Notice of Nondiscrimination
Click here for the Notice of Nondiscrimination for MedStar Medicare Choice.
Summary of Benefits
Please click on the links below for the Summary of Benefits for MedStar Medicare Choice plans.
Plan Ratings Information
Please click on the link below to see plan ratings information for our MedStar Medicare Choice plans.
Please click on the links below for the provider directory for MedStar Medicare Choice plan.
Evidence of Coverage
Please click on the links below for the Evidence of Coverage for MedStar Medicare Choice plan.
If you reside in the District of Columbia
If you reside in Maryland
MedStar Medicare Choice offers customer support in several languages to answer any questions you may have about our plan.
Click here for 2018 information
Annual Notice of Change
Click the links below to view the Annual Notice of Change for MedStar Medicare Choice plans.
Disaster Policy Information
Getting Care During a Disaster or Other Public Health Emergency Declaration
If the President of the United States, the Governor of the State of Maryland, or the United States Secretary of Health of Human Services declares a state of emergency or disaster in your geographic area, you may obtain care from out-of-network providers and facilities that accept Medicare patients at in-network cost sharing rates. You also won’t have to follow the prior authorization rules before you obtain that out-of-network care. Also, if you cannot use a network pharmacy during a state of emergency or disaster in your geographic area, you may fill your prescriptions at an out-of-network pharmacy. If there is an emergency or disaster in your geographic area, the Plan may also allow you to refill your prescriptions earlier than it otherwise normally would until the termination of a public health emergency or the end of a declared disaster or emergency.
Exclusions and Limitations Information
There are some services that are not covered and will not be paid for by MedStar Medicare Choice. The links below provide a detailed listing of these services.
If you reside in the District of Columbia or Maryland
Service Area Map
Click the link below to see a map of the MedStar Medicare Choice service area.
Authorized Representative Forms
A MedStar Medicare Choice member can appoint a person to act on his/her behalf or to view his/her protected health information (PHI). Choose the appropriate form below, complete the required fields, sign, print, and fax or mail it to us. Once we receive this completed request we will verify it, adjust our records accordingly, and speak to your appointed representative or share your PHI as needed. If you have any questions, please call our Member Services Department at 855-222-1041, from 8 a.m. to 8 p.m., seven days a week.* TTY/TDD users should call 855-250-5604.
Mail: MedStar Medicare Choice
P.O. BOX 65
Pittsburgh, PA 15230-9922
Appointment of Representative Form - Use this form to appoint a representative to make decisions for you and legally act on your behalf (e.g., make requests, present or get evidence, obtain appeals information, and receive notices regarding an appeal).
Personal Representative Designation Form - Use this form to appoint a representative to act on your behalf in discussing your health information and benefit coverage through MedStar Medicare Choice Plan.
Notice of Privacy Practices
Click the link below for the MedStar Medicare Choice Notice of Privacy Practices.
Helpful Websites About Medicare
H9915_18_4048 - Pending CMS Approval
Last Updated: 1/1/2018