Important Forms and Documents

High

HAP HMO Custom 2107 - Rx HMO Custom 2107_BS_508_H (PDF)

Standard

HAP HMO Custom 2108 - Rx HMO Custom 2108_BS_508_S (PDF)

High

PSHB High Option MAPD (PDF)

Standard

PSHB Standard Option MAPD (PDF)

High

PSHB High PDP Medical Only for PDP (PDF)

Standard

PSHB Standard PDP Medical Only for PDP (PDF)

PSHB PDP Plan Rx Only (PDF)

Health Alliance Plan (HAP) has HMO-POS plans with Medicare contracts. Enrollment depends on contract renewal.