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Thank You for being a Provider of Health Pointe Direct Complete Plan

(HMO I-SNP)

Decisiones de cobertura

If a drug is not covered in the way you would like it to be covered, you can ask us to make an exception or coverage decision to our coverage rules. Similar to other types of coverage decisions, if we turn down your request for an exception, you can appeal our decision. When you ask for an exception, please explain the medical reasons why you need the exception approved for consideration. More information can be found on the Medicare Part D (Pharmacy) Information page or the Evidence of Coverage (PDF).

You can use one of the following methods to request a formulary exception:

Making an Appeal/Redeterminations

If we make a coverage decision and you are not satisfied with this decision, you can appeal the decision or ask for a redetermination. You must make your appeal request within 60 calendar days from the date on the coverage decision written notice we sent. More information can be found on the Medicare Part D (Pharmacy) Information page or the Evidence of Coverage (PDF).


You can use one of the following methods to request an appeal:


Contáctenos:

Llamada gratuita: 1.844.269.3442 

TTY: 711

Dirección de envio:

Health Pointe of New York

810 Seventh Avenue - Suite 801

New York, New York 10019

Por favor contacte a nuestro Servicios a los miembros número en 1-844-269-3442 para informacion adicional. (TTY users should call 711.) Del 1 de octubre al 31 de marzo, estamos abiertos los 7 días de la semana, de 8 a.m. a 8 p.m. EST. Del 1 de abril al 30 de septiembre, estamos abiertos de lunes a viernes, de 8 a.m. a 8 p.m. EST.

No discriminamos, excluimos a las personas ni las tratamos de manera diferente por motivos de raza, color, nacionalidad, sexo, identidad de género, edad o discapacidad en nuestros programas y actividades de salud.

ATENCION: Si habla español, tiene a su diposicion servicios gratuitos de assistencia linguistica. Llame a 1.844.269.3442 / TTY: 711

Health Pointe Direct Complete Plan (HMO SNP) es un plan de salud con un contrato de Medicare. La inscripción en Health Pointe HMO SNP depende de la renovación del contrato.

CMS Material ID: H1722_HPweb2019 | Last updated 10/01/2019

Health Pointe of New York COVID-19 Statement – H1711

Health Pointe of New York is closely monitoring the COVID-19 (Coronavirus) outbreak.

Click on the following links for the most up-to-date information from NYC.gov y The New York State Department of Health websites.

If you have any questions, please call Member Services at 844-269-3442.

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