Forms & Documents
Instructions on How to Get Covered Services During a Disaster.
Medicare Plans
MediSun Plus (HMO D-SNP) 016
HealthSun MediSun Full Dual Plus (HMO D-SNP) 025
HealthSun MediSun Full Dual Extra (HMO D-SNP) 026
Member Notices and Updates
Member Announcements
Member Rights and Responsibilities
Member Rights and Responsibilities
Plan Changes and Disenrollment Information
Plan Changes and Disenrollment
Cultural Competency Program
Cultural Competency Program
Prescription Drug Benefits
Prescription Drug Benefits
- 2026 Creole Part D Transition Policy
- 2026 Creole Prescription Drug Formulary – updated 09/11/2026
- 2026 Creole Prescription Drugs Formulary Changes – updated 09/03/2026
- 2026 OTC Order Form - All Plans
- 2026 Part D Transition Policy
- 2026 Prescription Drug Formulary – updated 09/11/2026
- 2026 Prescription Drugs Formulary Changes – updated 09/03/2026
- 2026 Prior Authorization Criteria - updated 09/11/2026
- 2026 Step Therapy Criteria - updated 09/11/2026
- 2026 Step Therapy Criteria Part B Drugs only – 07/01/2026
- 2026 Therapy Management Medication (MTM) Program
- 2027 Creole Part D Transition Policy
- 2027 Creole Prescription Drug Formulary – updated 08/21/2026
- 2027 OTC Catalog
- 2027 OTC Order Form - All Plans
- 2027 Part D Transition Policy
- 2027 Prescription Drug Formulary – updated 08/21/2026
- 2027 Prior Authorization Criteria - updated 10/07/2026
- 2027 Step Therapy Criteria - updated 10/07/2026
- 2027 Therapy Management Medication (MTM) Program
- Appointment of Representative Form
- B vs. D Coverage Determination Request Form
- Lost, Damaged, or Stolen Medication Form
- Medicare Prescription Payment Plan Fact Sheet
- Medicare Prescription Payment Plan Participation Request Form - M3P
- Medication Sync Request Form
- Mizajou Lis Medikaman Preferansyèl
- Part D Reimbursement Request Form
- Personal Medication List Form
- Preferred Drug List Updates
- Prescription Coverage Determination Request Form
- Vacation Supply Form