Discover - Astiva Health Inc

IMPORTANT information about COVID-19.

Which is the right plan for you?

Do you live in Orange or San Diego County with Medicare?

Astiva Health Advantage Plan (HMO) 001 Orange County

Astiva Health Advantage Plan (HMO) 003 San Diego County

Summary of Benefits

Evidence of Coverage (HMO) 001 Orange County

Evidence of Coverage (HMO) 003 San Diego County

LIS Premium Summary Chart – Advantage

Do you live in Orange or San Diego County with Medicare and Full Dual Medi-Cal?

Astiva Health Value Plan (HMO) 002 Orange County

Astiva Health Value Plan (HMO) 004 San Diego County

Summary of Benefits

Evidence of Coverage (HMO) 002 & 004 Orange & San Diego Counties

LIS Premium Summary Chart – Value

Formulary Information

CY 2021 Comprehensive Formulary

Formulary Addendum 03/2021

Part D Formulary Requirements

Part D Formulary Transition Policy

Part D Formulary Transition Standard Operating Procedure

Part D Prior Authorization Information

Part D Quantity Limits

Part D Step Therapy Information

List of Drugs by Medical Condition

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