中文計畫資料 (Chinese plan materials)

中文計畫資料僅適用於紐約州金斯郡和皇后郡的這些 2027 年計畫：
Chinese plan materials are available only for these 2027 plans in Kings and Queens Counties, NY:

• H5334-007: 2027 CHOICE 007 NY (PPO)
• H5334-008: 2027 CHOICE GIVEBACK 008 NY (PPO)
• H5334-013: 2027 C-SNP CHOICE PLUS 013 NY (PPO C-SNP)
• H5334-019: 2027 C-SNP CHOICE ENHANCED 019 NY (PPO C-SNP)
• H5334-025: 2027 C-SNP CHOICE GIVEBACK EXTRAS 025 NY (PPO C-SNP)
• H5334-031: 2027 CHOICE GIVEBACK EXTRAS 031 NY (PPO)

2027 計畫文件 (Plan Documents)

福利摘要 (Summary of Benefits/SB)

• H5334-007 福利摘要 SB
• H5334-008 福利摘要 SB
• H5334-013 福利摘要 SB
• H5334-019 福利摘要 SB
• H5334-025 福利摘要 SB
• H5334-031 福利摘要 SB

承保範圍說明書 (Evidence of Coverage/EOC)

即將推出 (Coming soon):

• H5334-007 承保範圍說明書 EOC
• H5334-008 承保範圍說明書 EOC
• H5334-013 承保範圍說明書 EOC
• H5334-019 承保範圍說明書 EOC
• H5334-025 承保範圍說明書 EOC
• H5334-031 承保範圍說明書 EOC

醫療提供者與藥局名錄 (Provider and Pharmacy Directory)

• H5334-007 名錄 Directory
• H5334-008 名錄 Directory
• H5334-013 名錄 Directory
• H5334-019 名錄 Directory
• H5334-025 名錄 Directory
• H5334-031 名錄 Directory

處方藥名冊／藥物一覽表(Prescription Drug List/Formulary)

• H5334-007 藥物一覽表 Formulary
• H5334-008 藥物一覽表 Formulary
• H5334-013 藥物一覽表 Formulary
• H5334-019 藥物一覽表 Formulary
• H5334-025 藥物一覽表 Formulary
• H5334-031 藥物一覽表 Formulary

計畫表格 (Plan Forms)

• 登記加入 Enrollment

即將推出 (Coming soon):

• 取消登記 Disenrollment
• 代表委任 Appointment of Representative (AOR) 
• Medicare D 部分承保決定請求 Medicare Part D Coverage Determination Request
• Medicare 處方藥付款計畫選定請求 Medicare Prescription Payment Plan Election Request

參考文件 (Reference Documents)

• 無歧視通告與多語言插頁 Notice of Non-Discrimination and Multi-Language Insert

即將推出 (Coming soon):

• 隱私實務通告 Notice of Privacy Practices