopa / Pinal English Español
Santa Cruz / Yuma English

Español



2020 Summary of Benefits

This is a summary of drug and health services covered by Banner – University Care Advantage (HMO SNP) January 1, 2020 to December 31, 2020. The benefit information provided is a summary of what we cover and what you pay. It does not list every service that we cover or list every limitation or exclusion. To get a complete list of services we cover, see the “Evidence of Coverage.”

This information is not a complete description of benefits. Contact the plan for more information. Limitations, co-payments, and restrictions may apply. Benefits, premiums and/or co-payments/co-insurance may change on January 1 of each year.

You must continue to pay your Medicare Part B premium. The monthly Part B premium is paid for by State in some cases. Your cost-sharing is determined by your level of Medicaid eligibility.

Premium, co-pays, co-insurance, and deductibles may vary based on the level of Extra Help you receive. Please contact the plan for further details.

Summary of Benefits Documents

Review this section if you have both Medicare and Medicaid (AHCCCS Complete Care)

COUNTY / SERVICE AREA
Cochise / Gila / Graham / Greenlee / La Paz English Español
Pima English Español
Maricopa / Pinal English Español
Santa Cruz / Yuma English Español

Review this section if you have both Medicare and Medicaid (Arizona Long Term Care System)

COUNTY / SERVICE AREA
Cochise / Gila / Graham / Greenlee / La Paz English Español
Pima English Español
Maricopa / Pinal English Español
Santa Cruz / Yuma English Español