On this page, you will find important documents pertaining to El Paso Health Medicare Advantage Dual (HMO D-SNP).
Please click on any of the links below to download a PDF copy.
Annual Notice of Change
The Annual Notice of Change provides information of our 2025 plan benefit changes.
Enrollment Form
Use this form to enroll in El Paso Health Medicare Advantage
- 2025 Enrollment Form – (CMS Approved 09/5/2024)
- 2025 Enrollment Form – Version en Español
- 2024 Enrollment Form – (CMS Approved 08/18/2023)
- 2024 Enrollment Form – Version en Español
Summary of Benefits
The Summary of Benefits outlines your plan benefits for the current calendar year.
Evidence of Coverage
The Evidence of Coverage (EOC) explains your rights, benefits, and responsibilities as a Member of El Paso Health Medicare Advantage Dual (HMO D-SNP).
Provider Directory
The Provider Directory outlines your plan’s network of Primary Care Providers, Specialists, Hospitals, Skilled Nursing Facilities, Outpatient Mental Health Providers, DMEs, Dental, and Vision Provider contacts.
Pharmacy Directory
The Pharmacy Directory provides a list of your plan’s network pharmacies.
- 2025 Pharmacy Directory
- 2025 Pharmacy Directory – Version en Español
- 2024 Pharmacy Directory
- 2024 Pharmacy Directory – Version en Español
Formularies (Drug List)
The Formulary provides you with a list of drugs you may need.
Comprehensive Formulary (Drug List)
*Printed copies of information posted on our website are available upon request.
If you have questions, please call El Paso Health Medicare Advantage Member Services toll free at 1-833-742-3125 (TTY 711).
We are available:
- October 1 – March 31, 8 a.m. to 8 p.m. Mountain Time (MT) daily.
- April 1 – September 30, 8 a.m. to 8 p.m. Mountain Time (MT) Monday through Friday.
